Pelvic Health

Pelvic pain or dysfunction can feel isolating, but you don’t have to go through it alone. We specialize in treating a variety of pelvic issues, from pregnancy-related conditions to pelvic floor dysfunction. Our therapists work with you in a private, compassionate environment, helping you feel comfortable and supported. Together, we’ll develop a personalized program that focuses on relieving your pain, improving function, and restoring your confidence. No matter your age or condition, we believe you deserve relief—and we’re here to help you find it.

Table of Contents

Your pelvic floor consists of a group of muscles that span the bottom of your pelvis. These muscles contract and relax like other muscles in your body, but their range of motion is much smaller. They support your pelvic organs, including the bladder and bowels, and assist with essential bodily functions like urination and passing a bowel movement.

When the muscles of the pelvis aren’t functioning correctly, it can lead to problems like incontinence, pelvic pain, or pain during sex. Pelvic floor therapy is a type of physical therapy that targets the muscles of the pelvic floor to address symptoms of pelvic floor dysfunction.

Pelvic floor dysfunction is more common than you may think. Up to 32% of women have experienced at least one symptom of pelvic floor dysfunction, or pfd.1 While more focus is generally placed upon women with this condition, 16% of men have also been identified with PFD symptoms.2 

You may not be aware of your pelvic health on a daily basis, but your pelvic floor plays a key role in supporting your internal organs and helping you perform essential bodily functions. Depending on the severity of your PFD, your symptoms can significantly affect your quality of life and overall health. 

Physical therapy for pelvic floor dysfunction can help prevent, treat or manage your symptoms. With Direct Access, you can call today to get started with an experienced pelvic floor physical therapist. Keep reading to learn more about how pelvic floor physical therapy can help you.

Causes of Pelvic Floor Dysfunction

There are several possible causes of pelvic floor dysfunction. In females, pregnancy and childbirth can cause injury or damage to the pelvic floor muscles. This may lead to subsequent dysfunction if not properly addressed and rehabilitated.  Emotional or physical trauma may also contribute to PFD. In all of these cases, physical therapy for pelvic floor may be helpful to address pain and symptoms.  There are many risk factors for pelvic floor dysfunction. If you have any questions regarding these risk factors in your own life, talk to your physical therapist to discuss possible preventative measures.
  • Heavy lifting: using poor form, chronic straining or holding your breath (Valsalva)
  • Conditions affecting the bladder and bowels: chronic straining, chronic constipation
  • Hormonal imbalances across the lifespan
  • Aging: benign enlargement of the prostate, age related muscle weakness, menopause
  • Obesity
  • Spinal cord injuries
  • Pudendal compression: chronic pressure on the pudendal nerve, the nerve supplying sensation to the genitals and perineum (seen in cyclists and equestrians)
  • Post pelvic surgery: after prostatectomy hysterectomy, or C-section
  • Post abdominal surgeries: after appendectomy, cholecystectomy, endometrial excision surgery, or tummy tuck
  • Chronic stress/high-pressure jobs
  • Hypermobility spectrum disorders: may lead to instability and pain
  • History of sexual trauma
There are numerous urologic, gynecologic, colorectal and other conditions that contribute to pelvic floor dysfunction.3 These conditions may affect the tone of the pelvic floor muscles, cause loss of support from the pelvic floor, or a combination of the above.

Symptoms of Pelvic Floor Dysfunction

Common symptoms of pelvic floor dysfunction can include:

  • Difficulty with bowel movements: incontinence or blockage
  • Frequent/strong urgency for urination
  • Nocturia: waking at night to urinate more than once
  • Straining to void bowel and/or bladder
  • Urinary incontinence 
  • Pelvic organ prolapse or feeling of heaviness 
  • Pelvic or genital discomfort or pain
  • Erectile dysfunction
  • Spasms of anus or pelvic floor
  • Sensation changes to pelvic floor
  • Pain with sex, gynecological exams, or tampon insertion
  • Pain with arousal or orgasm 

It is important to discuss your symptoms openly with your physical therapist so they can build an individualized PFD treatment plan. Sometimes these symptoms can be difficult to talk about, but just know that your physical therapist is there to support you.

