What is pelvic floor therapy? The basics

Deep within your body lies a hidden network of muscles that form a kind of sling across your pelvis. These muscles are unsung heroes and are the pelvic floor muscles. They play a crucial role in your well-being. Attaching from the pubic bone in the front to the tailbone in the back, they work together to support your bladder, bowel and reproductive organs. They help everything function smoothly. They also contribute to sexual function and core stability. 

Pelvic floor therapy is training for the pelvic floor muscles. It helps strengthen and condition these muscles to improve your overall health and well-being. This type of therapy can be for everyone, both men and women, and can help address a variety of concerns. While a pelvic floor therapist might use external techniques focusing on the muscles around your hips and buttocks, they may also use internal therapy. Internal pelvic floor therapy is performed through the vagina or rectum and can be necessary for a more targeted approach. It can help make sure everything is strong and functioning properly. 

What is pelvic floor dysfunction?

Sometimes pelvic floor muscles get stretched, weak or tight. This can lead to a condition called pelvic floor dysfunction. It’s surprisingly common — it affects around 1 in 3 women at some point during their lives, and approximately 16% of men have a pelvic floor disorder. Common pelvic floor dysfunction symptoms include:

• Urinary incontinence — Urinary incontinence is the involuntary leaking of urine. It’s a common issue that affects up to 50% of women and up to 10% of men at some point during their lifetime. Types of urinary incontinence include:

• Stress incontinence — Leaks that occur with activities that put pressure on the bladder. These activities include coughing, sneezing, laughing or jumping.

• Urge incontinence — A sudden, strong need to urinate, often followed by involuntary leaking. 

• Mixed incontinence — A combination of stress and urge incontinence.

• Difficulty starting urination — Straining to urinate or feeling like you can’t completely empty your bladder.

• Frequent urination — Feeling the need to urinate often, even if you haven’t been drinking a lot of fluids. 

• Bowel problems — Difficulty emptying your bowels completely (constipation), leaking stool (fecal incontinence) or straining during bowel movements can be signs of pelvic floor dysfunction. Weak pelvic floor muscles can make it harder to control your bowels.

• Pelvic pain — Chronic pain in the pelvic region, including pain during sex, can be caused by tight or weak pelvic floor muscles. 

• Pelvic organ prolapse — When the pelvic floor muscles weaken significantly, they can’t properly support the organs they help hold. This can cause these organs to bulge or prolapse into the vagina. 

• Sexual dysfunction — Pelvic floor dysfunction can lead to pain during sex or difficulties achieving orgasms.

Pelvic floor dysfunction can present in a variety of ways. If you’re experiencing any symptoms that are disrupting your daily life, don’t hesitate to seek professional help. Early diagnosis and treatment with pelvic floor therapy can significantly improve your quality of life. 

When to consider pelvic floor therapy

If you’re experiencing any of the symptoms of pelvic floor dysfunction, don’t hesitate to seek help. Some situations where pelvic floor therapy can be beneficial include:

• Urinary leakage.
• Urinary frequency.
• Urinary urgency.
• Painful urination. 
• Interstitial cystitis.
• Difficulty stopping or starting urinating.
• Difficulty fully emptying the bladder.
• Sexual dysfunction.
• Pelvic prolapse. 
• Fecal leakage.
• Fecal urgency.
• Straining, constipation or painful bowel movements.
• Pain in the genitals and/or rectum.
• Lower abdominal pain. 
• Pain during pregnancy or postpartum.
• Postoperative care.
• Pediatric incontinence or constipation. 

Don’t wait: The risks of delayed treatment

Pelvic floor dysfunction can become worse over time if left untreated. Ignoring the problem can lead to increased leakage, pain and difficulty doing daily activities. As mentioned earlier, in some cases, it can even contribute to sexual dysfunction. Early intervention with pelvic floor therapy is key to help prevent these complications and achieve the best possible outcome. 

What can I expect at a pelvic floor therapy session?

