What is Pelvic Floor Therapy?
Pelvic floor therapy, also known as pelvic floor rehabilitation or physical therapy, focuses on the pelvic floor’s muscles, ligaments, and tissues. The pelvic floor is a complex network of muscles that extends from the pubic bone to the tailbone and plays a crucial role in supporting the pelvic organs, maintaining continence, and facilitating sexual function.
The treatment is for individuals, both men and women, experiencing dysfunction or pain related to their pelvic floor. Common conditions that may benefit from pelvic floor therapy include pelvic pain, fecal and urinary incontinence, painful intercourse, prenatal, pregnancy, and postpartum recovery. The pelvic floor may need to be considered with chronic hip or LBP when other physical therapy has not completely abolished symptoms.
A trained therapist will assess the individual’s condition through a comprehensive evaluation during a therapy session. It may involve discussing the patient’s medical history and symptoms and performing a physical examination of the pelvic region. The therapist may use various assessment techniques, such as observing muscle tone and strength, assessing muscle coordination, and checking for trigger points or areas of tenderness.
The therapist will develop a personalized treatment plan based on the evaluation findings. Treatment typically includes manual techniques, exercises, and education to address specific issues. The therapist may use techniques such as manual therapy, myofascial release, biofeedback, electrical stimulation, and therapeutic exercises to improve the function and coordination of the pelvic floor muscles.
Who Gets Pelvic Floor Physical Therapy?
Treatment can benefit both men and women experiencing various pelvic floor-related issues.
In the case of women, pelvic floor physical therapy is a standard recommendation for conditions such as pelvic pain, painful intercourse, prenatal, preparing for the birthing process, or postpartum concerns. Women may seek this therapy after childbirth to strengthen the weakened pelvic floor or during menopause to address changes in the pelvic region.
For men, pelvic floor physical therapy utilization is for conditions like, pelvic pain, post-prostatectomy recovery, and erectile dysfunction. Men may undergo treatment to improve bladder control, alleviate pelvic pain, or restore erectile function after surgery or other medical interventions.
What’s the Difference Between Pelvic Floor Therapy and Other Types of Therapy?
- Specialized Focus: Treatment centers around the pelvic floor, crucial in supporting the pelvic organs, maintaining continence, and facilitating sexual function. Unlike other forms of therapy that may have a broader scope, the treatment hones in on this specific area, providing targeted interventions to address pelvic floor dysfunction.
- Expertise: Pelvic floor therapists undergo specialized training to develop expertise in the pelvic floor’s anatomy, physiology, and treatment. They have in-depth knowledge of pelvic pain and sexual dysfunction. This technical knowledge enables them to provide practical assessment and treatment techniques tailored to the unique needs of their patients.
- Assessment Techniques: Treatment involves comprehensive assessments to evaluate the function and strength of the pelvic floor. Therapists may use internal palpation, biofeedback, and electromyography to assess muscle tone, coordination, and endurance. This hands-on approach differentiates the treatment from other types of treatment that primarily rely on external observation and assessment.
- Internal Interventions: One of the distinctive aspects of the treatment is using internal interventions. With the patient’s consent and comfort, therapists may use manual, intravaginal, or intrarectal trigger point release to release tension and improve muscle function. These internal interventions are specific to the pelvic floor.
- Exercise Prescription: Pelvic floor therapists prescribe specific exercises to improve pelvic floor strength, coordination, and flexibility. These exercises may include kegel exercises, pelvic floor muscle training, and relaxation techniques. Other types of therapy may focus more on general practice or stretching rather than the specific exercises targeted at the pelvic floor.
- Education and Lifestyle Modifications: The treatment emphasizes patient education and lifestyle modifications. Therapists provide information about healthy bladder and bowel habits, posture, and body mechanics to prevent or manage pelvic floor dysfunction. This educational component is a crucial part of treatment and may not be as prominent in other types of treatment.
