Pelvic Floor Rehabilitation

Pelvic floor physical therapy involves evaluation and treatment of the pelvic floor muscle group. These muscles are responsible for supporting the pelvic organs, assisting in bowel and bladder control, and contributing to sexual arousal and orgasm.

 

A person may be referred to pelvic floor physical therapy for any of the following symptoms:

 

  • Frequent urination

  • Strong urge to urinate (urgency)

  • Unwanted loss of urine or stool (incontinence)

  • Pain in the pelvis, hip, abdomen, thigh, low back, including with intercourse

  • Constipation

  • Pregnancy/post-pregnancy pain or incontinence

These symptoms are often caused by imbalances in muscle tone and strength of the pelvic floor and associated muscles and structures. The strength and muscle tone in your low back, hips, and abdomen will be assessed, along with your posture and spinal movements.

 The pelvic floor may be evaluated externally or internally. Your therapist and you will discuss ahead of time the right option for you.

An internal exam means that your therapist will use one finger, either vaginally or rectally, to do the assessment. This is different from a female gynecological exam, which uses instruments such as a speculum. The purpose of the exam is to assess muscle strength, excess tightness, trigger points (small muscle “knots”), painful areas, and muscle coordination. Usually, the internal exam is not painful. If you are coming to therapy because of a painful condition, it’s important during the exam to identify the specific muscles that are causing pain. This will help to create a proper plan of care.

Pelvic floor physical therapy treatment includes:

  • Strengthening or stretching exercises of the trunk, legs, or pelvic muscles

  • Relaxation and breathing exercises 

  • Coordination exercises

  • Education in self-management and prevention

Pelvic floor therapy treatment will vary depending on the specific problems

identified. It is recommended as a first-line treatment for many disorders of

the pelvic region.