What is Pelvic Floor Physical Therapy? Here’s Everything You Need to Know.
If you’ve never heard of pelvic floor physical therapy, you’re not alone. Many people are surprised to learn there is an entire specialty of physical therapy dedicated to pelvic health and wellness.
Just like a physical therapist can help you rehabilitate after an injury or recover from a surgery, pelvic floor PT can help strengthen your pelvic floor and provide relief from bladder and bowel dysfunction, pain in the pelvic area, constipation, incontinence, painful intercourse, and more.
Let’s take a look at what pelvic floor physical therapy is, what conditions it treats, and what you can expect to do in therapy.
What is Pelvic Floor Physical Therapy?
Pelvic floor physical therapy is a specialty within physical therapy that concentrates on supporting and strengthening the pelvic floor muscles and core so they function the way they are intended to.
A pelvic floor physical therapist treats many types of pelvic floor dysfunction such as bowel and bladder incontinence, urinary/bowel urgency/frequency, pelvic pain, constipation, pelvic organ prolapse, pain with sexual activity, abdominal muscle separation (diastasis recti) and various pregnancy/postpartum concerns.
What Do You Mean by the Pelvic Floor?
The pelvic floor is a group of muscles, ligaments, tendons, nerves and connective tissues that span the bottom of the pelvis and support the bladder, bowel, and uterus (consequently helping with bowel, bladder, and sexual function, and the stability of the pelvis as a whole).
In women and people with vaginas, the pelvic floor supports the bladder, uterus, and rectum. In men and people with penises, it supports the bladder, bowel, urethra and rectum.
In both men and women, the pelvic floor plays an important role in bladder and bowel function. When your pelvic floor isn’t working optimally, it can greatly affect your quality of life and lead to symptoms such as chronic pelvic pain, painful sex, difficulty with urination or bowel movements, erectile disfunction, incontinence, constipation, and more.
How Do I Know if I Need Pelvic Floor Physical Therapy?
While there are many reasons to see a pelvic floor physical therapist, here are 10 of the most common signs it’s time to see a pelvic floor physical therapist.
You experience urinary leakage when you cough, laugh, sneeze, jump, run, etc. It’s a common myth that leaking or peeing a little in your pants after you have a baby or when you reach a certain age is just something you have to live with. No matter how many children you have or how old you are, you should always be able to control your bladder. Seeing a pelvic floor specialist can help you regain your pelvic strength and take back control of your bladder.
You experience a frequent or urgent need to urinate (or poop). Are you constantly racing to the bathroom after the first urge, or getting up multiple times during the night to pee? Do you feel you must plan your day around bathroom availability? Does it seem to take forever to fully empty your bladder, or do you feel like you aren’t able to empty it completely? These are all common signs it’s time to see a pelvic floor physical therapist.
You feel a heaviness in your pelvis, as if something is “falling out” of your vagina. Pelvic organ prolapse is incredibly common, with an estimated 30-50% of women experiencing it at some point. Common symptoms of prolapse include a feeling of pressure, heaviness, or something falling out “down there.” Thankfully, pelvic floor PT can often help completely resolve the symptoms of prolapse without the need for surgery.
You are experiencing pain or discomfort in the pelvis area. Constant or intermittent pelvic pain (including lower abdominal pain) while walking, running, using the stairs, sitting, getting up from a chair, having sex, inserting a tampon, and so on could be a sign of pelvic floor dysfunction. Additionally, hip and low back pain could also have pelvic floor involvement. If you are experiencing pain or discomfort in or around your pelvis, a therapist may be able to help.
You are chronically constipated (or your child is). Straining, painful bowel movements, and constipation that lasts more than a month may be caused by a dysfunctional pelvic floor. Additionally, if your child is struggling with constipation, seeing a pelvic floor physical therapist may be able to help.
You experience pain with sexual activities. A painful erection, pain during penetration or painful cramping after sexual activities may all be a sign of pelvic floor dysfunction.
You are experiencing pain related to endometriosis, adenomyosis, IBS or fibromyalgia. Pelvic floor PT can often be helpful for people who experience chronic pain from endometriosis, adenomyosis, irritable bowel syndrome and fibromyalgia.