- Multidisciplinary Approach: Treatment often involves collaboration with other healthcare professionals, such as urologists, gynecologists, and colorectal specialists. This multidisciplinary approach ensures comprehensive care for patients with complex pelvic floor issues. Other forms of therapy may not always involve such collaboration and may primarily focus on the therapist-patient relationship.
- Addressing Specific Conditions: The treatment is particularly effective in addressing conditions such as urinary and fecal incontinence, pelvic organ prolapse, pelvic pain disorders, and sexual dysfunction. Therapists utilize various techniques, including manual therapy, biofeedback, electrical stimulation, and behavioral modifications, to alleviate symptoms and improve quality of life. While other types of treatment may touch on these conditions, the therapy provides specialized interventions tailored specifically for them.
How Does Pelvic Floor Therapy Work?
Evaluation and Assessment
During your initial visit to a pelvic floor therapist, they will conduct a thorough evaluation and assessment to understand your concerns and symptoms. It may involve a discussion of your medical history, lifestyle factors, and any previous treatments. The therapist may also perform a physical examination, including internal and external pelvic floor assessments. Internal exams do not have to be performed if the patient does not want this type of exam. There can still be treatments and behavioral modifications addressed to assist in changes in symptoms.
Treatment Techniques
Treatment employs various techniques to address specific issues.
- Manual therapy: Hands-on techniques to release tension, improve muscle function, and relieve pain.
- Biofeedback: Using sensors to provide visual or auditory feedback to help you become aware of and control your pelvic floor.
- Therapeutic exercises: Targeted exercises to strengthen weak muscles and improve coordination.
- Relaxation techniques: Training in relaxation and breathing exercises to reduce muscle tension and stress.
Home Exercises
Your pelvic floor therapist will provide personalized exercises to continue at home. These exercises may include kegel exercises, stretches, and relaxation techniques. Consistency and regular practice are crucial to achieving optimal results.
Treatment may also involve education on bladder and bowel habits, lifestyle modifications, and postural adjustments to optimize pelvic floor function. The therapist works closely with the patient to provide guidance, support, and monitoring throughout treatment.
Consistency and adherence to the therapy program are essential for optimal results. With time and practice, treatment can help alleviate symptoms, improve pelvic floor function, and enhance overall quality of life.
How Do I Find a Pelvic Floor Therapist?
Finding a pelvic floor therapist is essential in addressing pelvic floor disorder and related issues. A pelvic floor therapist can provide specialized treatment and guidance if you’re experiencing pelvic pain or any other symptoms.
Research Online
Start by conducting an online search for pelvic floor therapists in your area. Use search engines and online directories to find clinics or individual practitioners specializing in pelvic floor therapy. Look for experienced therapists with good reviews or ratings from previous clients.
Ask for Recommendations
Contact your primary care physician, gynecologist, or other healthcare professionals you trust and ask for recommendations. They can provide you with a list of pelvic floor therapists in your area with a good reputation and a track record of success.
Check with Physical Therapy Associations
Contact local physical therapy associations or organizations. They often maintain directories of registered therapists, including those specializing in the treatment. These associations can provide a list of licensed and qualified therapists to practice in your area.
Seek Referrals from Support Groups
Join online support groups or forums dedicated to pelvic floor issues. Engage with the community and ask for recommendations from individuals undergoing treatment. They can provide valuable insights and personal experiences, helping you find a therapist who suits your needs.
Contact Hospitals and Medical Centers
Contact your area’s hospitals, medical centers, or women’s health clinics. Inquire if they have a treatment department or if they can refer you to a therapist who specializes in pelvic floor rehabilitation. These institutions often have comprehensive networks of healthcare professionals and can point you in the right direction.
Verify Credentials
Once you have a list of potential therapists, verify their credentials and qualifications. Ensure they are licensed physical therapists or healthcare professionals with specialized training in the treatment. You can find this information on their websites, mainly written “pelvic floor therapy near me,” or contact them directly to inquire about their qualifications.
