How do I know if I need Pelvic Floor Physical Therapy?
Your pelvic floor is a 3 layered muscle group that supports your pelvic organs. It’s often described as a hammock that holds your bladder, uterus, vagina, urethra, and rectum. After vaginal births, C-section procedures, multiple UTIs, menopause induced hormonal imbalances, tailbone injuries, chronic low back pain, and sexual abuses, our pelvic floor muscles suffer and require additional care to return to previous length, strength, function, and mostly importantly, a healthier connection to our brain.
1. What are the common pelvic floor dysfunction symptoms?
• Leaking urine when you run, jump, laugh, sneeze, or cough；
• A feeling of pressure or heaviness in your pelvic area；
• Feeling a bulge in your vagina or feeling like something may be slipping out of your vaginal canal；
• Abs separation/doming when lifting and doing exercises；
• A frequent urge to pee;
• Constipation and bowel movement issues;
• Difficulty emptying your bladder;
• Sexual dysfunction, including pain with intercourse and difficulty reaching orgasm;
• Chronic lower back pain persistent after traditional orthopedic physical therapy or chiropractic care.
2. What diagnosis do Pelvic Floor Physical Therapists Treat?
• Urinary Incontinence
• Pelvic Pain
• Diastasis Recti Abdominis (DRA)
• Coccydynia (Pain in the tailbone)
• Constipation
• Endometriosis
• Interstitial Cystitis
• Low Back Pain
• Osteoporosis
• Painful Intercourse
• Pelvic Organ Prolapse
• Perineal Massage
• Piriformis Syndrome
• Prepartum PT
• Postpartum PT
• Pubic Symphysis Pain
• Pudendal Neuralgia
• Sacroiliac Joint Dysfunction
• Sciatica
• Vaginisimus
• Vulvodynia and Vesitulodynia
3. Who are pelvic floor physical therapists (Pelvic Floor PTs)?
Physical Therapists, PTs, are a group of medical professionals who are experts of muscles, joints and nerves. In the United States, PTs are required to have a doctorate degree (3-year program) to practice and also encouraged to specialize in different areas with continuing education such as residency and fellowship programs. Pelvic Floor PTs are the experts in the pelvic area with additional practical trainings on internal pelvic floor assessment and treatments, and extensive knowledge of pelvic floor specific pathologies. They are trained to treat your body as a whole while solving pelvic floor specific issues. They are also a very tight community across the globe with limited providers. You may find your pelvic floor physical therapist in your region here https://pelvicrehab.com/
4. What Treatment Methods do Pelvic Floor Physical Therapists Use?
Healing is not a one-size-fits-all approach. Treating a patient who leaks when she jumps and laughs is vastly different than treating someone who feels their vagina falling out during running or impact activities. An extensive medical history and physical exam reveals whether poor posture, faulty biomechanics, tight muscles, trigger points, weakness, or nerve disorders are part of your problem. Additionally, restricted scar tissue or adhesions, connective tissue and fascial restriction are always assessed.
We understand that in China, the go-to “postpartum rehab” is biofeedback machine training for the pelvic floor muscles. We believe, although biofeedback is a great tool to activate the pelvic floor muscles, guiding patients to learn how to use their pelvic floor muscles in functional daily activities, and assessing pelvic floor coordination with the core muscles, diaphragm, and even whole body movements are the true holistic method to allow patients to heal.
YOUR INDIVIDUALIZED TREATMENT PROGRAM MAY INCLUDE ANY OR ALL OF THE FOLLOWING:
• Manual therapy including myofascial release, trigger point release, joint mobilization, muscle energy techniques and connective tissue mobilization;
• Pilates based therapeutic exercise;
• Scar tissue adhesion release (graston tool, myofascial decompression / cupping therapy) ;
• Nerve flossing and neural tension releases;
• Neuromuscular re-education techniques;
• Core stabilization training;
• Functional exercise and prescriptive therapeutic exercise;
• Physioball and foam roller exercise;
• Postural re-education;
• Patient and family education;
• Instruction in a home exercise program;
• Pelvic floor biofeedback.
5. What to Expect to Your first Pelvic Floor PT treatment?
Like any other medical consultation, your PT will start with a number of questions to understand your health and concerns, like health history, current symptoms, lifestyle and habits etc. These questions can feel intimate and quite personal, and anything you discuss with your PT is kept confidential, and they will only ever ask you health questions relevant to your care.
Depending on your symptoms and concerns, your PT may perform an external and internal examination to assess your whole body, pelvic floor muscles and internal tissues. They will ensure you feel informed at every step of your examination, and they will always ask for your consent, which you are free to revoke at any point during your visit. Your comfort and safety is the top priority. Regarding to physical check-up, you do not need to wear something specific, just be comfortable and that’s it! As long as they will not restrict movement, as some treatments can involve hands-on therapies and exercises.
*For pregnant women, it’s suggested coming in after the first trimester. From 15-16 weeks pregnant, the game plan is to start strengthening the pelvic floor muscles, and at around 34 weeks we can prepare for labour and delivery. After baby arrives, we recommend waiting until the six-week postpartum check-up to consult your doctor for pelvic floor therapy.
