Pelvic Health – Pelvic Floor Physiotherapy & Pelvic Floor Physical Therapy

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Pelvic floor physiotherapy is an essential part of maintaining pelvic health and managing disorders related to pelvic muscle dysfunction. This increasingly popular rehabilitation option helps patients improve quality of life and take control of their wellbeing. Read on to learn why pelvic floor physiotherapy should be a consideration for anyone experiencing pelvic pain, incontinence, or other pelvic floor disorders.

What Conditions Can Pelvic Floor Physiotherapy Treat?

Pelvic floor physiotherapists can help with a variety of disorders related to the pelvic muscles, including:

  • Urinary incontinence – This involves uncontrolled leaking of urine. It can occur during physical activity like coughing, sneezing or exercise. Urinary incontinence may also lead to leaking urine when you feel a sudden urge to urinate but can’t get to the bathroom in time. Pelvic floor physiotherapy can help strengthen the muscles that control urine flow.

  • Fecal incontinence or constipation – Inability to control bowel movements can occur as pelvic floor muscles weaken. Constipation and straining to have a bowel movement can also cause pelvic floor dysfunction over time. Pelvic floor physiotherapy provides exercises and biofeedback to help regain bowel control.

           

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  • Pelvic organ prolapse – When pelvic muscles cannot adequately support pelvic organs, one or more organs can drop downward into the vagina. This causes pressure, discomfort, and problems with urination or sexual function. Pelvic floor physiotherapy can strengthen the muscles and reduce symptoms.

  • Painful sexual intercourse – Pelvic muscle weakness or spasms can make sex painful for women. Physiotherapists can provide manual therapy, dilator training, and exercises to reduce this pain.

  • Chronic pelvic pain – Pelvic floor muscle trigger points and spasms often contribute to chronic pain conditions like coccydynia or vulvodynia. A pelvic floor physiotherapist can release trigger points and teach relaxation techniques.

  • Painful bowel movements – Constipation and straining can be quite painful and cause anal fissures or hemorrhoids. Pelvic floor therapy is very effective for retraining bowel habits and reducing anal/rectal pain.

  • Pelvic muscle weakness – Generally, pelvic floor muscle weakness arises from pregnancy, childbirth, surgery, aging, or obesity. Weak pelvic muscles contribute to issues like incontinence and prolapse. Strengthening exercises are a core component of pelvic floor physiotherapy.

  • Musculoskeletal issues like low back or hip pain – Pelvic weakness allows too much movement in the pelvic region. This overstrain can radiate pain to the lower back and hips. Pelvic floor physiotherapy stabilizes the pelvis and reduces compensatory muscle strain.

           

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Resource: Canadian Physiotherapy Association

A man is receiving pelvic floor therapy on an exercise ball.

How Does Pelvic Floor Physiotherapy Work?

Pelvic floor physiotherapists are specially trained to evaluate and treat dysfunctions related to the muscles of the pelvic floor. Treatment normally includes:

  • Physical examination to assess pelvic muscle strength, flexibility, and trigger points. The exam is essential to identify impaired muscles and customize the treatment plan.

  • Manual therapy to reduce trigger points and muscle tension. The physiotherapist will perform hands-on techniques like massage, trigger point release, and myofascial stretching to relieve muscle tightness and pain.

  • Biofeedback to help patients understand and control pelvic muscle contractions. Real-time feedback of muscle activation through electrode patches allows gaining voluntary control.

  • Exercises to strengthen or relax pelvic floor muscles. Specific exercises will be prescribed based on each patient’s pelvic dysfunction and needs. Home exercise is crucial for ongoing progress.

  • Electrical stimulation to reduce pain and control urinary/fecal incontinence. Mild electrical currents can calm muscle spasms, improve blood flow, and stimulate nerve pathways involved in continence.

  • Education on lifestyle factors and self-care techniques. Your physiotherapist will explain how factors like diet, fluid intake, smoking, and toileting habits affect pelvic floor function.

