What is Pelvic Floor Physical Therapy?

So you’ve gotten a referral from your doctor, or maybe you’ve heard your friend tell you about the wonders of pelvic health physical therapy… but what exactly is pelvic floor physical therapy?

The Pelvic Floor

To first discuss what pelvic floor physical therapy is, we need to talk about what the pelvic floor is.

The pelvic floor is a group of muscles that sit at the base of your pelvis (the bottom of the bowl, so to speak). Like any other group of muscles in the body, these muscles can be too tight, weak, or painful.  The tone of the pelvic floor can also change throughout the lifespan and through major events like pregnancy and labor.

These muscles perform different jobs that we call the 4 S’s:

1. Sphincteric – it gives us control over urination and bowel movements so that leaking doesn’t happen
2. Support – it provides a sling-like support of our pelvic organs and vaginal wall
3. Stability – the muscles help provide stability to the bones of our lumbar spine, pelvic girdle, and hips.  It also helps regulate intra-abdominal pressure
4. Sexual – the pelvic floor plays a role in sexual arousal and orgasm.  Sometimes issues in the pelvic floor can show up as pain with sex.

IS PELVIC FLOOR PHYSICAL THERAPY FOR ME?

Pelvic floor physical therapy can help with a multitude of problems including:

• Urinary incontinence (stress incontinence, urge incontinence or mixed)
• Bowel problems – constipation, feeling like you are straining to have a bowel movement, inability to control passing gas 
• Pelvic organ prolapse or feelings of pressure in the vaginal region
• Pain with sex or penetration
• Pain in the labia or vaginal region
• Pressure in the lower abdomen
• Pain during pregnancy 
• Postpartum recovery

WHAT TO EXPECT WITH PELVIC FLOOR PHYSICAL THERAPY

We understand that talking about pelvic floor issues can feel embarrassing or awkward, but rest assured that our pelvic health PTs are professionals who have experience working with people with pelvic conditions (and there is no such thing as TMI in pelvic health).  

At an initial visit, you can expect your physical therapist to get a thorough understanding of what your symptoms are along with your unique history.  From there, the therapist will do an examination in order to assess the problem.  Your therapist will also take the time to thoroughly answer any questions and alleviate any fears that you may have.  Sometimes the exam includes an internal assessment, but not always, and this is ALWAYS optional.  

An internal assessment includes a visual exam of the genital area, and an internal assessment of the strength of the pelvic floor by insertion of a finger in the vagina.  The therapist may also assess any muscle tenderness of the pelvic floor in the same manner.  This is done in a private treatment room with sheets for draping, similar to an OBGYN visit. 

WHO CAN HELP?

At Onward, we have pelvic health physical therapists who are trained to help with any pelvic health conditions that you may experience.  Depending on the location, our therapists are trained in both external and internal exams.  

Rest assured that pelvic floor physical therapy is a highly effective treatment option to address any pelvic issues that you may be having.  You’ll wish you had started sooner!