Pelvic Floor Physical Therapy is a specialized area of practice within physical therapy that helps to address the health and function of muscles, ligaments, and structures that attach, sit within, or cross the pelvis. Dysfunction of the musculoskeletal structures of the pelvic region can cause or contribute to such diagnoses as pelvic inflammatory disease, stress incontinence, urge incontinence, irritable bowel syndrome, chronic constipation, coccydynia (tailbone pain), diastasis, prolapse, pain with pregnancy, pain with sexual activities, vulvodynia, and more. By finding areas of tightness or weakness in the muscles and soft tissue structures of the pelvic floor and addressing these concerns through release of tension, stretching, strengthening, and re-alignment, symptoms of pelvic pain, prolapse, incontinence, pain with sexual function, and more can be successfully managed and treated.
What is the pelvic floor?
The pelvic floor muscles make up a hammock or “sling” to support the abdominal organs. These muscles are supposed to be active in some movements of the hip and are necessary for balance, breathing, bladder, bowel, and sexual function. Dysfunction of these muscles – meaning weakness or abnormal increase of tone – can cause or contribute to pain or instability with active motions such as jumping or running, and can also contribute to bowel and bladder control issues and difficulty or pain with sexual activities. Pelvic floor musculature can become dysfunctional during or following pregnancy and delivery (both vaginal and cesarean) as well as following abdominal, prostate, and other surgeries, or from hip or back injuries or weakness or due to instability in other areas of the body.
The muscles in the pelvic floor function just like other muscles in our body in that they contract, stretch, relax, create movement, and have a resting tone. Male and female bodies have nearly identical musculature in the area.
Do I need pelvic floor therapy?
If you are having pain in the pelvic region, have been referred to find a pelvic floor physical therapist by another medical professional, or have bladder or bowel control problems, pelvic floor physical therapy might be right for you.
Leaving pelvic floor issues untreated can affect your quality of life. Patients who find they don’t want to run anymore for fear of leaking urine, are afraid of going out for a whole day because of fear they’ll need a toilet when it’s not convenient, and folks who fear allergy season not for the runny nose but the need to change underwear after every sneeze will find pelvic floor physical therapy a good option.
If you’re scared of addressing these issues, know that you are not alone and we are here to help. You deserve to have your whole body function at its best. Leaving issues untreated can compound the side effects down the line, leading to prolapse or worsening incontinence. Not sure if you’re ready for an appointment – send an email or call and maybe we can answer some of your questions to see if Good Life Physical Therapy is the right place to address your concerns.
What will an exam be like?
As with all treatments, the comfort of our clients is paramount and your comfort is the guide for what parts of the examination and treatment are performed.
For a pelvic floor exam, you will arrive at our private office and sit with your therapist and review your medical and social history. You are welcome to bring a companion with you to stay with you for any or all of the exam. Questions will include the history of your pain or dysfunction, areas of your life that are affected, and any questions you have. Following a thorough history, you will be asked to do some simple movements so your therapist can assess specific muscles and joints. Depending on the concerns you have, these might include actions such as standing on one leg, turning from side to side, or bending forward to touch your toes. Your therapist will then palpate (feel) for certain muscle contractions and tension in areas of your body related to the pelvis such as the low back, hips, and legs. Following this, the option will be given to perform an external and/or internal exam for further specific testing of the muscles that line the pelvis. If you choose to proceed, the therapist will step out of the room and you will remove clothing from the waist down and lay on the treatment table with a sheet covering you. When you’re ready, the therapist will enter the treatment room and will explain the procedures step by step as your abdominal and pelvic floor muscles are assessed. This process takes just a few minutes. Following this, the therapist will step out of the room again, you will get dressed, and then we will review the findings of the exam with you. A treatment plan will be established and discussed and some activities for you to do at home may be suggested.
Treatment for pelvic conditions includes muscle reeducation, release of muscle tension, strengthening, and activity modification. Goals will be individual for each client but might include things like decreasing the frequency of urinary leakage, improving balance, decreasing pain with sitting, improving the ability to fully empty bowels or bladder, decreasing urinary frequency, improving sexual function, or decreasing pain with sexual activities.
Dr. Myriah has taken continuing education courses with the Herman Wallace Institute, the premier research and education institute in America on pelvic floor rehabilitation.
Pelvic Floor PT FAQ
- What should I wear?
You can wear anything you are comfortable in. Clothing that moves easily is recommended, such as clothing you might work out in.
- What if I’m on my period?
Most female bodies have increased sensitivity around the menstrual cycle. It’s perfectly ok to come to physical therapy, including pelvic floor physical therapy, when you are menstruating; however, you may feel increased sensitivity to the tissues.
- I’m not sure I want an internal exam
That’s perfectly ok. If you believe you have pelvic floor dysfunction, seeing a qualified physical therapist is a good idea. We can review your history and perform an exam of the muscles in your back, hips, and abdomen without having to do an internal examination.
- I’m a male-bodied person – Do I have a pelvic floor?
Yes, you do! And it’s extremely important in your bowel, bladder, and sexual function. Dysfunction of the pelvic floor in males is treated similarly to dysfunction in females. An examination can be external only or can include an internal exam.
- Are you just going to tell me to do kegels?
Kegel exercises are one type of pelvic floor exercise. Some clients may benefit from kegels; however, some clients may have increased tension in the tissues of the pelvic floor, and releasing, not increasing, that tension may alleviate symptoms. If kegels are going to be helpful for you, we have found that many people benefit from guidance to perform the most effective kegel exercise.
- Do the pelvic floor muscles have names? Yes they do!
1. Coccygeus
2. Levator Ani
3. Pubococcygeus
4. Iliococcygeus
5. Puborectalis
6. Ischiocavernosus
7. Bulbospongeosus
8. Piriformis
9. Obturator Internus
10. Puborectalis
11. External Anal Sphincter
12. Urethral Sphincter
- I’ve had traumatic experiences
Trauma, both emotional or to the body, including specifically of the pelvic region, is unfortunately not uncommon. We are here to be on your team and look to you for positive consent throughout all sessions. Choosing to discuss your history is always a choice and will never be required. Choosing to proceed with any element of examination or treatment is always a choice and never required. Good Life Physical Therapy strives to create a safe and supportive space for all people, regardless of history, sex, sexual orientation, or gender identity. You are welcome to bring a supportive friend or family to any or all appointments. We invite you to share your limitations and/or concerns at all times throughout treatment. If there is anything you see we can do to improve your comfort, our inclusivity and safety, or our sensitivity to your needs, please let us know.
Pelvic Floor Physical Therapy in Tarrytown, NY
Book an appointment with Dr. Myriah Pahl today. She offers pelvic floor physical therapy in Tarrytown, NY.
