DO I need pelvic floor Physical therapy?
What is the pelvic floor?
The pelvic floor is a system of muscles, ligaments and connective tissue inside of your pelvis that help you to urinate, defecate and have sexual intercourse. They also provide postural support for your pelvic organs, low back and hips and coordinate with breathing.
What is Pelvic Floor Physical Therapy?
Pelvic floor PT restores normal, pain free function to the pelvic floor through the use of manual techniques, exercise, patient education, and other tools such as dry needling. I practice a movement-based, hands-on, whole body approach to treating pelvic pain, urinary, bowel, and sexual dysfunction and pregnancy and postpartum care. Or, as normal people say, issues with pooping, peeing, pregnancy and sex. People of all ages can have pelvic floor dysfunction with or without a history of pregnancy. Additionally, people of any gender can experience pelvic floor dysfunction, but I currently only treat women or people with female anatomy with pelvic floor dysfunction.
What can Pelvic Floor Physical Therapy treat?
If you have difficulty with any of the following areas, pelvic floor PT can help! You don’t have to “just deal” with these problems, and I will do my best to help restore your pelvic floor to its optimal function.
Pooping:
frequent constipation or diarrhea
straining or pain with bowel movements
difficulty emptying bowels fully
leaking or staining stool
Peeing:
leaking pee with a strong urge on the way to the bathroom or with coughing, sneezing, laughing or exercise
pain during or after peeing
peeing more often than every two hours or multiple times at night
difficulty starting your stream of urine
difficulty emptying your bladder fully
Sex:
pain with initial or deep penetration
pain with or inability to orgasm
pain with external stimulation
pain after sex
unwanted sensations of genital arousal without sexual desire that cause distress
Pregnancy and Postpartum:
any of the above issues with pooping, peeing or sex during pregnancy
low back, hip, tailbone or pubic bone pain during pregnancy
perineal pain postpartum
c-section pain postpartum
diastasis recti (separation of abdominals) postpartum
Other issues:
sensation of heaviness or like something is falling out of the vagina
tailbone pain
rectal pain
low back pain or hip pain that doesn’t get better with orthopedic physical therapy
pain with pelvic exams or tampon insertion
severe pain before, during or after your period
abdominal pain post hysterectomy or endometriosis surgery
What should you expect from your first Pelvic Floor Physical Therapy appointment?
Symptom Assessment
In order to understand how best to treat your condition and to develop an individualized plan for you, I will begin by hearing your story to get an overall understanding of your pelvic floor function. This will include questions about your menstrual cycle, water and fiber intake, any pregnancies and deliveries you’ve had, how your bladder and bowels function, your current tolerance for sexual activity and your goals for PT.
Physical exam
The exam is an assessment of the mobility and strength of your low back, hip and pelvic joints and muscles, an evaluation of your functional movements and breathing mechanics, and an external and an internal pelvic floor examination.
The external pelvic floor examination is performed to see how different muscles of the pelvic floor function voluntarily and involuntarily. I will ask you to perform exercises or motions (like a kegel, coughing and bearing down) to see if you can fully relax and contract the pelvic floor muscles correctly. I will also identify any painful muscles or tissues of the vulva.
With your permission, I will perform an internal pelvic floor muscle examination, similar to an exam by your gynecologist but without stirrups and speculums. The muscles of the pelvic floor should be resting with a little tension in order to keep sphincters closed to keep pee and poop from coming out when you don’t want them to. Too much or too little resting tension of these muscles can cause dysfunction. The internal exam provides essential information on resting tone, muscle function, mobility and tenderness of your pelvic floor muscles in order to determine the best exercises and techniques for you. The exam will be explained to you step by step and is only performed to your comfort and pain level. The internal exam does not have to be performed on the first visit if you’re not ready. It can be performed if you are on your period as long as you feel comfortable.
