Ask the Expert: Pelvic Floor Physical Therapy

What are pelvic floor muscles and what do they do?

Almost everyone has heard of physical therapy, but a large portion of individuals are not familiar with the specialized field of pelvic floor physical therapy and the important part it can play in helping women.

First, it’s important to understand the role of the pelvic floor muscles. This network of muscles are found at the base of the pelvis, extending from front to back and side to side, similar to a hammock. They maintain continence, support organs in the pelvic cavity, stabilize joints in the hip and lower portion of the spine, help support the key muscles used in intercourse and pregnancy, and also they help pump blood out of the pelvic cavity toward the heart.

Many pelvic floor disorders, such as urinary incontinence, fecal incontinence and pelvic organ prolapse, are actually a result of a musculoskeletal dysfunction. For example, if the muscles of the pelvic floor are weak, or hypotonic, they may be unable to maintain adequate muscle control, resulting in urinary or fecal incontinence. Weak pelvic floor muscles can also cause pelvic organ prolapse when various organs of the pelvic cavity lose support and begin to descend through the vaginal canal. In other cases, the pelvic floor muscles are too tight, or hypertonic, and can compress the urethra and bladder resulting in urinary urgency and/or urge incontinence, as well as painful intercourse.

According to the National Institute of Child Health and Development (NICHD), more than one-third of women in the U.S. have a pelvic floor disorder and almost a quarter have one or more symptomatic pelvic floor disorders. Musculoskeletal dysfunction within the muscles of the pelvic floor contributes to many different pelvic floor disorders, and physical therapy treatment is now being recognized within the literature as a first-line of defense against a variety of pelvic floor disorders.

What is Pelvic Floor Physical Therapy?

A physical therapist goes through extensive education in order to evaluate and treat musculoskeletal and neuromuscular dysfunctions throughout the body, including the pelvic floor. Physical therapists that have specialized training in treatment of the pelvic floor can provide skilled one-on-one care to individuals suffering from a variety of pelvic floor disorders, including but not limited to urinary incontinence, fecal incontinence and pelvic organ prolapse. Due to the sensitive nature of this particular therapy, many people are incredibly nervous and do not know what to expect when they arrive for their initial evaluation. Special care is taken to ensure that the patient feels comfortable and is, at all times, in control of the evaluation and treatment.

During the initial evaluation, a history is obtained and an objective assessment is performed, in order to create an individualized treatment plan based on the specific complaints and symptoms the patient is experiencing. After a plan of care is established on the initial evaluation, patients typically return 1-2 times per week for 45-minute treatment sessions. Treatment of pelvic floor disorders include a combination of manual therapy techniques, pelvic floor muscle exercises and behavioral training, tailored to address an individual patient’s needs.

Overall, pelvic floor physical therapy care is geared toward eliminating the symptoms of pelvic floor disorders, in order to improve an individual’s quality of life. Understandably, people are often embarrassed or ashamed of their condition and the symptoms it causes, which hinders discussions with their loved ones and physicians, and ultimately, causes a delay in the initiation of treatment. Pelvic floor physical therapy is a non-invasive treatment option that can drastically reduce, if not eliminate, the uncomfortable symptoms associated with these conditions. Don’t wait. There is hope. If you or someone you know is suffering from a pelvic floor disorder, speak with your Physician regarding a referral for Physical Therapy care.