Who Should Consider Pelvic Floor Therapy & What to Expect?

Pelvic floor therapy helps patients struggling with incontinence or leakage, urinary frequency issues, constipation, or urgency by strengthening the pelvic muscles. The pelvic floor is made up of ligaments and muscles that provide support for organs, bathroom control and sexual experience. The pelvic floor is present in both men and women, but it is structured differently. These therapy sessions are unique to pelvic floor dysfunction, and include the use of strengthening exercise, quieting/relaxation techniques and lifestyle modifications. Pelvic floor trained physical therapists work with youth and adult patients, male and female, for pelvic floor therapy.

Signs & Symptoms

“Pelvic floor therapy can help with urinary urgency, frequency and leaking,” says Leah Eslick, DPT. “It can be an adjunct therapy for people struggling with constipation.”

Some common signs and symptoms patients notice before pelvic floor therapy include:

• Dribbling/leaking with coughing, sneezing, physical activity
• Feeling like you need to use the bathroom more frequently
• Frequency/incontinence is starting to limit your social life or job activities
• Prostate surgery or enlarged prostate
• Noticing changes in your bladder health

“We do sometimes ask our patients to keep a brief diary, which we send out before their first session,” shares Joanne McEvoy, DPT. “This diary tracks their number of trips to the bathroom, and potentially number of leaks in a day. We also encourage patients to commit to a home program, as well as adopting lifestyle changes like drinking more water when starting pelvic floor therapy to ensure their success in the long term.”

Other issues that should not be ignored:

• Pelvic organ prolapse – This occurs when the bladder, uterus or rectum falls below the level of the pelvic floor muscles. Patients may feel heaviness, pain, or a lump sensation since the area's muscles, connective tissues and ligaments can't support those organs. Treatment options include pelvic floor and core strengthening as well as posture and body mechanics; training to avoid surgery. Furthermore, physical therapy can also be used before and after surgery to prevent the condition from reoccurring.
• Pelvic pain – Health conditions such as vaginismus, vulvodynia, vestibulitis, interstitial cysts, coccydynia or anismus can cause pain in the vaginal or rectal area. A person may experience pain while sitting, during intercourse or general pain in the lower abdomen and hips.

Types of urinary incontinence

• Stress incontinence – This occurs as the pelvic floor is not usually trained to take on the stress of running, sneezing, jumping, coughing or even walking. This occurs gradually with possible weight gain and/or in post-pregnancy, after vaginal deliveries.
• Urge incontinence – This is the result of an unstable bladder. This may be seen in television advertisements, showing women (or men) needing to go “right now.”
• Mixed incontinence – This is a combination of both types of urinary incontinence.

What to Expect During Pelvic Floor Therapy

During a treatment session, patients will work with a therapist on exercises specific to the pelvic floor dysfunction, as well as hip and core strengthening. The team also utilizes techniques like diaphragmatic breathing for calming the nervous system – particularly seen in cases of overactive bladder or urge incontinence.

“We have the ability to utilize biofeedback, which uses sensors to track muscle activity and the therapists and patient can ensure they are activating the correct muscles,” says McEvoy. “Patients are able to view the computer screen and see how their muscles are working, while completing their exercises.”

Patients are fully clothed, and the sensors can be applied externally or internally to allow the patient and therapist to track improvement over time. Patients will be in a private treatment room for their entire session and will continue to see the same therapist for each appointment. Your pelvic floor therapist may also recommend muscle-strengthening techniques to use at home, like Kegel exercises.

“While starting pelvic floor therapy can be intimidating, we are here to help you,” says Eslick. “All information is kept strictly confidential, and we stay in close contact with the referring provider to address any additional concerns that may arise.”

Find a Pelvic Floor Therapist Near You

Often, a referral is required for pelvic floor therapy and can come from any provider a patient is working with or currently seeing for this issue, schedule an appointment with a provider today.