Pelvic floor physical therapy is a treatment for problems related to the pelvic floor. This specialized therapy includes exercises that can help relieve symptoms like pain, discomfort, and disruptions to your quality of life.
The Pelvic Floor
Everyone has a pelvic floor. It’s made up of the muscles that support the urinary and reproductive tracts. This group of muscles also controls your bladder and bowels.
In women, the pelvic floor keeps your bladder in place in the front and the vagina and rectum in the back. Your uterus is held in place at the top of the pelvic floor by muscles, tendons, and connective tissue. In men, the pelvic floor helps keep the bowels, bladder, urethra, and rectum in place.
The pelvic floor muscles attach to your tail bone and pubic bone. If the muscles in the pelvic floor are weak or don’t work as they should, this is called pelvic floor dysfunction.
Pelvic Floor Dysfunction
When you have pelvic floor dysfunction, your pelvic muscles can’t relax or work together the way they should. If these muscles can’t relax, only tighten, you may have:
- Constipation
- Peeing frequently
- Trouble controlling your bowels or urine, leading to leaks
- Pain during sex in women
- Erectile dysfunction in men
Sometimes, experts aren’t sure what causes pelvic floor dysfunction. But things that may trigger it include:
- Pelvic surgery
- Aging
- Pregnancy
- Being overweight
- Overuse of the pelvic muscles
- Serious injuries to the pelvic area
Physical Therapy
Pelvic floor physical therapy is a specialized kind of physical therapy to relieve the symptoms of pelvic floor dysfunction and help the muscles work the way they should. This includes several exercises that help your pelvic muscles relax and get stronger.
When you begin pelvic floor therapy, a physical therapist (PT) will learn more about your symptoms. Your PT will check your core muscles to see how strong they are, along with how much core endurance you have. Your PT will also have you try certain activities and positions to check the coordination of your pelvic floor muscles.
Your assessment helps your PT make a pelvic floor physical therapy plan that best suits your needs. Your treatment will probably include both internal and external therapy. But they won’t begin internal therapy until you’re ready, because this can be uncomfortable for some people.
The goal of pelvic floor physical therapy is to ease your symptoms so that you can get back to your daily routine. This includes being able to control your bladder better or take part in sports and exercises that you enjoy.
Physical therapy can also relieve the discomfort and pain that women may feel during sex. Some exercises may help them to become more aware of their muscles and have better orgasms.
Techniques and Exercises
Pelvic floor physical therapy can include techniques or exercises like:
Trigger point therapy. This technique puts pressure on a spot on your body, internally or externally, called trigger points. Your doctor or PT may also inject anesthesia into the area.
Kegels.Kegels are a popular exercise for strengthening the pelvic floor muscles by contracting and relaxing them. This exercise can help relieve pain during sex and control incontinence. Your PT can teach you how to do Kegels so that you can get the most out of this exercise.
Electrical stimulation. This technique helps to reduce pelvic pain and muscle spasms. Your PT may do this in the office or teach you how to do it at home with special equipment.
Biofeedback. This technique uses devices to check the contraction of your pelvic floor muscles. Your PT will most likely use biofeedback to see how your exercises are going and to watch for improvement. They may place electrodes on the outside of your body, such as between the vagina or anus. Or they might use an internal probe to measure the tension and relaxation of your pelvic floor muscles. The results are shown on a computer screen, and your PT will discuss them with you.