What is the Pelvic Floor?
“Pelvic floor” refers to the group of muscles at the bottom on the pelvis. These muscles help with bowel, bladder, and sexual function. When the pelvic floor muscles are overly tight, weak, or lack coordination, they can cause pain and dysfunction. When they become too tight, too weak, or lose coordination, they can lead to pain, leakage, constipation, pelvic pressure, and other symptoms. Pelvic floor physical therapy helps restore strength, flexibility, coordination, and proper muscle function to reduce symptoms and improve your quality of life.
Common symptoms that may indicate pelvic floor dysfunction include:
- Pelvic, hip, groin, or low back pain
- Severe menstrual pain or cramping
- Urinary urgency
- High urinary frequency (having to go to the bathroom often, or feeling like you have a “small” or “weak” bladder)
- Difficulty emptying the bladder or starting a urine stream
- Urinary incontinence/leakage with laughing, coughing, sneezing, jumping
- Urinary incontinence/leakage with urgency (not being able to hold it)
- Pain or difficulty with sexual intercourse, tampons, or medical examinations
- Constipation
- Feeling of heaviness in the pelvis, or a feeling that organs are “falling out”
You may have been told that these symptoms are “normal” for your age or after pregnancy, or that it is just something you have to “deal with.” While these symptoms are common, you don’t have to accept them as inevitable. Pelvic floor dysfunction is treatable with physical therapy.
What can we treat?
- Urinary issues
- Incontinence/leakage
- Urgency
- Frequency
- Retention or difficulty starting a stream
- Pelvic pain, including pain associated with these diagnoses
- Vulvodynia (vulvar pain)
- Vaginismus/dyspareunia (pain with insertion/intercourse)
- Dysmenorrhea (painful periods)
- Endometriosis
- Interstitial Cystitis (painful bladder syndrome)
- Pelvic organ prolapse
- Pelvic floor dysfunction during pregnancy and post-partum
- Post-operative for hysterectomy, endometriosis excision, or other pelvic surgeries
- Pelvic floor dysfunction secondary to Ehlers-Danlos Syndrome, joint hypermobility, and connective tissue disorders
- Pelvic floor dysfunction secondary to SI joint dysfunction
What happens during a pelvic floor physical therapy evaluation?
During your physical therapy evaluation, the physical therapist will first take a thorough medical history and ask questions about your symptoms. Then, they may perform an assessment of your low back, hips, and pelvic girdle to identify any musculoskeletal problems. This may include an evaluation of your perineal region for skin condition, tissue mobility, pelvic floor muscle strength, muscle coordination, and overall pelvic floor function. Your evaluation may include an optional internal assessment of the pelvic floor muscles, which the therapist will complete vaginally using a gloved finger. Your physical therapist will discuss all parts of the exam with you and receive your consent BEFORE initiating the exam. You can say no to any part of the exam at any time.
What does treatment look like?
The physical therapist will discuss the findings of your exam with you, and will work with you to develop an appropriate treatment plan. Treatment may include but is not limited to education, therapeutic exercises, internal manual therapy to pelvic floor muscles, and external manual therapy to hips, back, and other musculature.
Still have questions?
Don’t see your specific diagnosis or symptoms listed here? Have more questions about pelvic floor PT? To ask questions or schedule a FREE discovery call with Anna Reiser, PT, DPT to learn more about our program and how we can help: call our Irvine/Lake Forest Clinic at 949.750.8499 or simply use our email contact form.