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pelvic floor physical therapy

What is pelvic floor physical therapy?

When you are suffering from neck or shoulder pain, it is common to go see a physical therapist to help correct any issues with like alignment, movement, strength, and flexibility to reduce pain and improve function. Pelvic floor physical therapy is performed by physical therapists with advanced training to help correct those same issues in the pelvis, lower extremities, spine, and abdomen.

Pelvic floor muscles: What are they?

The inside of the pelvis is lined with muscles referred to as the pelvic floor muscles, these muscles are made of the same types of muscle tissue as other parts of the body, like the neck or shoulder. Similarly, the pelvis is home to ligaments, nerves, fascia, and bones, just like other parts of the body. Pelvic floor physical therapy utilizes an inegrative approach to get all of these functions working together as they should.

Pelvic floor muscles: What do they do?

The pelvic floor muscles have a variety of jobs:

  • Support the organs in the pelvis and abdomen; keeping your organs inside you is a good thing! Otherwise issues such as organ prolapse may occur.
  • Stabilize the movement of the hips and pelvis- poor movement patterns can begin as dysfunctions in the pelvic floor and can often cause low back pain and hip pain.
  • Sphincter, or closure of the openings of the urethra, vagina, and anus- keeping you continent and dry.
  • Lymphatic drainage and circulation
  • Sexual Function- pelvic floor muscles aide in sexual function including orgasm and pain free sex.

What does pelvic floor physical therapy treat?

Dysfunctions in the pelvic floor can cause or contribute problems that greatly affect quality of life. Pelvic floor physical therapy can help with the following conditions:

Incontinence and Voiding Dysfunctions:

  • Leaking urine with sneezing, coughing, and laughing
  • Leaking urine when you are fumbling with your clothes, keys or washing the dishes
  • Light-heavy bladder leakage
  • Urinary urgency and frequency
  • Delayed or painful voiding
  • Interstitial cystitis (IC) and Painful Bladder Syndrome (PBS)
  • Overactive bladder
  • Nocturia- night time urination
  • Enuresis (bedwetting)
  • Fecal / Bowel Incontinence ; Accidental Bowel Leakage
  • Painful bowel movements
  • Irritable bowel syndrome (IBS)
  • Constipation

Painful Intercourse:

  • Vaginismus / Genito-Pelvic Penetration disorder
  • Vulvodynia
  • Vulvar vestibulitis
  • Vestibulodynia
  • Unprovoked and provoked vestibulodynia
  • Dyspareunia
  • Endometriosis
  • Levator Ani Syndrome

Pelvic Pain:

  • Stabbing, throbbing, or jabbing pain in the abdomen, low back, and/or pelvic area
  • Inability to tolerate gynecological exams or tampon use
  • Pain with sitting
  • Pain with cycling
  • Persistant Genital Arousal Disorder (PGAD) / Persistent Sexual Arousal Syndrome (PSAS)
  • Painful Orgasm / Dysorgasmia
  • Anorgasmia (no orgasm) or Diminished or Less Intense Orgasms
  • Pudendal Neuralgia
  • Coccydynia (tailbone pain)
  • Painful Bladder Syndrome / Interstitial Cystitis
  • Deep hip pain / Piriformis Syndrome

What do you do in pelvic floor physical therapy?

Pelvic floor therapists help normalize dysfunction in the pelvic floor. Problems can be caused by a variety of things including spasms, muscle guarding, weakness, lymphatic drainage problems, connective tissue dysfunction, poor habits, chronic stress, and poor movement patterns.

The treatment modalities you will receive in pelvic floor physical therapy depend on your body and the issues present. Tight pelvic floor muscles, myofascial trigger points, and chronic stress and constipation, for example, could cause a flare up of pelvic pain. Your therapist would then help treat those underlying conditions to help bring your body back into balance and function.

Some of the modalities used in the clinic can include:

  • Therapeutic exercise to strengthen or lengthen the tissues in the body that may contributing to problems
  • Manual therapy to treat connective tissue dysfunction and myofascial trigger points
  • Visceral mobilization (gentle massage techniques that loosen internal adhesions and restore movement to the organs including the intestine, bladder, uterus, and ovaries)
  • Postural training and therapeutic exercise to treat dysfunctional movement
  • Internal pelvic manual therapy to treat sensitive tissues, muscle spasms, trigger points, and muscle guarding that can cause pain with activities like sex, tampon use, or bowel movements
  • Training in self treatment techniques including foam rolling, lymphatic massage, autonomic relaxation, and stress reduction
  • Neuromuscular re-education and autogenic relaxation to reduce chronic muscle over-activity, reduce pain, and improve sleep
  • Cold laser, ultrasound, and other physical agent modalities to aide in the reduction of inflammation, pain, and improve tissue healing.
  • Education regarding habits that could be contributing to the problem: diet, constipation management, stress management.

