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Pelvic floor physical therapy: What you need to know |
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Pelvic-floor bodywork and musculoskeletal therapy promote strength, relaxation, and coordination in the pelvic-floor muscles so as to help treat muscle issues on the pelvic floor and associated medical issues. When pelvic-floor muscles have sufficient strength and tone, It also has a positive impact on the corresponding pelvic organs, urine, and bowel movements.
Pelvic muscle tone may alter if muscles get too stretched and easy or too tight and stretched, usually resulting from childbirth or aging, or other stressors. Lowered and increased muscle tone in the pelvic floor muscles may lead to pelvic floor dysfunction.
According to the results of current clinical tests, pelvic floor physical therapy should be the first-choice treatment for use in a minimally invasive way to treat different forms of pelvic floor dysfunction, such as pelvic organ prolapse, incontinence, fecal incontinence, and painful intercourse.
Process
On the day of your physical therapy evaluation, you will be brought to a private room where your physical therapist will review your medical history, symptoms, and complaints. Your physical therapist will next conduct an internal and external physical examination. During the physical exam, your physical therapist will examine your lumbar spine, sacroiliac joints, and the muscles that surround or attach to the pelvis, including the rectus abdominis, iliopsoas, and piriformis, for pain, tightness, or tenderness.
During the internal examination, your physical therapist will check your pelvic floor muscles for muscle tone, elasticity, and tenderness. Your therapist will use one or two gloved fingers in your vagina and or rectum to palpate your pelvic floor muscles from the inside. A lubricant will often be used to help ease the discomfort.
Your physical therapist will also evaluate your ability to perform voluntary contraction and relaxation of your muscles of the pelvic floor, along with breathing patterns.
After your physical therapist has carried out exterior and interior examinations and made a clinical judgment regarding the possible causes of your symptoms, you will be scheduled for follow-up visits. Every follow-up appointment will take place in a private treatment room.
Your treatment may consist of the following:
- Physical exercises or movements like Kegels are a great way to relax or contract your pelvic muscles.
- Manual therapy may be done by the physical therapist to ease the muscles of the pelvic floor and relieve stress points.
- Biofeedback through the insertion of a sensor probe into your vagina or rectum, so that you can sense the strength of contractions of the pelvic floor muscles to understand when you are contracting or relaxing these muscles.
- Electrical stimulation to help elicit pelvic floor muscle activation.
Who Does It
Pelvic floor physical therapy is treatment from a certified physical therapist who is specially trained to address pelvic floor disorders. A physical therapist can either obtain a Certificate of Achievement in Pelvic Physical Therapy (CAPP) or a lot more specialized coaching and abilities as a women's health skilled specialist (WCS) to treat medical conditions related to women's health.
Conditions Treated
Pelvic floor physical therapy is used to treat various types of pelvic floor dysfunction. Pelvic floor dysfunction can be divided into hypotonic, or low tone, and hypertonic, or high tone, disorders.
Muscle tone is the amount of muscle contraction and relaxation in your muscles when it's not contracted. Too little or too much tone in the pelvic floor muscles can trigger different sorts of pelvic floor dysfunction.
Low Tone Disorders
If your muscle tissue has a low tone, it magnifies your discomfort and makes it harder for you to actively contract. When pelvic muscle tissue happens to be fatigued and somewhat weak owing to low tone, this affects your core strength and may cause problems when it comes to bladder and bowel movements.
Low tone pelvic floor disorders include:
- Pelvic organ prolapse: Abnormal descent of the pelvic organs, including the uterus, vagina, bladder, or rectum, from their normal positioning can sometimes be characteristic of pelvic organ prolapse.
- Stress incontinence: Involuntary dripping of urine during activities that increase intra-abdominal pressure, including coughing, sneezing, laughing, squatting, and heavy lifting.
- Overactive bladder: Urinary urgency, frequency, and urge incontinence form the basis of a medical condition known as bladder contracting.
- Anal incontinence: Involuntary leakage of fluid, gas, or stool from the rectum.
High Tone Disorders
Whenever a muscle mass has a high tone, the muscle is tighter and more restricted than normal. This can sometimes lead to pain when trying to relax or stretch the muscle. If the pelvic muscles become excessively tight as a result of high tone, you may experience pelvic pain, muscle spasms, pain, and difficulty in insertion during intercourse or a gynecological exam.
High tone pelvic floor disorders include:
- Pelvic floor myofascial pain: Chronic pain that results from tightened pelvic floor muscles
- Vaginismus: Uncontrolled, involuntary spasm of the muscles surrounding the vagina that occurs with penetration
- Dyspareunia: Pain during sexual intercourse from vaginal penetration
- Vulvodynia: Pain and discomfort in the vulva, often referred from tight and dysfunctional pelvic floor muscles
How to Prepare
To prepare for pelvic floor physical therapy, you should wear comfortable clothes that allow you to move freely without restricting your movements. Your exam includes a secondary component, so be sure your groin and genital area is clean before your visit.
It can be beneficial to come prepared with a list of questions and concerns you'd like to ask your physical therapist during both exams and evaluations. Come prepared with extra time to fill out the initial paperwork for your first visit to the physical therapy facility.
You should bring the following with you to your first appointment:
- Form of identification, such as a driver’s license or passport
- Health insurance card
- List of any medications you are taking
- A prescription from a referring physician, if needed
Eligibility
Those who have low muscle tone or high muscle tone forms of pelvic floor dysfunction and related pelvic floor muscle pain can benefit from pelvic floor physical therapy.
Pelvic pain may not necessarily stem from pelvic floor muscle dysfunction. Pain in the pelvic region may actually be symptom of a more serious illness.
- Burning sensation during urination
- Heavy bleeding during menstruation
- Severe menstrual cramping
- Irregular periods
- Blood in urine or stool
- Abnormal vaginal discharge
- Fever
- Chills
- Nausea and vomiting
Before you start treating any symptoms, contact your primary care physician or gynecologist. You might be suffering from an infection or other condition that is related to your gastrointestinal, urinary, or reproductive organs that require medical care.
Summary
Pelvic floor physical therapy is a treatment option for pelvic floor dysfunction, whether pelvic muscles are too tight or too weak. It can help with problems urinating, performing sexually, and other conditions. The initial assessment of this form of therapy includes an examination of the patient's pelvic region.
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