Pelvic floor physical therapy (PFPT) can help women and men with bladder, bowel, and sexual problems. This treatment helps tighten these muscles, ease pain, reduce or eliminate infections, and restore function.
During your first session, your physical therapist will privately discuss your medical history and symptoms. Additionally, they will examine you physically and check your spine, bony pelvis, and hips.
Strengthening the Pelvic Floor Muscles
The pelvic floor muscles form a braided hammock that supports the pelvic organs by extending from the front to the back of the pelvis. These muscles play a critical role in bladder and bowel control and sexual health in both men and women. Weak or tightened pelvic floor muscles may contribute to urinary problems like chronic constipation and bladder pain or lead to urological disorders. One is a rectocele, a weakened prolapsed bladder wall that requires surgery. Tightened muscles can also cause vaginismus, which prevents a woman from having sex or causes painful intercourse.
Physical therapists perform manual techniques and exercises to strengthen or relax the pelvic muscles. These include electrical stimulation therapy, in which a painless, low-level electrical impulse is delivered through electrodes placed on the skin or a specialized device you can take home.
Other therapies include trigger point release, which involves manual pressure on sensitive areas of muscle and connective tissue that radiate pain to other parts of the body; visceral mobilization, a gentle manual technique that can help restore normal movement to internal organs; and myofascial acoustic compression therapy, in which sound waves penetrate deep into fascia and muscles to break up scar tissue and remodel it.
Reducing Urinary Tract Infections
If you experience pelvic pain or dysfunction, talk to your doctor about getting a referral for physical therapy. Primary care providers, urologists, and gynecologists can all refer you for this treatment.
An extensive evaluation will start the initial appointment. The therapist may ask you to stand, walk, and sit to evaluate the internal and external muscles. They will also check your lumbar spine and hips for posture or joint issues affecting your pelvic floor muscles.
Your therapist will frequently utilize a technological apparatus to gauge the force of your muscle contractions. They might also use manual techniques, such as kneading the muscles and performing a diaphragmatic “belly” breathing technique to ease musculoskeletal pain.
Pelvic PT, like Sage Physical Therapy, can reduce or even eliminate the painful symptoms of interstitial cystitis (a chronic bladder condition), irritable bowel syndrome, vulvovaginal dyspareunia, and pelvic organ prolapse. It can also help relieve the pain and discomfort women feel during sex.
Relieving Pelvic Pain
Pelvic floor therapy can help reduce pelvic pain and the need for prescription pain medications. It is often paired with other treatments like massage, yoga, and nutritional guidance. The treatment is also considered low-invasive compared to other forms of pain management.
Your first visit will begin with thoroughly evaluating your condition and symptoms. Depending on your state, you may have an internal examination (vaginal or rectal) to assess the strength and flexibility of your pelvic floor muscles.
Your physical therapist might also use Kegels, electrical stimulation, or biofeedback to help strengthen or relax your muscles. They might even recommend a tube-shaped plastic dilator to stretch tight tissues. This might sound uncomfortable, but many women find the sensation to be bearable. They might also use a low-voltage electric current to teach you how to coordinate the contractions of your muscles, which helps reduce pain and muscle spasms. The PT might also apply pressure on specific points, known as trigger points, to relieve your pain.
Reducing Sexual Dysfunction
When paired with pelvic floor muscle retraining, physical therapy can reduce sexual dysfunction in women. It can ease the pain and discomfort female patients experience during intercourse and help them become more aware of their muscles to achieve better orgasms.
During a session, the physical therapist will review the patient’s medical history and symptoms before examining the hips, spine, bony pelvis, and pelvic floor muscles. The exam can involve external and internal techniques, which could include passing fingers through the vagina or rectum to do trigger point therapy or using specialized instruments to measure the contraction of the muscles.
In addition to manual therapy, the therapist may recommend other treatments, including functional dry needling (insertion of needles along trigger points), biofeedback (which helps patients observe their muscles contracting or relaxing through a device connected to the rectum or vagina), and myofascial release. They might also prescribe exercises, stretches, and breathing exercises.
