Your Pelvic Floor Muscles Need PT Too
Can Pelvic Floor Physical Therapy Help You?
PHYSICAL THERAPY FOR PELVIC HEALTH
Did you know that your pelvic floor may need physical therapy too? Your pelvic floor refers to the muscles, ligaments and connective tissue that support pelvic organs (uterus, bowels and bladder) and assist with bowel, bladder and sexual functions. No matter your sex, gender identity, sexual orientation, or age, pelvic floor muscles (PFM) are a normal part of our anatomy. Just like the muscles in your shoulder or hips, the PFM can become injured or lose function and contribute to a whole host of issues including pelvic pain, pain with sex, low back and hip pain, bowel and bladder leakage, pelvic organ prolapse, postpartum issues and post-prostatectomy leakage.
Luckily, physical therapy can address most of these issues. Unfortunately, many health care practitioners and persons in the community are not aware of its existence or its wide application to patient care and wellness. Pelvic floor dysfunction affects a substantial portion of the population and due to the sensitive nature of these issues many are embarrassed to bring their concerns up with their doctors and therapists. This article aims to educate you further on the purpose and function of the PFM, what you might expect during a physical therapy treatment and what conditions a pelvic floor physical therapist can address.
LET’S GET TO KNOW THE PELVIC FLOOR BETTER
If you think of your pelvis as a bowl made up of the two large pelvic bones that wrap from back to front, the sacrum and the coccyx at the end of the spine, then the pelvic floor forms the inside of the bowl including a sling of muscles that stretch across the bottom. The PFMs are an important component of what we often call our “core.” Several important ligaments stretch between bony structures and connective tissue adds support throughout the pelvic floor.
The PFMs perform five major functions. First is support for the pelvic organs. Second is stability of the hips, pelvis and low back in conjunction with the muscles of the trunk. Third is bowel and bladder control to allow comfortable bowel and bladder movements and prevent leakage. Fourth is to assist in sexual function including allowing for comfortable intercourse and assisting in arousal and orgasm. Finally, the PFMs help with circulation of blood and lymph in the pelvic area.
WHAT CAN YOU EXPECT DURING YOUR EXAMINATION?
Physical therapists specializing in pelvic health have gone through extensive post-graduate training in the assessment, evaluation and treatment of pelvic floor dysfunction. While this is a sensitive area of the body, you can expect your physical therapist to approach these conditions respectfully and discuss with you how they approach the exam and treatment before they start. You should feel comfortable communicating with them which parts of the examination and treatment you are comfortable with and know that you can stop and change your mind at any time.
Because many disorders of the pelvic muscles are due to changes in the strength, flexibility and coordination, the physical therapy examination will be assessing each of these areas. At times, a second person may be present during the examination--it may be a person you request to accompany you, another staff member or you may decline to have another person in the room. To begin, your therapist will have a conversation with you about your medical history, your symptoms and how they are affecting your day to day life including any previous treatments you may have undergone.
Similar to assessments for other conditions, you may be asked to perform certain movements to check the strength and flexibility of hip, back or abdominal muscles and to evaluate your biomechanics and movement patterns. Because the tissues of the body are so interconnected, dysfunction in areas adjacent to the pelvic floor may be contributing to your symptoms.
Because of the location of your pelvic floor muscles, examination may consist of an internal assessment of your pelvic floor muscles. After education on these structures, and with your consent, your physical therapist will often begin with an external exam by palpating (feeling) for areas of scar tissue, tenderness or tightness around the external structures then if you are comfortable, may insert a lubricated and gloved finger to examine the muscles, ligaments and tissues internal to the body.
During the internal examination your therapist can assess the deeper layer of the pelvic muscles to determine which may be weak, lack flexibility or coordination so that they can tailor your plan of care to target those specific structures. If you are not comfortable undergoing an internal examination, your therapist may ask a more detailed set of questions to help identify which structures are contributing to your pelvic floor dysfunction.
HOW WILL A PHYSICAL THERAPIST TREAT MY SYMPTOMS?
Once the examination is complete and you and your therapist have agreed on a plan for your care, treatment will begin. Treatment may consist of internal treatments, external treatments, exercise and education.
External Treatments: Depending on your specific presentation this may consist of joint mobilizations, trigger point release, soft tissue mobilization, dry needling, or myofascial release
Internal Treatments: The deeper PFMs are able to be accessed transvaginally or transrectally. With your permission, your physical therapist may perform internal manual therapy techniques directly to the PFMs, or may incorporate biofeedback which utilizes a small internal sensor to help you retrain your pelvic floor muscles.
Exercises: Your custom physical therapy treatment plan will likely include exercises you will do in the clinic or at home to improve the strength and coordination of your pelvic floor. You might also learn relaxation techniques.
Education: Perhaps one of the most important components of your treatment plan, you will learn not only about the anatomy of your pelvic floor but about techniques and habits you can utilize throughout your day to improve your PFM functions.
Many will go too long dealing with these conditions on their own or without proper support and treatment and will experience a significant impact on their quality of life. Though you may have been living with the discomfort and isolation of pelvic floor dysfunction for some time, you should feel hopeful that a physical therapist specializing in pelvic health at Evolve may be able to help you improve your symptoms and regain the comfort and confidence to take on the activities you love.
Click here for more information about pelvic floor physical therapy in Brooklyn
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Brooklyn's Premier Holistic Physical Therapy Clinics-
There’s physical therapy, there’s training, and then there’s EVOLVE. We use the science of biomechanics merged with fitness to help our patients get better and stay better!
First we evaluate, then we heal, then we strengthen our clients so they can reach their goals, feel better, and live happier lives. We do so by utilizing a range of core techniques and specialized treatments to reduce pain, improve mobility, enhance physical strength and deal with the underlying issues, not just the pain itself.
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