Pelvic Floor Physical Therapy for Women

The Benefits of Pelvic Floor Physical Therapy for Women

 Written by Dr. Jennifer Berman, M.D.

Pelvic floor physical therapy has proven benefits for a wide range of systems including gastrointestinal, sexual and reproductive, orthopedic, neurological and dermatologic. It is also a potential additional treatment for pelvic pain conditions.

For women in particular, the vagina, urethra, and bowels are such close neighbors that an adverse effect to one can disrupt the function of all three. The muscles surrounding these organs play a major role in their ability to function smoothly, so if the pelvic floor muscles go into spasm or involuntarily contract, this causes pain and other problems for the pelvis.  Pain in this area can transfer to surrounding regions like the lower back, spine, hips, and buttocks. This is where pelvic floor physical therapy comes into play.

Pelvic Floor Physical Therapy Treats a Wide Range of Problems, including:

·         Pelvic and bladder pain

·         Painful intercourse

·         Pain when using tampons

·         Vaginismus - Painful spasmodic contraction of the vagina from physical contact or pressure

·         Urinary leakage, frequency or urgency

·         Post-pregnancy problems - Separation of the abdominal muscles or diastasis recti, bad back pain or SI joint pain

·         Infertility

·         Endometriosis

·         Abdominal pain from surgery or scar tissue; and

·         Healing for sexual abuse, rape or trauma

It can also be used to treat the often-enigmatic interstitial cystitis.

Pelvic physical therapists treat the pelvic floor musculoskeletal system both internally and externally. An initial assessment will give the therapist an idea of where the patient’s problem areas are before taking direct action. They will typically start by observing how the patient sits, stands and walks.

For internal techniques, the physical therapist can manually massage out kinks or “trigger points” which are tight muscles or spasms found on the pelvic floor. These symptoms are often related to interstitial cystitis.

If this simple fix does not alleviate pain, the therapist also assesses the interrelated functioning of the colorectal regions – vulvar, vaginal, and rectal – to find underlying causes. Because a pelvic floor PT can look at and treat several problem areas at once, patients have a better chance of tackling their issue in one sitting, eliminating the need to see multiple doctors specializing in one specific area within the colorectal region.

External therapy may include deep tissue massages, skin rolling, outer “trigger point” therapy, nerve release and joint mobilization. These techniques will generally be administered prior to internal therapy in order to get the patient comfortable with the processes.

There are also helpful exercises and techniques that patients can use while at home. These include general relaxation techniques like visualizing the relaxation of the pelvic floor muscles, back and leg stretches, and a focus on good posture.

Due to the pelvic physical therapist’s ability to see the big picture within the region, they have an advantage in both diagnosing and treating problems that arise in this and other areas within the musculoskeletal system. They may also discern other conditions that are overlooked or misdiagnosed by general practitioners.

When a patient can get past any initial discomfort with the hands-on process, pelvic floor physical therapy can potentially have lasting and far-reaching effects in eradicating pelvic pain and like conditions.

Dr. Jennifer Berman, urologist and recurring co-host on “The Doctors,” has joined Depend.com to provide her insights into bladder leaks and related issues. She’ll be answering your questions here in our forums. If you have a question, please submit it in the comments and watch for the answer here in the next few weeks.