Throughout a woman’s life, the body undergoes a number of physical changes that may impair the pelvic muscles’ ability to provide support and control for proper functioning. From pregnancy to menopause and beyond, various factors contribute to ongoing stresses to the pelvic floor. Conditions such as incontinence, pelvic pain, or urinary urgency and frequency are common but also adversely affect quality of life. There are many effective strategies that can improve these conditions.

What Is Pelvic Floor Physical Therapy?

Pelvic floor physical therapy (PT) is a specialized form of rehabilitation that focuses on restoring optimal musculoskeletal balance and function to the pelvic floor. The muscles in this area serve a number of important purposes, including:

  • Providing support to the organs within the pelvis (bladder, bowel, and reproductive organs).
  • Allowing or inhibiting the passage of urine, stool, or gas.
  • Assisting in sexual function and enjoyment.

Who Will Benefit From Pelvic Floor Physical Therapy?

If you experience any of these symptoms, you may benefit from pelvic floor PT:

  • Frequent trips to the bathroom (from six to eight per day), or waking up to use the bathroom more than once each night.
  • Inability to prevent leakage of urine or stool in the presence of an urge to go.
  • Leakages of urine with cough, sneeze, laugh, or exercise.
  • Lower back, abdominal, hip, or buttock pain.
  • Pain with bowel movements and/or constipation more than three times per week.
  • Pain within the pelvis or at the entrance of the vagina with intercourse.
  • Sensation of not completely emptying your bladder or having to strain to empty.

Your First Appointment

Your first PT appointment will be an evaluation to determine the type of intervention that will be most effective based on your symptoms. This includes a review of your medical and surgical history, including any medications you are taking. The exam includes a visual inspection of your postural alignment, assessment of trunk and lower extremity, and a detailed examination of your pelvic muscles. This helps to assess strength, endurance, and coordination, as well as the presence of muscular tenderness and/or pain. This information is necessary to build an appropriate rehabilitation program based on your specific musculoskeletal and neuromuscular issues. You will receive a home exercise program as well as educational materials that will reinforce what you learned during your session. After the evaluation, you will be scheduled for weekly treatments.

Common pelvic floor PT interventions include:

  • Progression of individualized exercise program for abdominal/back/lower extremity/pelvic floor muscles.
  • Biofeedback-assisted pelvic floor exercises to improve awareness and strength of muscle function.
  • Electrical stimulation to improve pelvic muscle strength, decrease bladder urges, and promote more complete emptying.
  • Bladder retraining to help extend void intervals and control urgency.
  • Education in urge-suppression techniques.
  • Positioning and exercise for prolapse management.
  • Instruction in relaxation techniques including progressive muscle relaxation and guided imagery.
  • Instruction in fluid management for optimal bladder control.
  • Soft tissue mobilization such as massage, myofascial release and stretching for painful, tight muscles and connective tissue restrictions.
  • Scar massage for “bound down” or adhesed scar tissue.
  • Education in proper body mechanics including correct lifting techniques to protect spinal and pelvic joints.
  • Modalities such as ultrasound, TENS (transcutaneous electrical nerve stimulation) for pain release.

To make an appointment with a pelvic floor physical therapy specialist, please call 856.325.6674.