A pelvic floor therapist is a licensed, trained physical therapist experienced in pelvic conditions. Your first session with a pelvic floor therapist will likely include a conversation about your symptoms, medical history and lifestyle habits. This conversation can help your physical therapist understand your unique situation and goals for therapy. A physical exam may also be part of your first session. This exam will focus on your pelvic floor muscles and surrounding areas. This exam can be done externally or internally, depending on your comfort level and your physical therapist’s assessment. 

Once your physical therapist has a clear picture of your needs, they’ll create a personalized treatment plan. This plan will likely involve a combination of techniques chosen to help address your specific symptoms. These techniques can help strengthen, retrain and improve the coordination of these muscles. Pelvic floor therapy is a collaborative effort between you and your physical therapist. Your physical therapist will guide you through performing the techniques correctly and provide ongoing feedback on your progress. 

They may also teach you how to do these techniques yourself so that you can continue your training program beyond therapy sessions and see improvement. By consistently practicing the techniques you learn in therapy, you can gradually strengthen, retrain and improve the coordination of your pelvic floor muscles. This can lead you to have significant improvement in your symptoms like better bladder control, reduced pain or a more fulfilling sexual experience. 

Techniques used in pelvic floor therapy

Just like any workout program, pelvic floor therapy can incorporate a variety of techniques intended to help strengthen and retrain your pelvic floor muscles:

• Kegel exercises — These are the superstars of pelvic floor therapy. They involve contractions and relaxations of the pelvic floor muscles. It’s similar to holding and releasing your pee stream. Your physical therapist will teach you how to do them correctly to help maximize their effectiveness.

• Biofeedback — Biofeedback involves placing sensors on your skin or internally to measure the activity of your pelvic floor muscles. The information is displayed on a screen, allowing you to see the results of your muscle contractions in real time. Biofeedback can help you visualize and improve your muscle control.

• Electrical stimulation — Gentle electrical currents are delivered through probes inserted into the vagina or rectum. These currents can help stimulate weak pelvic floor muscles, causing them to contract and strengthen. This can be a helpful technique for those who are having difficulty contracting their pelvic floor muscles on their own.

• Manual therapy — Your physical therapist may use their hands internally or externally to massage tight muscles, improve flexibility and reduce pain. This hands-on approach can help relax overly tense muscles and boost circulation to the pelvic region through techniques like:

• Internal trigger point release — Your physical therapist can access and deactivate trigger points within the vagina or rectum using their fingers. Trigger points are tight knots in the muscles that can cause pain and dysfunction. 

• Vaginal dilators — These are smooth, cylindrical tools that come in a variety of sizes. Your physical therapist might recommend these if you are experiencing pain during intercourse or vaginal tightness. These dilators are inserted and gradually increased in size over time. This can help improve vaginal elasticity and reduce discomfort during sex.

• Lifestyle changes — Your physical therapist may recommend you make adjustments to your daily routine to help support your pelvic floor health. These changes could include bladder training exercises to strengthen your bladder control, dietary changes for bowel control, or proper posture techniques to help ensure optimal pelvic floor alignment. 

Does pelvic floor therapy work?

Yes! Pelvic floor therapy can be a highly effective treatment for a variety of pelvic floor dysfunctions:

• Research backs its effectiveness — A review of studies concluded that pelvic floor muscle training, a cornerstone of pelvic floor therapy, is effective for treating urinary incontinence in women. 

• Success rates are significant — Studies show success rates of up to 59% for urinary incontinence and bowel dysfunction. Success rates can depend on the specific condition and treatment approach. 

• It’s a safe and noninvasive approach — Unlike surgery or medications, pelvic floor therapy can have minimal risks and is a natural way to help improve your condition. 

Results may vary from person to person and take time and consistent effort. However, pelvic floor therapy can significantly improve your quality of life. 

Take control of your well-being with pelvic floor therapy at Peak Performance

At Peak Performance, we understand that pelvic floor dysfunction can be a challenging issue for men and women. Our team of licensed expert physical therapists is here to help you regain control and improve your quality of life. Through personalized pelvic floor programs, we can help guide you in strengthening your pelvic floor muscles, reducing pain and achieving optimal pelvic health. Don’t hesitate to seek help and experience the difference our expertise can make. 
Call us or request an appointment today for pelvic floor therapy.