Kegels, Core and More: What Pelvic Floor Physical Therapy Can Do For You

Kim Blackwell, is our resident Women’s and Men’s Health Physical Therapist, located at our CoralWest Medical Center Location. Find more about her at praiowa.com

“I had no idea physical therapists could treat the pelvic floor!”  I hear this almost daily by clients who are referred for Pelvic Floor Physical Therapy (PFPT). If you’ve heard this term and are wondering what in the world this is, here’s what you need to know about PFPT and what to expect.

First things first, what is the pelvic floor?

We have many structures within our pelvis, including layers of muscles, nerves, ligaments and fascia (layers of connective tissue throughout our bodies).  These structures help control function of our digestive, urinary and reproductive systems.  Our pelvic floor refers to layers of muscles that span the bottom of our pelvis from our tailbone (coccyx) to the pubic bone in front.  Here is an excellent video from Hfitness.com with a detailed overview of pelvic floor anatomy:  https://www.youtube.com/watch?v=wOjo5tBWoZo&feature=youtu.be

What is Pelvic Floor Physical Therapy?

Pelvic floor physical therapy is performed by a physical therapist that has undergone months, and often years, of training and additional courses, to be skilled at evaluating the mechanics of the muscles, ligaments and bones of the pelvis.  Most PF physical therapists have extensive orthopedic backgrounds, as well, and are able assess how the hips, back and really, the whole body may also be influencing symptoms.  

Pelvic floor physical therapy can address a variety of concerns, including:

• Urinary or fecal incontinence, frequency, urgency, overactive bladder
• Prenatal or post-partum issues, including diastasis recti (separation of the abdominal wall)
• Pelvic pain
• Recovery from bladder or prostate surgery
• Tailbone/Coccyx pain or injury

At your first appointment, your physical therapist will review your medical history, your symptoms and how they affect your daily life.  Depending on your condition, an orthopedic evaluation is often performed to assess posture, strength, movement, and breathing patterns. An internal assessment of pelvic floor muscles can also be performed; however, there are many other options for treatments if you’re not comfortable with this. A plan will be developed with exercises to improve strength or flexibility, biofeedback to measure muscle activity, and education about your condition. Manual techniques, such as myofascial release, dry needling, cupping and visceral mobilization (mobilizing the tissues of the abdomen) can also be helpful. The good news is that we have lots of treatment options that can have a huge impact on symptoms and your quality of life!

Now that we’ve covered what PFPT IS, let’s talk about it is NOT:

1. PFPT is not just for women

PFPT for males is a growing trend as more and more physical therapists offer treatment for both men and women. Within my practice, close to 50% of my clients are males seeking treatment for symptoms such as urinary incontinence or frequency, prostate or testicular pain, or recovery following prostate surgery or prostate cancer. 

2. PFPT is more than just Kegels

Pelvic floor strengthening may be part of PFPT; however, this is not always the case.  We need to be able to coordinate all of our muscles to contract AND relax and the pelvic floor is no exception. Our goal is to teach proper coordination and timing of the muscles for daily activities, from lifting, running and exercise to toileting, sitting, or walking. 

3. PFPT is not only PFPT

Now what in the world does that mean?  The structures in the pelvis are so intricately associated with the abdomen, back, and hips that rarely is PFPT only addressing the pelvic floor.  I assess how my clients walk, sit, move and even how they breathe to get a full picture of how I can help them.  Because the pelvis is incredibly complex with so many factors, physical therapists often work with other skilled providers, including doctors, nurses, midwives and doulas, psychologists or sexual health counselors.

Pelvic floor physical therapy is an evolving trend in health care, with research showing great potential for improving symptoms and quality of life.  With growing awareness on the role of physical therapy, more men and women can address these concerns openly and be on the road to regaining control of their intimate health.

Photo Credit: Physicians to Women