You’ve recently given birth. Pelvic floor dysfunction is especially common in postpartum women and people, mainly due to the toll pregnancy has on the body, changing hormones and the physical act of childbirth (vaginal or cesarean). Pelvic floor physical therapy can help resolve postnatal complications such as diastasis recti, C-section scar mobilization, pelvic organ prolapse, painful intercourse, incontinence and more. It can also help safely guide you back to healthy exercising and enjoying all the activities you love.
You are currently pregnant or planning to become pregnant. Anyone who has been pregnant knows that our bodies change profoundly during pregnancy. A good pelvic floor physical therapist can help you stay active throughout your pregnancy, relieve hip, back and sciatica pain, and teach you how to protect your pelvic floor while you give birth. Advanced training in specialties such as Spinning Babies, a technique to help improve the baby’s positioning for childbirth while Mercier Therapy and visceral mobilization can aid in conception.
You’ve had a Cesarean section, abdominal or pelvic surgery, or are preparing for a VBAC. Just like you see a physical therapist after a hip or knee surgery, it’s important to see a pelvic floor physical therapist after an abdominal or pelvic surgery. Pelvic floor therapists commonly work with people after cesarean birth, as they prepare for a VBAC (vaginal birth after cesarean), as well as before and after pelvic organ prolapse surgery, prostatectomy, and hysterectomy.
Pelvic Floor PT…It’s Not Just for Women!
Everyone has pelvic floor muscles. Contrary to popular belief, pelvic floor physical therapy isn’t only for women and it isn’t just about kegels! Anyone who is experiencing any discomfort in the pelvic area, or any of the symptoms mentioned above, may benefit from seeing a therapist.
In men, pelvic floor PT can be especially helpful in preparing and recovering from prostate surgery. It can also help men suffering from the following:
Erectile dysfunction
Painful ejaculation
Frequent and involuntary urination (incontinence often occurs after prostate surgery)
Painful urination or bowel movements
Constipation
Penis or testicular pain
What Should I Expect at My First Physical Therapy Session?
Since each treatment plan is individualized and tailored to meet your needs, the first appointment is all about getting to know you! Your therapist will spend time listening, asking questions and helping to answer all of your questions. You can expect to discuss your history, the reasons that brought you in, your concerns, discomforts and daily struggles, and your goals for treatment. Your therapist will also likely spend a little time educating you on your condition, the various treatment options available to you, and how your treatment plan will proceed.
After that, the therapist will generally take a look at your posture and how everything moves throughout your hips and back. With your input, your therapist will then develop a treatment plan tailored to meet your needs and help you get back to doing what you love!
What Happens After My First Visit? What Do You Do at Pelvic Floor Physical Therapy?
Like other types of physical therapy, pelvic floor PT is individualized based on your specific needs and concerns. It typically involves a hands-on combination of manual techniques, exercises, and movement coordination to help retrain and strengthen your pelvic floor muscles.
You will also likely develop an at-home therapy program that may include breath work, strengthening and stability exercises, stretches, and modifications to some of your daily activities.
Some of the treatments and modalities a pelvic floor specialist will use include:
Pain education
Strengthening and flexibility exercises
Breathing techniques
Visceral manipulation
Myofascial release
Soft tissue massage
Scar tissue mobilization
Craniosacral therapy
Dry needling
Biofeedback or visual ultrasound
Taping
Functional movement and postural coaching
How Long Will I Need Physical Therapy?
The number of visits you need will vary based on your specific pelvic floor concerns, how long you’ve had these problems, your overall health, consistency with your home program, and what you want to get back to doing.
That said, the average person will start to notice an improvement in just 3-4 visits.
About Us
Pelvic Health & Wellness was built with you in mind. We practice whole-person, individualized pelvic floor physical therapy in a caring and safe environment. Our therapists specialize in treating pelvic health concerns such as pain, incontinence, prolapse, constipation, and various pregnancy and postpartum related conditions.
We understand that being ready to talk about and address your pelvic floor wellness concerns comes from a place of strength. Our pelvic floor physical therapists are here to support and encourage you on your journey back to pelvic health so you can get back to doing what you love!
If you are ready to take the first step in reclaiming your pelvic health and wellness, contact us today.