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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 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!

Testimonial by T.C.

While pregnant with my twins, Heather took care with keeping me on my feet and pain free. She saved my back, my sanity and the holidays! I would recommend her to every “mom” looking to stay on her feet during pregnancy and post-partum.

-- T.C.

Testimonial by A.W., age 32

I wanted to let you know that my pelvic floor held strong and gave me no trouble whatsoever in my trail race this morning (12 miles)! In a way, I felt like I ran better than ever because my core feels so rock solid from all the exercises you have me doing. That was especially valuable on the technical downhill - I just flew down the trail because I had confidence in my balance and form. Thank you for helping me get back to doing what I love.

-- A.W., age 32
(completed Post-partum Renewal Program using the InTone biofeedback/stim unit)

Testimonial by J.B.

My husband and I were having problems with painful intercourse. My therapist recommended that I go and get a pelvic floor evaluation from a physical therapist. Having never been treated by a physical therapist, I wondered how this really was going to help me. My husband who is a physician was very supportive and agreed that a PT evaluation would be a great idea. So i made the appointment and was blown away by what I learned. I had no idea that pelvic floor muscles could get tight and have trigger points just like any other muscle in the body. I'm a massage therapist and very familiar with tight muscles, and this new thought really amazed me. Heather's program to help relax and strengthen these muscles made such a difference. I can say that I am 100% pain free during intercourse now. Yippee! Going to the PT appointments and doing the at-home exercises was definitely a discipline, but it's 100% worth it! The rewards are amazing.

-- J.B.

Testimonial by M.M.

A personal journey and testimonial from one of my patients:

My husband and I were married for 5 years before we were able to have intercourse due to my vaginismus. There was nothing traumatic in my past but for some reason, even though I wanted sex, I mentally avoided "that area" of my body and didn't even admit to myself that there was a problem for a long time, even though I was never able to put tampons in. Once I finally opened my eyes up to the fact that I had a problem, I had a surgery that was supposed to fix the issue.

Read more: Testimonial by M.M.

Testimonial by S.P., Age 26

I would like to start off by thanking Heather Jeffcoat for educating me and curing me of Vaginismus. I had been married for almost three years before I was referred to Heather. I never knew about Vaginismus until almost three years into my marriage. I knew something was wrong when I went on my honeymoon and came back a Virgin. I had always imagined how magical my first night would be but boy was I wrong.

Read more: Testimonial by S.P., Age 26

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