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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 Julie T.

Femina PT (née Fusion Wellness & Physical Therapy) has honestly changed my life. Before receiving treatment at Femina, I was going doctor to doctor to try and find the answer to my pelvic pain. It has taken me YEARS to find someone that can help fix this. It wasn't until my gynecologist recommended your clinic that I finally felt relief. My pelvic pain is almost gone, and granted I still have a lot more to work on with Laureen (my PT), my original problem is nearly cured. I am so grateful to her.

What is even better is she gave me practical exercises to do at home that were not tedious and provided instant (and lasting) relief. Although I mainly work with Laureen, my interaction with the owner (Heather) has been great. She is very generous, kind, and committed to her business.

It hurts to know there are women out there suffering who will never know or have the opportunity to work with women like Laureen and Heather because this issue is hardly talked about and this field is so rare. I hope more doctors and physical therapists see the value in this work and can relieve more woman of their pain.

-- Julie T., 12/4/16 via Yelp!

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 A.B.

Before I was referred to Heather Jeffcoat I was living in a nightmare. I had been married to my husband for three years and I was suffering from Vaginismus. That all changed when I visited my OBGYN and she said she knew of someone with a great success rate. To be honest I was hesitant at first because my first doctor had already told me that all I needed to do was order dilators from the internet and I should overcome my problem. She was wrong because I had followed the book on how to use the dilators with absolutely no advancements in my condition. However, that all changed when I went in for my first visit and Heather took the time to explain my condition and how we were going to work together to overcome it.

I remember leaving her office with a glimmer of hope that I could live a normal life. As my sessions continued I began to see immediate results. With only four sessions and a strict dedication to my home programs I was cured of Vaginismus. In the beginning of this process I was made aware that my health insurance company might not cover the costs, which was disappointing but today I can say one hundred percent that it was the best money I ever spent. Now thanks to Heather I am finally enjoying my life to the fullest with my husband. Thank you Heather, I can’t begin to tell you how much I appreciate all that you have done for me. I will never forget it. Those who are suffering from these types of conditions don’t be afraid because she makes you feel so comfortable and the end result is worth it. Good luck to you all and I hope you experience the success I have.
-- A.B.

Testimonial by T.H.

I started seeing Heather in October 2014. For more than two years, I had been suffering from painful urinary tract infection type symptoms after my bartholins gland surgery which included constant burning and urinary frequency sensation that led to more and more painful intercourse. I had made multiple visits to internist, obgyn and urologist's offices, went through a range of treatment with UTI and bladder frequency medication that included antibiotics, vesicare, estrogen cream, but nothing worked.

Read more: Testimonial by T.H.

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 T.H.

I started seeing Heather in October 2014. For more than two years, I had been suffering from painful urinary tract infection type symptoms after my bartholins gland surgery which included constant burning and urinary frequency sensation that led to more and more painful intercourse. I had made multiple visits to internist, obgyn and urologist's offices, went through a range of treatment with UTI and bladder frequency medication that included antibiotics, vesicare, estrogen cream, but nothing worked.

Read more: Testimonial by T.H.

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