What is Pelvic Floor Physical Therapy?
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Why would I need pelvic floor exercises?
Has a friend or a doctor recommended physical therapy for your pelvic floor? Are you having pelvic pain that prevents you from becoming intimate with your partner? Do you leak urine or stool when you get up from the toilet or run after your child at the playground?
Some of what you may be experiencing may be related to what is going on with the muscles inside your vagina or rectum. These muscles, known as the levator ani or the pelvic floor muscles, have four main jobs to do:
- prevent leakage and make sure you empty easily when you urinate or have a bowel movement
- support and hold up the internal pelvic organs
- enhance sexual pleasure and
- provide stability at your pelvis as part of your core muscle group.
What to expect during your first physical therapy session?
Since pelvic floor physical therapy is not as well-known as physical therapy for your knee or shoulder, knowing what to expect when you see a pelvic health specialist is helpful when getting started. A thorough evaluation will include checking your posture and alignment, testing your mobility and strength at the abdominals, spine, and hips, and completing an internal pelvic exam. At The Right Balance, we complete an assessment of your pelvis and other parts of your body to obtain a clear picture of what is causing your symptoms. This is because the muscles inside and outside of your pelvis do not act apart from one another.
Many clients do not expect an internal pelvic exam, and if you are uncomfortable with one, you should speak to the physical therapist about your concerns. While some of the muscles of your pelvis can be examined externally, most of the time the muscles involved are inside the vagina or rectum.
Your physical therapist will use a gloved finger to determine the muscle’s response to light touch or pressure, which is especially important if you are experiencing pain during a pelvic examination or sexual intercourse. She will also test the coordination or strength of these muscles. For instance, can you contract the muscles inside the vagina when asked to? How strong is the “squeeze,” and do the muscles relax before and after your contract?
Most patients are hesitant to start physical therapy for fear of the unknown. Hopefully, after reading this article, you will better understand how physical therapy can help and what to expect. There are usually no stirrups or speculum in a physical therapist’s examination of your pelvic floor, and generally, it is more comfortable than an exam at a gynecological visit.
Pelvic floor physical therapy has been helping women and men overcome common conditions, including pelvic floor dysfunction, pelvic pain, vulvodynia, interstitial cystitis, prolapse, urinary or fecal incontinence, and constipation for over twenty years. Fortunately, it is becoming more of a familiar treatment option, but still, many people don’t know much about it and are worried it will be awkward or uncomfortable.
What should I do next?
If you are still uneasy about starting pelvic floor physical therapy, here are a few tips that may be helpful. Ask your physician for recommendations for physical therapists in your area and try to learn about their credentials and experience level. A great site to find pelvic health specialists in your region is pelvicglobal.com. See if you can visit the clinic you are attending or set up a phone consultation with the physical therapist before your first visit. Be open with the physical therapist if you have pain or apprehension about a pelvic exam.
Most physical therapists are trained to talk you through the process and help calm your mind and body during your evaluation and subsequent treatments. Remember, you are always in control and can ask for modifications or changes to your session that suit you at any time.