Diagnosing Pelvic Floor Dysfunction

Contact your physical therapist if you’ve been experiencing urinary or fecal incontinence, pelvic pain, or any of the symptoms listed above. You can also talk to your physical therapist if you have any of the associated risk factors listed earlier in this article. Your physical therapist can help you determine the need for a screening.

You don’t need a referral to see a physical therapist. Direct Access allows you to call and schedule an appointment with one of our experienced pelvic floor physical therapists today.

At your initial evaluation (first physical therapy appointment), your physical therapist will begin by taking a thorough medical history and reviewing your symptoms and complaints. After gathering this information, they will begin your physical examination.

The physical examination consists of two components, the external and internal exams. During the external examination, your physical therapist will assess your pelvic region, including your lower back, glutes, and core for strength, pain and tenderness. Your physical therapist will also conduct a functional screening to rule out other contributing factors to your pelvic symptoms.

During the internal examination, your physical therapist will assess your pelvic floor directly. This involves your physical therapist using gloved fingers to palpate the muscles of the pelvic floor while performing voluntary contractions/relaxations. 

Your physical therapist may also use a biofeedback device to monitor your pelvic floor muscle activity. The machine provides auditory or visual cues to help you become more aware of your pelvic floor and improve your voluntary control of these muscles. 

If needed, your physical therapist will refer you to your doctor for further diagnostic imaging, like an ultrasound.

Treatment Options

There are many factors to consider when determining treatment options for your pelvic floor dysfunction. Talk to your physical therapist about your symptoms and how they affect your daily life. After evaluation, your physical therapist can discuss the best treatment options with you.

Non-surgical Treatment Options:

Pelvic floor physical therapy (PFPT) is an effective, first-line conservative treatment for pelvic floor dysfunction.4 Pelvic therapy focuses on retraining the muscles of the pelvic floor to improve contraction and relaxation. This can help with PFD symptoms like urinary or fecal incontinence, pelvic organ prolapse (POP), and pelvic pain. A pessary may be used in cases of pelvic organ prolapse (POP) where the pelvic floor muscles are weak and cannot provide adequate support to the pelvic organs. The pelvic organs may slip out of place and cause pain or discomfort. A pessary is a removable device inserted into the vagina to provide additional external support to the pelvic organs and relieve discomfort.  Non-surgical treatment of PFD may also involve medical management of related conditions:
  • Constipation: difficulty passing stool
  • Interstitial cystitis: chronic bladder pressure/pain that can also lead to pelvic pain
  • Vaginismus: involuntary spasms of the vagina
  • Vulvodynia: chronic pain around the outer female genitalia (vulva)

Surgical Treatment Options: 

Talk with your physical therapist if you are considering surgery for your pelvic floor dysfunction. They will help you ensure all of your conservative treatment options have been exhausted before undergoing surgery.  However, if surgery is an appropriate option for your case, there are a few common procedures that may be performed:
  • Sling procedures: a mesh support is placed to support the urethra and bladder in some cases of stress urinary incontinence. 
  • Sacral nerve stimulation (SNS): a device implanted to stimulate the sacral nerve for the treatment of urinary and/or fecal incontinence.
  • Hysterectomy: surgical removal of the uterus
  • Bladder tacking: a small piece of mesh is inserted to support the urethra and bladder
  • Hernia repair: surgical repair when an organ or internal tissue pushes through the surrounding muscles

Preventing Pelvic Floor Dysfunction

There are many ways you can promote your long-term pelvic health and well-being.5 If you have any questions or concerns, talk to your physical therapist. You don’t need a referral—with Direct Access, you can call to make your appointment today.
  • Physical Activity: Stay active on a regular basis. Recommendations include 150 minutes of moderate intensity activity, or 75 minutes of moderately high intensity activity per week.6 Pregnant and postpartum women may need to modify their activity based on their health status. Talk to your physical therapist if you have questions or concerns about your physical activity levels.
  • Healthy Diet: Strive to eat a balanced diet with plenty of fiber. Fiber can help improve stool consistency and prevent fecal incontinence symptoms. Drink non-sugary, non-alcoholic fluids to maintain adequate hydration. Pregnant and postpartum women may have special dietary needs, so talk to your physical therapist to ensure you’re on the right track.
  • Healthy Body Weight: Try to maintain a healthy body weight to reduce unnecessary pressure on the pelvic floor. Pregnant and postpartum women will have different guidelines regarding body weight and weight gain during pregnancy, so talk to your physical therapist about your individual case.
  • Smoking Cessation: Smoking has been linked to decreased pelvic floor strength, which may lead to PFDn.5 
  • Medical Management: As discussed above, medically managing conditions like constipation will promote overall pelvic health and well-being.