Sessions are typically one-on-one with a physiotherapist. Treatment plans are tailored to each patient’s specific dysfunctions and goals. The number of sessions needed will vary per patient, ranging from just a few appointments to several months of therapy.

What Exercises Are Used In Pelvic Floor Physiotherapy?

Exercises may include Kegels, diaphragmatic breathing, core stabilization, hip/gluteal strengthening, and posture correction. Your physiotherapist will determine the optimal exercises to help strengthen your pelvic floor.

       

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Kegel exercises strengthen the pubococcygeus muscles which support the pelvic organs. Proper Kegels utilize slow, sustained contractions rather than quick squeezes. Physiotherapists guide patients in performing Kegels correctly.

Breathing exercises help gain awareness and control of core muscles involved in pelvic stability. These include the diaphragm, abdomen, deep back muscles, and pelvic floor.

Core and hip exercises further strengthen muscles that provide pelvic support. Yoga, Pilates, and resistance training can help depending on your needs.

Biofeedback tools can help you learn to properly contract the relevant muscles. Therapy may also include manual techniques like trigger point release and dry needling. Home exercise programs are prescribed to continue progress outside of therapy sessions.

Who Can Benefit From Pelvic Floor Physiotherapy?

While most patients are women, pelvic floor dysfunction can affect men as well. Pelvic floor physiotherapy can benefit anyone experiencing:

  • Leaking urine when coughing, laughing, or exercising – This urinary incontinence indicates pelvic floor muscle weakness. Physiotherapy can strengthen these muscles and reduce leakage.

  • Frequent or urgent urination – Pelvic muscle spasms can provoke a constant feeling of needing to urinate. Pelvic floor physiotherapy relieves these spasms and retrains normal bladder function.

  • Trouble fully emptying the bladder – Weak pelvic muscles prevent the bladder from fully contracting during urination. Strengthening exercises can improve bladder emptying.

  • Constipation or straining to have a bowel movement – Exercises, biofeedback, and manual therapy normalize muscle coordination involved in defecation. This reduces straining and discomfort.

  • Hemorrhoids – Straining to pass stool can inflame hemorrhoids. Pelvic floor physiotherapy reduces straining through bowel retraining, exercise, and manual techniques.

           

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  • Pelvic organ prolapse – When weakened muscles fail to support pelvic organs, exercise and postural training can reduce prolapse symptoms. However, severe prolapse may require surgery along with physiotherapy.

  • Pelvic or sexual pain – Physiotherapists employ massage, dilator training, trigger point release and relaxation techniques to reduce pelvic muscle pain.

  • Musculoskeletal pain related to pelvic weakness – Strengthening exercises stabilize the pelvis and reduce compensatory back/hip muscle strains.

Pelvic floor physiotherapy can also help prepare for or recover from pregnancy and childbirth. Postpartum therapy helps new mothers regain pelvic muscle strength after vaginal delivery.

Who Can Benefit From Pelvic Floor Physiotherapy?

For many patients, pelvic floor physiotherapy reduces urine or stool leakage, allowing them to return to work and physical activity without shame or fear of embarrassment. Pain and discomfort during sex or bowel movements also improve dramatically.

Overall, patients report greatly improved quality of life thanks to reduced symptoms, medication needs, and activity limitations. The customized exercises and lifestyle changes you learn can help you manage pelvic floor dysfunction long-term.

While some mild prolapse or incontinence may persist after therapy, symptoms typically become much more manageable. Patients feel empowered by a greater sense of control over their pelvic floor.

Most importantly, pelvic floor physiotherapy gives you the tools to properly strengthen and coordinate these important muscles again. Just be sure to commit to your prescribed home exercise routine for the best and longest-lasting results.

A man is receiving pelvic floor therapy on an exercise ball.

