Top 9 Reasons You Need A Pelvic Floor Physical Therapist

If you think pelvic health is something that only affects some women, you might be surprised. Men and women of all ages can experience health issues related to their pelvic floor. The common thread is that it’s often something people hesitate to bring up to their providers.

Pelvic floor dysfunction has a variety of causes, including bowel, bladder and sexual dysfunction as well as chronic pelvic and lower back/hip pain. It is frequently not just one thing causing pelvic floor dysfunction, but a “break down” in the system.

Pelvic health physical therapy is a multi-modal, conservative approach to treating pelvic floor dysfunction. It’s more than “just doing kegels.” In fact, performing kegels often is not the sole appropriate intervention for symptom reduction and includes many exercises that target pelvic floor muscles.

A pelvic health physical therapist provides a thorough initial examination, looks at the entire body, how it is functioning as a unit and makes individualized recommendations for treatment. Common health issues addressed by pelvic health physical therapists include, but are not limited to:

1.) Bowel/Bladder Pain or Continence Issues

Too often, people suffer in silence because they assume not much can be done for these issues, when nothing could be further from the truth. The following symptoms and conditions can be improved or resolved with pelvic health physical therapy:

• Urinary urgency or difficulty urinating
• Urinary frequency
• Urinary incontinence (leakage)
• Nocturia (getting up at night to urinate)
• Interstitial cystitis (inflamed or irritated bladder wall)
• Fecal incontinence or constipation
• Irritable Bowel Syndrome
• Crohn’s Disease

2.) Vaginal/Pelvic Pain

This is another area patients may hesitate to bring up to their provider, or they assume nothing can be done, when that isn’t the case. Typical diagnoses we can help with include:

• Endometriosis – Endometrial-like cells grow outside the uterus.
• Vaginismus – Tensing/contracting muscles around and within the vaginal region.
• Vulvodynia – Chronic pain/discomfort at the vaginal opening.
• Vestibulodynia – Chronic pain/discomfort at the vaginal opening.
• Pudendal neuralgia – Pelvic pain from pudendal nerve damage/irritation.

3.) Pelvic Organ Prolapse

Women are often surprised to learn that one or more organs can slip down and bulge into the vagina. This is not life-threatening but can cause pain, discomfort and/or other symptoms. It’s estimated to affect almost 3 percent of women in the US, though that number may be higher because many may be embarrassed to talk about it or are unaware it is present.

4.) Sexual Dysfunction or Pain

This can be a difficult subject for men and women alike to bring up in their provider’s office. The good news is there is help for a variety of sexual issues related to the pelvic floor, including:

• Pain before, during or after sex (dyspareunia)
• Pain with orgasm/difficulty with orgasm
• Prostate dysfunction
• Testicular or penile pain
• Ejaculation dysfunction (retrograde, premature and painful ejaculation)
• Peyronie’s disease (injury or scar tissue causing curvature of penis)

5.) Pregnancy and Postpartum Issues

New moms can benefit from learning techniques for proper lifting mechanics and positions for breastfeeding, plus postural re-education for their changing bodies. Other diagnoses addressed include:

• Diastasis recti (separated abdominal muscles)
• Sciatica/lumbar spine, pelvic or hip dysfunction

6.) Post-Menopausal Care

Promoting good pelvic floor health through menopause and beyond can improve urinary and gynecologic symptoms including incontinence, prolapse and sexual issues.

7.) Cancer and Cancer Treatment

Several types of cancer and modes of cancer treatment can impact the pelvic floor and affect the body’s bowel, bladder and sexual function.

8.) Surgeries and Injuries

Pelvic health physical therapy is important after all kinds of surgeries, including gynecologic, abdominal and bowel surgeries.

9.) Orthopedic Issues

The pelvic floor is integral to how the body moves. An orthopedic issue can trigger problems with the pelvic floor, and pelvic floor dysfunction can contribute to orthopedic issues. Specific diagnoses include:

• Tailbone pain (coccydynia)
• Hip and lumbar pain (lower back)
• Sacroiliac joint (between spine and pelvis)
• Pelvis and groin pain

If you think you may have any of these issues, reach out to your primary care provider or to our Pelvic Health Center team.