Pelvic floor physical therapy is a treatment approach that uses the principles of physical therapy to provide a structured, effective and safe reconditioning of pelvic floor muscles. The goal of the treatment is to improve the strength and function of pelvic floor muscles and alleviate pain, weakness and dysfunction in the muscles. During the treatment, a skilled physical therapist accesses the muscles through the rectum or vagina and makes manipulations on them to improve their strength and functioning. The therapist may either stretch the muscles if they are short and contracted or apply resistance to improve strength if they weak and dysfunctional.
When is pelvic floor physical therapy recommended?
Pelvic floor therapy is targeted at the pelvic floor muscles, ligaments and connective tissues, all of which work together to support the pelvic organs, contribute to sexual arousal and orgasm, and assist in bladder and bowel control. The tissues are attached to the pelvis, tailbone and sacrum and are coordinated to support the urinary and reproductive tract, including the uterus, prostate, bladder, rectum, urethra, and vagina. They provide pelvic stability and promote proper function of pelvic organs, such as sexual and voiding function, together with posture and breathing. When pelvic muscles fail to work as they should, pain and symptoms that interfere with normal functioning occur.
Pelvic floor physical therapy and orthopedic rehabilitation can help with:
- Urinary incontinence, frequency and urgency
- Painful urination
- Bladder and bowel movements
- Fecal incontinence
- Painful sex or pain in the genital area
- Endometriosis
- Constipation
- Menopause symptoms
- Vaginismus
- Pain in the pelvis, hip, abdomen, thigh, or low back
- Rectal pain
- Unexplained pain
- Endometriosis
- Postpartum and pregnancy wellness
- Interstitial cystitis (IC)
- Pregnancy-related pain
- Testicular pain
Who needs pelvic floor physical therapy?
Pelvic floor physical therapy is recommended as first-line remedy for many disorders of the pelvic region. Both men and women with weakness in pelvic floor muscles can perform exercises to strengthen the floor and enhance bladder and bowel control. Specifically, a physician will refer a patient for the therapy if pelvic floor dysfunction is suspected to have a neuromuscular cause. The dysfunction may result from aging, illness, childbirth, surgery or other conditions and may coexist with other genitourinary problems, such as urinary incontinence, fecal incontinence, bladder-emptying problems, and constipation.
Patients are referred for pelvic floor therapy when they have incontinence, chronic pelvic pain, painful intercourse, and difficulty with bowel movements or urination. Women may see pelvic floor therapists for treatment of endometriosis or vaginismus while men may be treated for premature ejaculation and painful ejaculation. Pelvic floor exercises are beneficial for women with a lower risk of vaginal prolapse, bowel and bladder issues, and those recovering after childbirth. The treatment also helps men who have undergone prostate surgery to have speedy recovery, reduced risk of rectal prolapse and improved bladder and bowel control.