Consider Insurance Coverage
Many pelvic floor therapists choose to be out-of-network providers in order to give longer duration of treatment time. This allows for sessions that are not rushed which is important with the sensitivity of the region being treated. Out-of-network also means providers are not bound by what the insurance will or will not cover and treatments will be based on what is best for the patient. If you have health insurance and prefer to try this route, check your policy to see if treatment is covered. Inquire about any specific requirements or limitations, such as needing a referral from your primary care physician. Contact the pelvic floor therapists you are considering and ask if they accept your insurance. It will help you narrow down your options based on affordability and coverage.
Schedule an Initial Evaluation
Once you have selected a pelvic floor therapist, schedule an initial evaluation. During this appointment, the therapist will assess your condition, discuss your symptoms and medical history, and develop an individualized treatment plan. Be prepared to ask questions and share any concerns you may have. This evaluation will help you determine if the therapist fits you and you feel comfortable working with them. If you feel the therapist is not a good fit, it is encouraged to try and find another one.
Finding the right pelvic floor therapist may require time and effort, but it is crucial for overall well-being. Don’t hesitate to seek professional help, as treatment can effectively treat many pelvic floor condition.
Is Pelvic Floor Therapy Only for Women?
While it is commonly associated with women’s health, the treatment is not exclusively for women. Men can also benefit from the treatment for various conditions and concerns.
For Men
- Pelvic Pain: Men can experience pelvic pain due to a variety of reasons, such as pelvic muscle dysfunction, chronic prostatitis, or pudendal neuralgia. The treatment aims to identify and treat the underlying causes of pelvic pain, helping to alleviate discomfort and improve quality of life.
- Erectile Dysfunction: Pelvic floor plays a crucial role in erectile function. Weak or dysfunctional muscles can contribute to erectile dysfunction. Treatment can help strengthen these muscles, enhance blood flow to the pelvic region, and improve erectile function.
- Urinary Incontinence: Men may experience this after prostate surgery or due to other factors like a weak pelvic floor. Treatment can assist in strengthening these muscles, leading to better urinary control and reduced leakage.
- Post-Surgical Rehabilitation: Men who undergo surgeries in the pelvic region, such as prostate surgery or hernia repair, may benefit from treatment as part of their post-surgical rehabilitation. It can help restore muscle function, reduce pain, and improve overall recovery.
- Bowel Dysfunction: Dysfunction can also affect men’s bladders and bowels movements, leading to issues like constipation or fecal incontinence. Treatment can address these concerns by improving muscle coordination and function in the pelvic floor and promoting regular bowel movements.
For Women
- Pelvic Pain: Women often seek treatment for various types of pelvic pain, including conditions like vulvodynia, endometriosis, or painful intercourse. The therapy can help identify muscle imbalances, release trigger points, and improve pelvic floor function, reducing pain and discomfort.
- Urinary Incontinence: Pregnancy, childbirth, hormonal changes, and aging can contribute to this disorder in women. Treatment can effectively treat stress, urge, or mixed incontinence by strengthening the pelvic floor and improving bladder control.
- Prolapse(POP): POP occurs when the pelvic organs (such as the bladder, uterus, or rectum) descend into the vaginal canal. Treatment can help manage prolapse symptoms by strengthening the muscles and supporting the organs, potentially reducing the need for surgical intervention.
- Pre and Postnatal Care: Therapy is often recommended during pregnancy and after childbirth. It helps women prepare for labor by teaching relaxation techniques, optimizing pelvic floor function, and facilitating postpartum recovery.
- Sexual Dysfunction: The treatment can benefit women experiencing sexual dysfunction, such as decreased arousal or pain during intercourse. By addressing pelvic floor tension, promoting blood flow, and enhancing muscle coordination, therapy can contribute to improved sexual function and enjoyment.
What Are the Different Types of Treatment?
While there is no standardized classification of types of treatment, therapists may employ various techniques and approaches based on the individual’s specific needs and symptoms.