Living with Pelvic Floor Pain

Pelvic floor pain can significantly affect your daily life. Talk to your physical therapist about your pelvic pain and symptoms. A personalized treatment plan is essential to your success and long-term pelvic health.

If you have questions or concerns about your pelvic floor symptoms, call today to book a consultation with an experienced pelvic floor physical therapist. They will provide professional guidance and support to treat and manage your pelvic floor dysfunction.

Physical Therapy for Pelvic Health

There are many positive outcomes you can achieve with pelvic floor physical therapy:

  • Pain reduction
  • Improved bladder and bowel control
  • Improved sexual function
  • Improved emotional well-being

Pelvic floor physical therapy can also provide guidance and support for pregnant and postpartum women.

Your pelvic floor treatment session may include some of the following physical therapy techniques, exercises and/or modalities:

  • Manual therapy to address muscle tone and trigger points in the pelvic floor muscles
  • Exercises like Kegels to improve pelvic muscle control and strength
  • Biofeedback to improve awareness and control
  • Dry needling to reduce pain and improve function
  • Electrical stimulation to improve muscle activation and control
  • Pelvic floor therapy devices like pessaries, vaginal dilators, or weighted cones

The goals of pelvic floor physical therapy sessions will vary based on each patient. Your physical therapist will help you determine your therapy goals, which typically include pain reduction and symptom management. 

  • Include parent/patient success stories and testimonials.

Choosing the Right Physical Therapist for Your Needs

Our staff can help pain you with an experienced pelvic floor physical therapist to fit your needs. Pelvic floor physical therapists will frequently have received additional training regarding pelvic floor dysfunction and associated treatments. Call us with your questions—you don’t need a referral to make an appointment.

The partnership between you and your therapist, also called the therapeutic alliance, is extremely important for your success in pelvic floor physical therapy. While some of the symptoms of PFD can be difficult to talk about, it’s essential to maintain open communication with your physical therapist to ensure the best treatment. Take an active role in your rehabilitation, ask questions, and commit to your exercise prescription to see the best results. Your physical therapist is there to encourage and empower you to reach your therapy goals and take ownership of your pelvic health.

Physical therapy for pelvic pain is a proven, effective treatment for pelvic floor dysfunction. Your experienced physical therapist will guide you through a specialized program designed to treat and manage your pelvic floor symptoms. Using a combination of pelvic floor therapy exercises and other treatment techniques, your physical therapist can help you find relief from your pelvic pain and symptoms.

Call to book a consultation with one of our pelvic floor physical therapists. With Direct Access, you don’t need a referral to be seen. Contact us today and our helpful staff will answer any questions and get you started on your path to pelvic health.

Frequently Asked Questions

Sessions are conducted in private rooms, ensuring confidentiality and comfort during treatment. 

Yes, specific pelvic floor exercises can help manage and reduce the symptoms of prolapse. 

Yes, these are commonly treated issues associated with pelvic PT. 

People of all genders and ages can have PFD. However, it is more commonly associated with females, especially in regards to childbirth and menopause.

PFD exercises focus on strengthening and improving control of the pelvic floor muscles. Your physical therapist will determine the best exercises for you, but commonly prescribed exercises include Kegels, bridges, squats and diaphragmatic breathing.

Pelvic floor therapy is a type of physical therapy that uses targeted exercises and other treatment techniques to strengthen or relax the muscles of the pelvic floor and improve your control over these muscles.

Some pelvic floor dysfunction risk factors, like age, cannot be avoided. However, there are many ways to reduce your risk of developing PFD. These include physical activity, maintaining a healthy body weight and quitting smoking.

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