Physical Therapy for Pelvic Floor Dysfunction

Pelvic floor disorders are extremely common and underreported, affecting at least 25% of women nationwide (1). Pelvic floor dysfunction includes urinary incontinence, frequency and urgency, pelvic pain, dyspareunia, fecal incontinence and urgency, constipation, and pelvic organ prolapse.

What is the Pelvic Floor?

So what is this pelvic floor we are talking about? The pelvic floor is a group of muscles that support the organs in the pelvis and form a sling around the urethra, vagina and rectum. No other muscle group is so closely linked to everyday functions including urinary, bowel and sexual function. Because of this, a problem with the pelvic floor muscles and their ability to contract and/or relax can contribute to a disruption in your everyday activities and greatly affect quality of life.

How Can Therapy Help Pelvic Floor Disorders?

Many women think they have to live with pelvic floor dysfunction, but this is not true. Using an exercise-based approach, pelvic floor therapy can help women of all ages experience symptom relief and improve confidence to participate in daily activities.

Pelvic floor therapy typically includes exercises to restore pelvic floor function including strengthening, relaxation, and/or re-education of the pelvic floor muscles. Bladder and bowel retraining, manual therapy, functional exercise biofeedback and education on proper body mechanics or posture is also included.

Pelvic Floor Dysfunction in Pregnant Women and Mothers

Pelvic floor dysfunction affects women of all ages. While one does not need to have given birth to experience pelvic floor dysfunction, this does increase the risk for experiencing some of these conditions. A pelvic floor rehab specialist can help women during pregnancy and postpartum as well. One study found 33% of postpartum women experience incontinence (2), four in ten women experience incontinence during pregnancy (3), and 50-60% of women experience painful intercourse or dyspareunia.

In healthcare today there is often a lack of support for women following the birth of a child. The new baby has eight scheduled visits with a physician during the first year of life while the mom only has one. Following most orthopedic surgeries there is a very specific protocol and guidelines that include a gradual return to activity, physical and/or occupational therapy and many follow ups with one’s physician. However, following child birth, which may have included a major surgery (c-section) or vaginal tearing there is no prescription for therapy or gradual return to activity. Pelvic floor specialists can help women to return to their previous level of pain free function including exercise, work, and caring and for their new baby.

Can I Just Do Kegels?

One common misconception about pelvic floor therapy is the assumption that you will only be doing “kegel” exercises. While kegel exercises may be included in your therapy program, 60% of people do kegels wrong or are doing kegels when they should not be doing them. This can actually be contributing to pelvic floor dysfunction and, at times, worsening the condition. This is why being seen by a pelvic floor therapist is so important. They can do a proper assessment to see what type of exercise and treatment you need to reach your goals.

Pelvic floor therapy plays a unique and important role in the world of rehab. We are able to help women of all ages with issues they have sometimes been dealing with for years because they are too embarrassed to seek out treatment. They may think there is nothing they can do to help their condition, however, in many cases pelvic floor therapy can help!

Starting pelvic floor rehabilitation is easy. If you think you may benefit, talk to your primary care physician, gynecologist or obstetrician. They can help determine if you are a candidate for therapy and can provide you a prescription to be seen by a pelvic floor specialist. Don’t let these common, but not normal, conditions interfere with your life.

References:

1) Hallock, J. L., & Handa, V. L. (2016, March). The epidemiology of pelvic floor disorders and childbirth: an update. Retrieved May 12, 2020, from ncbi.nlm.nih.gov.

2) Thom, D. H. & Rortveit, G. (2010). Provenance of postpartum urinary incontinence: a systematic review. Acts obstetricia et gynecological Scandinavia, 89 (12), 1511-1522.

3) Hayworth, H. N. (2019, January 31). Office on Women's Health. Retrieved May 12, 2020, from https://www.womenshealth.gov/.