Pelvic Floor Training
Also known as Kegel exercises, it is a technique used to strengthen the muscles in the pelvic floor. A pelvic floor is a group of muscles that supports the bladder, uterus, and rectum. Both men and women can benefit from pelvic floor training, as it can help improve bladder and bowel control and sexual function.
To perform pelvic muscle training, start by identifying the correct muscles. The easiest way to do this is by stopping the flow of urine midstream. The muscles that you engage in doing this are the pelvic muscles. However, it’s essential to refrain from stopping urine flow during urination, as it can lead to other problems.
Once you have identified the correct muscles, you can start the exercises. Begin by lying down on your back with your knees bent and feet flat on the floor. Take a deep breath, and squeeze the muscles as you exhale as if trying to lift them inside. Hold the squeeze for a few seconds, and then relax. Repeat this process ten times, aiming for three sets of 10 repetitions daily.
As you become more comfortable with the exercises, you can increase the duration of the squeezes and the number of repetitions. Gradually work your way up to holding each contraction for 10 seconds and completing three sets of 20 repetitions.
Consistency is critical when it comes to pelvic muscle training. It may take several weeks or months of regular practice to see noticeable improvements. It’s important to note that results can vary depending on individual factors and the severity of any existing pelvic floor issues.
In addition to strengthening the pelvic floor, it’s essential to maintain a healthy lifestyle overall. It includes maintaining a balanced diet, staying hydrated, and avoiding excessive straining during bowel movements. Incorporating regular physical activity into your routine is also helpful, as this can support overall muscle tone and function.
Suppose you have concerns about pelvic muscle training or experience pain or discomfort while exercising. Consulting with a healthcare professional for guidance and further evaluation is advisable.
Electrical Stimulation
In the treatment, electrical stimulation commonly treats various conditions and disorders affecting the pelvic muscles. Electrical stimulation involves the application of low-intensity electrical currents to specific areas of the pelvic floor, intending to improve muscle strength, coordination, and function.
The pelvic muscles are crucial in maintaining continence, supporting pelvic organs, and sexual function. Dysfunction of these muscles can lead to various problems, including urinary and fecal incontinence and sexual dysfunction. Treatment addresses these issues through exercises, manual techniques, and modalities such as electrical stimulation.
During an electrical stimulation session, small electrodes placed on the pelvic muscles’ skin or the vagina or rectum, depending on the specific condition requiring treatment, connect to a device that delivers controlled electrical impulses. The impulses cause the pelvic floor to contract and relax, mimicking the natural contraction during normal muscle function.
Electrical stimulation helps improve muscle strength, endurance, and coordination by stimulating the pelvic muscles. It can also enhance blood circulation to the area, which promotes tissue healing and reduces inflammation. Additionally, electrical stimulation can help to reduce pain and discomfort associated with pelvic floor disorders.
The parameters of electrical stimulation, such as intensity, frequency, and duration, are determined by the healthcare professional based on your condition and treatment goals. Electrical stimulation treatment consists of several sessions for weeks or months, each lasting around 20 to 30 minutes.
It’s important to note that a qualified healthcare professional specializing in the treatment should conduct electrical stimulation conduction. They will assess your condition, tailor the treatment plan to your needs, and monitor your progress throughout the therapy.
Bladder and Bowel Retraining
Bladder and bowel retraining are essential components of treatment to improve the function and control of the urinary and digestive systems. The therapy, also known as pelvic floor rehabilitation, is a specialized approach that focuses on strengthening and re-educating the pelvic floor.
Bladder retraining involves establishing a regular urination pattern to regain control over the bladder. It often treats conditions such as overactive bladder. The therapist works closely with the patient to develop a personalized schedule for urination, gradually increasing the time between voids. Doing so increases bladder capacity, and the urge to urinate becomes more manageable. The therapist may also provide relaxation and urge suppression techniques to assist in retraining the bladder.
