What is Pelvic Floor Physical Therapy?

Pelvic floor physical therapy is more than just a prescribed number of kegels. If you’ve heard of pelvic floor physical therapy, you might be wondering what it is, how it can help, and how it differs from traditional physical therapy. Read on to learn all about pelvic floor physical therapy!

What is Pelvic Floor Physical Therapy?

Pelvic floor physical therapy is a specialized area of physical therapy that focuses on dysfunctions that affect the pelvic floor muscles or nerves. The pelvic floor muscles are the muscles that create a bowl at the bottom of the pelvis (see picture below). These muscles function to support all the abdominal contents and organs, stabilize the pelvis and spine, aid in labor and delivery, control the bowel and bladder, and support sexual function.

Here are three views of the pelvic floor muscles. All the red areas you see are the pelvic floor muscles!

pelvis model, side view
(Looking straight on to the pelvis)
Pelvis model, top view
(Looking into the pelvis from the top) 
Pelvis model, bottom view
 (Bottom up view of the pelvis)

How can Pelvic Floor Physical Therapy help me?

Pelvic floor physical therapy can be used to treat pelvic floor dysfunctions. Dysfunctions of the pelvic floor include incontinence, pelvic organ prolapse, diastasis recti, painful intercourse, pelvic pain, cesarean delivery recovery, etc. 

To find out if you have pelvic floor dysfunction, here's a quick quiz:

  1. Do you leak urine (even just a little) or feces or accidentally passing gas while exercising, playing a sport, jumping, laughing, coughing, or sneezing?
  2. Do you need to hurry to the bathroom and/or do you worrying you may not get there in time?
  3. Do you take frequent trips to the bathroom (more than 8 times per day) that disrupt your activities throughout the day or your ability to sleep?
  4. Do you experience feelings of heaviness or pressure on the pelvic floor or in the vaginal area? Or do you have a history of pelvic organ prolapse?
  5. Do you experience pelvic, vaginal, or tailbone pain with sitting, walking, exercise, or with intercourse?
  6. Do you have feelings of constipation more than 2 times per month?
  7. Do you know you have an abdominal separation or diastasis recti? 

If you answered “yes” to any of the following questions, you would benefit from pelvic floor physical therapy (PT).

What does pelvic floor physical therapy entail?

Treatment can include exercise, stretching, body mechanics and posture retraining, breath training, and internal or external manual therapy. During a pelvic floor PT evaluation we will identify what specific areas of treatment will best help you to get back to the best you possible! There is no cookie cutter approach for pelvic floor PT. The key to success with pelvic floor PT is addressing the whole body so all of the different parts can work together to solve the dysfunction that is occuring. 

Internal Treatment? That sounds awkward!

In order to fully understand the specific pelvic floor dysfunction that you are experiencing, an internal pelvic floor assessment may be necessary. An internal assessment is only performed if the client is comfortable with it. And we will stop at any point that you experience pain or aren’t comfortable with the assessment. 

An internal assessment really is not as scary as it sounds. Luckily, we don’t use a speculum or the crazy table with stirrups. We use just one finger, and you’ll be able to relax on one of our typical treatment tables (think: massage-style table). We can vaginally assess the three different layers of the pelvic floor, assess for scar tissue (possibly from tearing with a vaginal delivery), check for prolapse, and assess the strength and coordination of the pelvic floor muscles. With a complete internal pelvic floor assessment, we can narrow down what specific treatment you may require. 

Still not so sure about an internal assessment? No problem! Pelvic floor PT doesn’t have to involve or require an internal assessment. There are many other areas of the body that we assess, and we can begin treatment externally in most cases.

What if the assessment is painful?

The assessment should not feel painful. If you start to feel uncomfortable or you feel pain we do not have to assess any further. You are in control and always have a say in all the assessments and treatments that we do.

What if I just do more kegels instead, won’t that help?

There are occasions where sometimes doing kegels can help pelvic floor dysfunctions. But in order for us to give you the best recommendations we usually don’t recommend kegels without assessing the pelvic floor first. Perhaps your pelvic floor muscles have gotten so tight after having a baby (this is super common!). This could be causing your painful sex or urinary incontinence. With manual pelvic floor therapy, we will gently release the pelvic floor muscles before jumping into kegels. This will prevent kegels from making the problem worse because the muscles are already in a contracted or tightened state.

Read more about when to not do kegels in this blog post.

If I’m not working on kegels, will you give me things to do at home?

More than likely, yes. To make your time at PT as beneficial as possible we work on treatment that can only be provided in the clinic instead of spending time on more simple activities (such as exercise or ice/heat) that you can do at home. We understand you are busy and try to narrow down home exercises to only a few key exercises to give you the best outcomes. 

The Revitalize Difference

In our experience, we have seen a common theme that so many women have suffered for months or years with unresolved pain or dysfunction without improvement or answers. Maybe you’ve been told to just wait six more months and it will get better. Or that your pain or leakage is just part of becoming a mom. Or maybe that you just need to relax more. All the while the issue you are dealing with doesn’t improve or even worsens, which is just plain frustrating. 

At Revitalize Physical Therapy, we focus on making our clients feel comfortable during treatment since these can be very sensitive topics to talk about. Our office includes private treatment rooms with a door that fully closes for privacy.. We also work FOR our clients in order to give them exactly what they need to get better faster because we don’t like to waste your time or money!  We believe in providing a personalized, hands-on approach to each of our clients.  We work together with you to develop a game plan that will work best for you and give you the best results so you can live a healthy, active life!  

For more about what your first pelvic floor visit may look like check out our video! If you''d like to know more about how pelvic floor physical therapy can help you, contact us to set up a free consultation!

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