The Importance of Pelvic Floor Therapy

Gravity isn’t kind to us as we age and the pelvic organs are often the first to succumb. Over the years, pressures from physical activities like running, jumping, and lifting heavy things, and normal life events like pregnancy and the aging process, can make the pelvic organs shift out of place. The result is pelvic floor dysfunction. But there’s a fix for that. Pelvic floor therapy can help prevent or reverse the symptoms of pelvic floor dysfunction.

What is the pelvic floor and why does it malfunction?

The muscles, tendons, and ligaments of the lower pelvis form a type of connective tissue support system, called the pelvic floor, that helps hold the pelvic organs in place. When the pelvic floor is over-stressed (see above) some muscles become stretched out and weakened, while others become tight and tense.

Weak pelvic muscles can lead to bladder and/or bowel incontinence and potentially to prolapse of the uterus, vagina, bladder, or rectum. Tight pelvic muscle cause muscle spasms and pelvic pain, including painful intercourse. If left untreated, serious issues can occur, such as permanent impairment of function or severe prolapse requiring surgery.

Pelvic floor therapy restores balance and function

Pelvic floor dysfunction tends to progress and worsen over time, so it’s best to address it early, when symptoms first appear. Pelvic floor therapy is a safe and minimally invasive way to retrain and restore balance to the pelvic muscles and thereby resolve the painful, uncomfortable, and embarrassing symptoms that go along with pelvic floor dysfunction. Pelvic floor therapy can be used as a preventive measure, such as in the early stages of pregnancy, to identify and minimize potential problems and if you begin pelvic floor therapy after you’ve been experiencing symptoms for a while it can also help prevent the need for surgery.

What to expect

A qualified therapist will first evaluate the muscles of your lower back looking for any signs of weakness, pain, or tender points. The therapist will also be able to evaluate the pelvic floor muscles manually through the vagina and rectum.

A treatment plan will be devised based on the information obtained during the exam. In a review of published studies 59–80% of women reported improvement in their pelvic pain symptoms from using pelvic floor physical therapy. Pelvic floor therapy may consist of a combination of treatments, including:

• Exercises designed to strengthen weak muscles and stretch tight or contracted muscles. These can include Kegel exercises, in which you contract your pelvic floor muscles, as well as core and low back strengthening exercises.
• Biofeedback can be used in combination with active exercises to increase your awareness of certain muscles, such as sphincter muscles, that we don’t often think about consciously and can result in greater improvements than muscle training exercises alone.
• Massage or other forms of manual therapy techniques loosen tight muscles and may specifically address trigger points, tight contracted areas in muscles that are often resistant to stretching or strengthening exercises. 
• Electrical muscle stimulation to activate weak muscles that may be difficult to access through exercise.
• Vaginal dilators to help gently release contracted vaginal muscles.

Pelvic floor therapy sessions last approximately 30 minutes to an hour. Generally, they are done as a series of up to 12 sessions consisting of one or a combination of therapies. These may include passive techniques that the therapist performs, such as manual trigger point therapy, electrical muscle stimulation, laser therapy, etc., or active techniques that you perform under the guidance n of your therapist, such as Kegel exercises or use of vaginal dilators.

Who offers pelvic floor therapy and hw to choose a qualified practitioner

Training in pelvic floor therapy can be provided by a variety of healthcare professionals. Their license must allow them to perform the required physical examination, form a diagnosis, and prescribe a treatment plan. These include physical therapists, nurses, nurse midwives, occupational therapists, medical doctors, naturopathic medicine practitioners, and chiropractors. However, licensing laws vary from state to state, so services that might be allowed for a particular profession in one state might not be covered under the laws of another.

Certification and credentialing in pelvic floor therapy are available for healthcare professionals who wish to be recognized as pelvic floor therapy specialists. These individuals can be located by contacting state or national professional organizations. For physical therapists, relevant programs are accredited by the Commission on Accreditation in Physical Therapy Education. Experienced physical therapists with at least 2000 hours of direct pelvic therapy patient care are eligible to take the credentialing exam.

Pelvic floor dysfunction is not an inevitable fact of life. With pelvic floor therapy it’s possible to manage or reverse the symptoms.

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