What is Pelvic Floor Physical Therapy?
Updated: Apr 23
One of the most unknown and underrated physical therapy (PT) specializations is pelvic floor PT. This specialty utilizes the principles of physical therapy in order to provide a structured and effective reconditioning of the pelvic floor muscles, ligaments, and connective tissues. These muscles, ligaments, and connective tissue work together in order to support the pelvic organs, play a role in sexual arousal, and aid in bladder and bowel control. The pelvic floor is essentially a bowl-shaped set of muscles that supports the bladder, bowel, rectum, and uterus. The aim of this type of PT is to improve the strength and function of the pelvic floor muscles and alleviate pain and weakness in the muscles. Initially in 1995, pelvic floor PT was referred to as women’s health. However, in an effort to be more inclusive and to acknowledge the fact that men can also face pelvic floor issues that can be solved through PT, pelvic floor has been used more commonly to refer to the specialty.
When the pelvic muscles don’t perform as they should, several issues can arise following with pain and discomfort in varying degrees. Pelvic pain may sometimes occur when muscles of the pelvic floor are too tight and this can cause a condition called myofascial pain (pain caused by muscle irritation). Some of the issues a pelvic floor PT can help alleviate are painful urination, endometriosis, constipation, menopause symptoms, postpartum and pregnancy wellness, testicular pain, among many other dysfunctions.
A physical therapist will begin by taking the history of the patient, this includes prior surgical and medical history, medications, and sexual, gynecologic, or obstetric history. Then, a thorough orthopedic examination is conducted with increased attention to the lumbar spine and hips, gait and posture. This examination often includes the evaluation of both the internal and external muscles. Patients can expect to be asked to stand, walk, and sit in order to help the therapist in detecting any underlying posture or joint issues affecting the muscles in the pelvic floor. As usual, the type of therapy that is recommended to the patient depends on the symptoms they are experiencing. Relaxing and lengthening muscle exercise may be given to relieve certain symptoms whereas for other symptoms strengthening exercises may be more appropriate. Pelvic floor therapy techniques are mostly hands on. External therapy techniques include nerve release, trigger point therapy, deep tissue massage (myofascial release), skin rolling and joint mobilization.
The eventual treatment plan created by the PT may include a combination of: stretching or strengthening exercise of the legs, trunk, or pelvic muscles, coordination exercises, relaxation exercise for shortened pelvic muscles, and ice, heat, or electrical stimulation modalities. Ultimately, the treatment plan conducted by the PT aids in easing the pain and associated symptoms and eventually restores normal functioning. In terms of the duration of the treatment, for example, treatment for a condition such as myofascial pelvic pain usually takes a six-to-eight hour long session. It may take longer, even several months, to help the patient with increasing severe cases. Patients may also return to physical therapy periodically in order to keep the issue in check. This little-known specialty carries a unique interest in the human body, but this distinctive interest has helped many people become more confident in their body’s ability!