The pelvic floor muscles are increasingly gaining time in the spotlight, most commonly thought of in reference to the famous (or infamous?) ‘Kegel’ strengthening exercise. In all reality, the pelvic floor is like Grand Central Station for our body. It includes a complex group of muscles, nerves, tendons, ligaments, and fascia. In both males and females, the pelvic floor works in conjunction with core muscles and the abdominal diaphragm to assist with the 5 S’s: sexual functioning, support (of pelvic organs and posture), sphincter control (maintains bowel/bladder continence), sump pump (lymphatics and blood flow), and stability (for lumbar spine, hips, and pelvis).
So what is pelvic health physical therapy? Pelvic health PT is a non-surgical approach for both men and women aimed at restoring impairments that arise from dysfunctions within the pelvic floor. Example impairments include but are not limited to unresolved low back/hip/sacroiliac pain, poor trunk/”core” functioning, urinary urgency/incontinence (including overactive and/or painful bladder), fecal incontinence, constipation, pain with sexual intercourse, pelvic organ prolapse, and pelvic girdle pain. When patients present with these concerns, a pelvic health PT will perform a comprehensive assessment of the pelvic floor via specific internal palpation (through the vagina and/or the rectum). If this sounds strange, think of it this way: you would never have your shoulder be treated by a physical therapist without having them test and palpate the muscles of the shoulder first. Through internal palpation, the PT discerns whether pelvic floor muscles are overactive or underactive as well as whether they are coordinated with other muscle groups. A pelvic health PT also considers the orthopedic components that may be contributing to the individual’s symptoms (examples: overall alignment, gluteal/core strength, joint range of motion, and general balance abilities). Different pelvic health PTs have different backgrounds and approaches. So just like any other provider, you have to find the right fit for you!
Upon examination, individuals receive an integrative treatment approach that emphasizes current sources of dysfunction but also aims to prevent further concerns down the road (after all, prevention is the best medicine!). Treatment options typically include bowel/bladder behavioral modifications, manual therapy and soft tissue work, modalities, therapeutic exercise, patient education, lifestyle medicine ideas, neuromuscular re-training, and various types of biofeedback. These treatment options help with strength deficits, muscular coordination issues, tight muscles, tender points, sensitive nerves, and myofascial restrictions. Just like any muscle group in the body, pelvic floor muscles function the best when they share the work but also continue performing the action(s) they were designed to do in a pain free manner.
If you are wondering if any of this pertains to you or if you are experiencing any related symptoms, peek at this fabulous screening tool created by Pelvic Sanity. It can help you discern if you might be a candidate for pelvic health physical therapy!