Pelvic Floor Physiotherapy for Pregnancy and Postpartum Recovery

Pelvic floor physiotherapy is highly recommended for expecting mothers to help prepare the pelvic floor for childbirth. Prenatal physiotherapy focuses on:

  • Strengthening pelvic muscles to aid in delivery and prevent tearing
  • Learning optimal pushing and breathing techniques
  • Improving pelvic alignment and posture to accommodate pregnancy
  • Addressing pelvic girdle pain caused by relaxin hormone

Postpartum pelvic floor physiotherapy helps new mothers recover after vaginal delivery. Goals include:

  • Healing any perineal tears or reducing scar tissue discomfort
  • Restrengthening weakened pelvic floor muscles
  • Reducing urinary or fecal incontinence that often follows childbirth
  • Relieving painful intercourse that can occur postpartum
  • Improving core strength and posture

Whether before or after delivery, physiotherapy empowers women to quickly regain pelvic floor function and enjoy new motherhood.

Take Control Of Your Pelvic Health

If you’re struggling with pelvic floor dysfunction, don’t suffer in silence. Pelvic floor physiotherapy employs proven techniques to help you gain control over your symptoms. A customized treatment plan can improve muscle strength, bladder/bowel control, and quality of life. Consult a pelvic health physiotherapist to start addressing your pelvic floor problems today.

Frequently Asked Questions (FAQs)

Q: What is physical therapy?

A: Physical therapy is a treatment that involves the use of therapeutic exercises, manual therapy techniques, and other modalities to help restore and improve the function, mobility, and quality of life of individuals who are experiencing pain, injury, or physical impairments.

Q: What is pelvic floor physical therapy?

A: Pelvic floor physical therapy is a specialized branch of physical therapy that focuses on the evaluation and treatment of musculoskeletal dysfunctions related to the pelvic floor. It addresses issues such as pelvic pain, incontinence, pelvic organ prolapse, and sexual dysfunction.

Q: What is pelvic floor dysfunction?

A: Pelvic floor dysfunction refers to a wide range of problems that occur when the muscles in the pelvic floor are weak, tight, or imbalanced. This can lead to symptoms such as pelvic pain, urinary incontinence, constipation, and difficulty with sexual function.

Q: How can pelvic floor therapy help?

A: Pelvic floor therapy can help by addressing the underlying imbalances in the pelvic floor muscles. Through a combination of exercises, manual therapy techniques, and education, physical therapists can help patients strengthen or relax their pelvic floor muscles, improve their muscle coordination, and alleviate symptoms related to pelvic floor dysfunction.

Q: What does a physical therapist do in pelvic floor physical therapy?

A: A physical therapist specialized in pelvic floor physical therapy will work closely with you to evaluate your pelvic floor function and develop an individualized treatment plan. They may perform manual techniques, guide you through pelvic floor exercises, and educate you on lifestyle modifications to improve your pelvic health.

Q: What areas of the body are involved in pelvic floor physical therapy?

A: Pelvic floor physical therapy focuses on the muscles, ligaments, and connective tissues in the pelvic area. This includes the muscles that surround the bladder, rectum, and reproductive organs. By addressing the issues in these areas, it can help alleviate symptoms and improve overall pelvic health.

Q: What are some symptoms of pelvic floor dysfunction?

A: Symptoms of pelvic floor dysfunction can vary depending on the individual, but some common ones include pelvic pain, urinary or fecal incontinence, constipation, pain during sexual intercourse, and a frequent need to urinate.

Q: How does physical therapy help with pelvic floor weakness?

A: Physical therapy can help with pelvic floor weakness by providing exercises and techniques to strengthen the pelvic floor muscles. These exercises target the specific muscles involved and help improve muscle tone and coordination.

Q: Can physical therapy help with problems related to going to the bathroom?

A: Yes, physical therapy can help with problems related to going to the bathroom. By addressing the underlying pelvic floor dysfunctions, physical therapists can provide techniques and exercises to improve bladder and bowel control, reduce urgency, and alleviate symptoms of incontinence or difficulty with urination or bowel movements.

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