Your pelvic floor muscles play a huge role in controlling bladder and bowel function. In a nutshell, your muscles help with control by keeping urine and stool in when you want, and voluntarily letting urine and stool out with control when you go to the bathroom. If you experience any of the following: involuntary loss of urine or stool, any difficulty with toileting such as pain or straining, or changing your daily habits or routines to accommodate your symptoms, then you might benefit from pelvic PT. In physical therapy you will first be assessed for overall function. Sometimes muscles are weak and need to be strengthened, sometimes they are tight and need to be relaxed, and sometimes you just need to learn how to control them better so that they work appropriately when you need them to.  

We understand that pelvic pain can be debilitating and have a huge impact on quality of life. It is a very sensitive area and it is difficult when pain interferes with work, physical activity, self-care, or intimate relationships. We address pelvic pain from a holistic perspective, and work to understand the underlying cause of pain so that it can be treated effectively. Often there is some contribution from the pelvic area including muscle or fascial tightness, scar tissue, trigger points, or chronic tension that contributes to your overall pain experience, and these things are treatable. Treatment may involve a blend of relaxation techniques, movements such as stretching or gentle strengthening, hands-on manual therapy to the low back or hips, and instruction in self-management to do at home to help with symptoms. Even if there is an underlying medical condition such as endometriosis, physical therapy can help ease pain, improve function, and improve quality of life. 

Your pelvic floor muscles are actually a part of your “core,” and they help support posture along with your stomach, back, and hip muscles. If you have pelvic floor muscle dysfunction, this can impact your ability to properly use your other trunk muscles and can lead to low back pain, sacroiliac pain, impaired posture, and difficulty performing daily activities. Research also suggests there is often a link between low back pain and pelvic floor dysfunction leading to stress or urge incontinence. Learning to properly engage your pelvic floor muscles can help with overall trunk control and help you move better without experiencing back pain.  

Your comfort is of utmost importance during your physical therapy treatment. We do sometimes recommend an “internal” pelvic floor muscle assessment by accessing the muscles through the vaginal or rectal canals, because this gives us good information on muscle strength and muscle tightness. However, plenty of information can be gained through external-only assessment, so an internal exam is not a prerequisite to receiving pelvic physical therapy. The decision to perform an internal exam will be based on your personal history, your personal preference and consent, and the clinical value of performing an exam. If we do decide to proceed with internal examination, it is performed in a private room with measures taken to ensure privacy and comfort. The exam takes about 5-10 minutes and will involve you contracting your pelvic floor muscles to assess strength and endurance, checking to make sure you can voluntarily relax, and palpation to see if there is any muscle tightness. The exam would only be performed after listening to your history and explaining what information we are hoping to get from the exam, and obtaining your consent.