Patient Education and Empowerment

An important aspect of pelvic floor therapy is the collaboration and trust that is created between the therapist and client. The ultimate goal of pelvic floor physical therapy at Femina is educating you with the tools you need in your toolkit to help you heal yourself and to be able to deal with flare-ups and the occasional bumps in the road with confidence. As pelvic floor therapists, we are guides, support, and cheerleaders for you along the journey back to wellness and function! We only employ licensed Physical Therapists, all with a pelvic health speciality and advanced degrees and certifications to optimize your outcome. Make an appointment today and let’s get started.

**This information is for educational purposes only and is not intended to replace the advice of your doctor.**

What Our Patients Have to Say

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Testimonial by Jackie W.

I was in multiple car accidents a decade ago, and I have been to many physical therapists through the years without success. They found the root of my lower back pain problems and after nearly a decade of barely being able to walk I finally can again without pain. They are also the best pelvic floor pts and the only ones who found the connection between my pelvic floor and lower back problems. If you need help with physical pain, they are your answer.

-- Jackie W., 1/19/17 via Yelp!

Testimonial by S.B.

As someone who suffered the debilitating physical and emotional effects of vaginismus (as well as a complicated history of back injuries) for more than 15 years, I thought a "normal" life was just a fantasy. Then I found Heather.

Read more: Testimonial by S.B.

Testimonial by Fritzette H.

I went to Heather after the birth of my third child. It was lucky, really, that I was referred to her, because my doctor had referred me to a surgeon for a possible hysterectomy or pelvic wall rebuild. Thankfully, I went to Heather before undergoing either surgery, she was able to fix the problem. She has studied extensively in women's health--even written a book about it--and was able to diagnose my problem, suggest a course of treatment (6 weeks), and then follow through with said treatment. By the end, as she said, I was as good as gold. Boy, was it worth it! Though uncomfortable to talk about, much less write about, it is worth getting the word out there. If you have painful intercourse, especially after birth or other trauma, the treatment may be as simple as Physical Therapy (with Heather, of course). I highly recommend her.

-- Fritzette H., 3/24/16 via Yelp!

Testimonial by Lauren B.

Femina PT (née Fusion Wellness & Physical Therapy) has been such an answer to prayer, i'm so glad I found them! I've been struggling with vaginismus my whole life, but didn't have a name for it until about 6 or 7 months ago. Even once I did have a name for it though, I didn't know where to begin in getting help. My OB/GYN had me get a set of dilators, but I couldn't even insert the smallest one by myself. Most times I tried I just ended up frustrated and in tears. I felt really alone, like I was broken and didn't have the energy to keep trying. When I got engaged a few months ago though, I realized I needed to get answers so i wasn't dreading my honeymoon.

Read more: Testimonial by Lauren B.

Testimonial by R.H.

No one could tell me why I was having pain during sex--sharp pain, not just uncomfortable, pain. I was referred to Heather Jeffcoat after researching several different options. I had seen a specialist who told me physical therapy would not help and my only option was surgery. I really didn't want to go that route, so when we got a referral, I decided to try it--it can't hurt, I thought. I am so glad I did. She diagnosed the problem right away, which was a relief in itself.

To know why I was having pain eased my mind immensely. And to hear that she could fix it without surgery was another relief. She said she could fix the problem in 6 weeks. I think it was actually 4 for me. She was very methodical, and treated me as an intelligent human being capable of participating in my own recovery. I would absolutely recommend her to anyone. She did not try to prolong my session numbers, she worked hard to accommodate my schedule (and the fact that I had to bring a baby to sessions), and she was completely honest the entire time. It is so hard to find someone with these characteristics, much less a professional who is so good at what she does. She has my highest respect.

-- R.H.

Testimonial by Carolina J.

I had tried Pelvic Floor Physical Therapy before (with another PT) and I had a really bad (painful) experience. A friend of mine and fellow patient, told me about Heather, Laureen and Femina PT (née Fusion Wellness & Physical Therapy) and I decided to try again. I am so happy I did! Femina PT have, literally, changed my life. I was able to do again things I couldn't do for over 10 years!! Their bedside manners are impeccable, their knowledge and understanding make me feel comfortable to recommend this place to anyone in pain. Specially if you have Endometriosis. 100% recommended!!

-- Carolina J., 12/28/16 via Yelp!

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