Pelvic floor physical therapy at a glance
- The pelvic floor is the group of muscles stretching from a woman’s tailbone (back) to pubic bone (front) that serve as a physical support to local organs.
- Over time, weakness of the pelvic floor muscle can adversely affect urination, bowel function and sexual intercourse.
- Pelvic floor physical therapy offers a series of nonsurgical interventions.
- Physical therapists help women to retrain their pelvic floor muscles through outpatient sessions to improve function and strength, typically within six to eight weeks.
Benefits of pelvic floor physical therapy
This pelvic floor acts as a support structure to the bladder, uterus, rectum and urethra, which aids bladder retention. The ability to relax and contract the pelvic floor allows for healthy function of the bladder and bowels.
The pelvic floor can become weak or damaged resulting in a pelvic floor disorder, such as pelvic organ prolapse, urinary or fecal incontinence, and other storage and evacuation problems. When this occurs, pelvic floor therapy can help to “rewire” the brain and muscles to control the coordination of key muscle groups.
Every patient undergoing pelvic floor physical therapy will have a specialized program built around the level and frequency of rehabilitation needed.
What pelvic floor dysfunctions does the therapy address?
Pelvic floor therapy can be used to address a variety of conditions such as:
- Urinary incontinence & frequent urination, including frequent nightly urination.
- Overactive bladder.
- Stress incontinence.
- Pelvic organ prolapse.
- Fecal incontinence.
- Chronic constipation.
- Pregnancy and postpartum wellness.
Pelvic floor therapy can also help improve other conditions such as rectal pain, painful intercourse, chronic pelvic pain, endometriosis, vaginismus, and menopause symptoms.
Physical therapy treatments for incontinence, prolapse and the pelvic floor
We offer multiple types of treatment options for someone who is suffering from a pelvic floor disorder. When your provider feels that physical therapy would be the ideal treatment option, they will refer the patient to a local physical therapist who specializes in pelvic floor rehabilitation. The physical therapists will find the best type of therapy for each patient depending on the condition, her medical history and the desired outcome.
Pelvic floor exercises
Physical therapists teach patients how to properly do Kegels and other exercises to contract and relax pelvic floor muscles. They will also teach breathing and timing techniques to make the exercises the patient is learning more effective. The goal of these exercises is to stretch tight muscles, strengthen weak muscles and improve flexibility.
Manual therapy
A physical therapist may use soft tissue mobilization techniques to help with muscle tightness, function and posture of the pelvic floor. Physical therapists may also show patients how to use a vaginal dilator during this time. A vaginal dilator is a tube-shaped device that can help women learn to relax their pelvic muscles to allow for easier penetration or help women who have been treated for gynecologic cancers.
Bladder training
A physical therapist can help patients learn how to extend the time between voiding. This can be done through scheduling times to use the bathroom and managing the overwhelming urges to urinate.
Biofeedback therapy
Biofeedback therapy involves placing a sensor near the pelvic floor muscles, which transmits the amount of force the woman is exerting to a computer. The computer displays the results on a monitor so the patient can immediately see whether she is using the correct muscles. Once she gets a sense of how to properly do the exercises, she can continue doing them without biofeedback therapy.
Electrical stimulation
In extreme circumstances, a physical therapists might need to suggest a treatment called a percutaneous tibial nerve stimulation (PTNS) as the main external electrical stimulation device. This low voltage electrical current is sent up from the ankle to the pelvic floor via the tibial nerve.
Physical therapy follow-up
- Following the initial evaluation, the therapist will put together an exercise program and schedule follow-up appointments to assess muscle coordination, strength and overall function.
- Patients typically will experience improvement in pelvic floor function 3-4 weeks following strength training.
Where to receive physical therapy treatment for the pelvic floor
If a patient needs to be seen by a physical therapist, a list of local specialized therapists will be provided.