Similarly, bowel retraining aims to establish regularity and control over bowel movements. Its typical use is to treat conditions like fecal incontinence or constipation. The therapist assists the individual in developing a consistent bowel routine, including scheduled times for defecation. The person is encouraged to listen to their body’s signals and attempt to have a bowel movement during these designated times. Techniques such as abdominal massage, posture adjustments, and dietary modifications may also enhance bowel function.
During treatment, the therapist educates the individual about the anatomy and function of the pelvic floor. They teach exercises to strengthen these muscles, which involve contracting and relaxing the pelvic floor. Strengthening the pelvic muscles can improve support to the bladder and rectum, promoting continence and preventing leakage.
Types of Pelvic Floor Exercises
Pelvic Floor therapy exercises are essential to pelvic floor rehabilitation and can benefit both men and women. Even though these are examples, it is important to be evaluated first to assess what is right for you. People often believe if they only perform kegel exercises that their pelvic floor dysfunction will improve; however, this is not always the case.
Kegel Exercises
Kegel exercises are the most well-known and frequently recommended pelvic floor exercises. These exercises involve contracting and relaxing the pelvic muscles. Over time you may need to gradually increase the duration and intensity for the desired effect.
Pelvic floor Drops
Pelvic floor drops, reverse Kegels, are the opposite of Kegel exercises. Instead of contracting, you focus on relaxing and lengthening the pelvic muscles. This exercise can benefit individuals who experience pelvic floor tightness or pain.
Pelvic Floor Bridges
Pelvic floor bridges combine traditional bridge exercises and pelvic floor contractions. Lie on your back with your knees bent and feet flat on the floor. Slowly lift your hips off the ground, engaging your glutes and lower abdominal muscles. At the same time, contract your pelvic muscles, holding the contraction for a few seconds before lowering your hips back down. This exercise helps strengthen the pelvic floor while also engaging other muscle groups.
Squats
Squats are versatile exercises targeting multiple muscle groups, including the pelvic floor. Even body weight squats can be helpful at improving your pelvic floor function.
Pilates Exercises
Pilates is a form of exercise that focuses on core strength and stability. Many Pilates exercises incorporate pelvic floor engagement as part of the movement. Exercises like the Pilates bridge, supine pelvic tilt, and quadruped leg lifts can effectively target and strengthen the pelvic floor. Consider joining a Pilates class or working with a certified instructor who can guide you through these exercises with proper form.
Breathing Exercises
Breathing exercises can help facilitate relaxation and coordination of the pelvic floor. Synchronized breathing and pelvic floor contraction can promote awareness and control of the pelvic floor.
Biofeedback Exercises
Biofeedback is a technique that uses technology to provide real-time information about the functioning of your pelvic floor. It can be an effective tool in treatment. With the help of a biofeedback device, you can see visual or auditory cues that indicate the strength and coordination of your pelvic floor contractions. This feedback allows you to adjust and optimize your exercise routine accordingly.
Functional Exercises
In addition to specific pelvic floor exercises, incorporating functional exercises into your routine can enhance pelvic floor strength and coordination. Practical exercises mimic everyday movements and activities, including walking, lunges, and step-ups. You promote their integration into daily life by engaging the pelvic floor during these functional movements.
Pelvic Floor Therapy Glossary
- Pelvic Floor: Refers to a group of muscles, ligaments, and tissues that support the organs in the pelvis, including the bladder, uterus, and rectum.
- Pelvic Floor Therapy: A specialized form of physical therapy that focuses on treating and strengthening the pelvic floor to address conditions such as pelvic pain, incontinence, and pelvic organ prolapse.
- Pelvic Pain: Discomfort or pain in the pelvic region, with various factors, including muscle dysfunction, nerve issues, or inflammation.
- Incontinence: The involuntary loss of urine or feces due to a weakened or dysfunctional pelvic floor. There are different types of incontinence, including stress incontinence (leakage during physical activity or exertion) and urge incontinence (sudden and intense urge to urinate).
- Kegel Exercises: A series of pelvic floor exercises to strengthen and tone the muscles. Kegels involve contracting and relaxing the muscles that control urination and bowel movements.
