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Pelvic Floor Therapy: An Overview

August 22, 2016 | Meghan Graf, LPT

Pelvic floor therapy is a hidden gem that many women don’t even know about.  It’s not uncommon to hear, “I didn’t even know this type of therapy existed!”  Pelvic floor therapy is physical therapy treatment designed to address pelvic floor dysfunction.  It can help with a variety of conditions including, but not limited to, the following: incontinence, sexual dysfunction such as painful intercourse, pelvic/vaginal pain, pelvic organ prolapses, low back pain/sciatica, vulvodynia, interstitial cystitis/painful bladder syndrome and urinary frequency or urgency (overactive bladder).

Treating pelvic floor disorders with exercise
Physical therapy can be an excellent option when seeking conservative management.  In fact, surgical options are often postponed or eliminated because the therapy is so effective.  Studies have shown, that women of all ages can experience up to a 70% improvement in their symptoms following appropriately performed pelvic floor exercise – “appropriately performed” being key to a good outcome.

Many women get discouraged and frustrated when “doing their kegels” at home doesn’t yield the results they want. This is often explained by the fact that 50% of women do not correctly contract their pelvic floor muscles with written or verbal instruction alone. The other reason this self-treatment may not be effective is that the problem could be pelvic floor tightness or asymmetry in the pelvic/tailbone alignment, in which case kegels can actually worsen the symptoms.

Some women have found that strengthening the pelvic floor muscles with pelvic floor physical therapy has even had some sexual benefits!

What’s it like to visit a pelvic floor therapist?
A physical therapist can evaluate your pelvic floor muscles gently using just a finger (not a speculum) and only within your comfort level and tolerance. She checks your pelvic floor for tightness and/or weakness and your ability to perform a contraction.  In some cases, biofeedback or electrical stimulation may be incorporated to help you engage your muscles and learn how to do a contraction properly.  If you have tightness, gentle manual therapy techniques done by the therapist can include trigger point releases and muscle strumming/massage.

Beyond exercise, your physical therapist may also recommend limiting or eliminating bladder irritants from your diet. Keeping a bladder diary and following a voiding schedule can be very helpful in the areas of urgency and frequency as well.  These simple changes can be really effective and help you regain control so your bladder isn’t running the show.

Most importantly, don’t be embarrassed about these issues. Incontinence is more common than you may realize, affecting 1 in 3 women at some point in her life.  The great thing is that there are noninvasive ways to improve or correct the issue quickly – often within 8-10 sessions, if not sooner.


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