What is Pelvic Floor Physical Therapy?

Question: What is pelvic floor physical therapy?

Answer: Pelvic Floor Physical Therapy is gaining recognition as a specialized treatment for problems in the pelvic region.

The pelvic floor consists of three layers of skeletal muscle tissue, connective tissue, and nerve innervations. Just like other muscle groups such as the biceps, glutes, or shoulders, the pelvic floor can experience dysfunction, including muscle weakness, poor control, difficulty coordinating with neighboring muscles (like the low back, thighs, diaphragm, or deep core), limited range of motion, neurological issues, pain from injury or overload, chronic conditions, and post-operative recovery (e.g., after a hysterectomy or prostatectomy). Although these issues may involve different areas of the body, pelvic floor dysfunction has unique personal and functional aspects, making it a specialty within physical therapy.

Question: What does my pelvic floor do?

Answer:The pelvic floor has several important functions. The first two layers are responsible for continence (controlling urine and bowel movements), while the third layer provides stabilization and support for your internal organs and spine. The pelvic floor also helps with venous and lymphatic drainage in the pelvis and plays a role in sexual arousal and performance.

Question: What kinds of things do you do in pelvic floor physical therapy?

Answer: Treatment in pelvic floor therapy is personalized to your needs and often includes the following:

● Goal Setting and Plan of Care: You and your therapist will set goals and create a treatment plan together.
● Re-education: This involves learning how to breathe properly, coordinate your diaphragm, deep core, and pelvic floor, and apply toileting and nutrition strategies. You’ll also learn how to regulate and calm your nervous system.
● Tools and Recommendations: You may be introduced to tools such as wands, dilators, trainers, and supportive undergarments. Additionally, your therapist may recommend fittings for pessaries or collaborate with other healthcare providers like mental health specialists or primary care providers, with your consent.
● Managing Internal Pressure: Pelvic floor therapy can help you manage internal pressure forces to prevent leakage or prolapse symptoms. Leaking, whether in small amounts or large, is not considered normal and is not a part of aging.
● Strengthening External Muscles: The therapy also focuses on strengthening and improving the mobility of the external muscles in your hips and thighs to support the pelvic floor.
● Manual Therapy: Techniques like manual therapy, nerve stimulation, and biofeedback may be utilized.
● Modalities: Treatment may include the use of electrical stimulation, heat, or ice.
● Functional Tasks: Ultimately, the goal is to help you return to activities that previously caused issues or discomfort.

Question: What are symptoms of pelvic floor dysfunction?

Answer: Pelvic floor dysfunction can manifest in a variety of symptoms, including:

● Urinary leakage (from dribbling to floods)
● Urinary retention or difficulty starting/stopping urination
● Poor urinary stream
● Fecal incontinence and/or constipation
● Pre and postnatal pelvic pain
● Excessive urinary urgency
● Sensations of things “falling out”
● Chronic pelvic or low back pain that doesn’t resolve with traditional therapy
● Post-operative pelvic pain
● Testicular pain
● Pain with intimacy or inserting a tampon or speculum during a gynecological exam

If you’re experiencing any of these symptoms, a provider can discuss your needs and determine whether pelvic floor therapy is appropriate for you.

Question: Is pelvic floor therapy for men too?

Answer: Yes, pelvic floor therapy is for both men and women. Everyone has pelvic floor muscles that can experience dysfunction and may benefit from therapy.

Evelyn Williams is a Pelvic Floor PT and mind body instructor at Club Apple. She is delighted to dedicate her time to serve this niche because everyone has a pelvic floor and optimal function greatly enhances quality of life.