- Biofeedback: A technique used in treatment to provide visual or auditory cues that help you become more aware of your pelvic floor activity. This feedback assists in learning proper muscle contraction and relaxation techniques.
- Trigger Points: Sensitive areas within the muscles that can cause pain or discomfort. Trigger point release involves applying pressure or massage to these points to relieve tension and pain.
- Prolapse: The descent or dropping of pelvic organs from their regular positions due to a weakened pelvic floor. It can result in symptoms like a bulging sensation in the vagina, urinary difficulties, or pelvic pressure.
- Myofascial Release: A technique used in pelvic treatment to release tension and restore mobility in the muscles and connective tissues. It involves applying gentle pressure to specific areas to stretch and soften the fascia, a fibrous tissue that encases the muscles.
- Vaginal Dilators: Medical devices, typically cone-shaped, that stretch and relax the vaginal muscles gently. They are often employed in treatment to treat conditions like vaginismus or dyspareunia.
- Bladder Training: A behavioral therapy technique that helps manage urinary frequency and urgency. It involves gradually increasing the time between bathroom visits to train the bladder to hold larger volumes of urine.
- Relaxation Techniques: Methods to reduce tension and promote relaxation in the pelvic floor. These techniques can include deep breathing exercises, meditation, or guided imagery.
- Pain Mapping: A process used to identify and document areas of pain or discomfort. Pain mapping involves charting pain’s location, intensity, and characteristics to help guide treatment and track progress.
- Postpartum Rehabilitation: This treatment is for women recently giving birth. It focuses on restoring pelvic floor strength and function after pregnancy and childbirth.
- Pelvic Floor Educator: A healthcare professional specializing in pelvic floor health and treatment. They provide education, guidance, and therapeutic interventions to address pelvic floor problems.
- Electrical Stimulation: A technique used in treatment that involves applying mild electrical currents to the pelvic floor. This stimulation can help improve muscle tone and coordination.
- Transcutaneous Electrical Nerve Stimulation (TENS): An electrical stimulation that uses low-voltage electrical currents to relieve pain. TENS units manage pelvic pain symptoms in treatment.
- Bowel Retraining: A therapeutic approach to establish regular bowel movements and manage conditions like constipation or fecal incontinence. It involves creating a schedule and implementing strategies to improve bowel function.
- Scar Tissue Release: A technique used to address scar tissue causing pain or restricted mobility in the pelvic area. Manual therapy techniques, such as gentle stretching or massage, can help release adhesions and improve tissue health.
- Interstitial Cystitis: A chronic condition characterized by bladder inflammation and pelvic pain. Treatment can be beneficial in managing symptoms and improving the quality of life for individuals with interstitial cystitis.
While the treatment is historically associated with women’s health, it is essential to recognize that men can also benefit from this specialized form of therapy. The treatment addresses a range of conditions, including pelvic pain, erectile dysfunction, and bowel dysfunction in both men and women. The treatment provides numerous benefits, such as pain relief, improved bladder and bowel function, enhanced core stability, and increased pelvic floor awareness. Whether you are a man or a woman, considering treatment can be a valuable step toward better pelvic health and overall well-being. It is highly effective in addressing a wide range of pelvic floor disorders.
It is important to note that the treatment is specialized; not all therapists have the necessary training and expertise and require a private treatment room. When experiencing any symptoms of pelvic floor disorder, seeking care from a qualified pelvic floor therapist who can provide a comprehensive assessment and develop an appropriate treatment plan tailored to your specific needs is essential. Therapy is a valuable resource for women and men experiencing pelvic floor issues.
The Bottom Line
We at Better Health, believe in understanding the importance of the treatment for both genders is crucial in destigmatizing the notion that it is exclusively for women. By embracing the benefits of the treatment, individuals can achieve better overall health, enhanced quality of life, and improved physical well-being. If you have any questions in regards to pelvic floor therapy; give us a call or book an appointment with us today!
