The field of pelvic floor physical therapy has skyrocketed in the last several years-what used to be a hard to find subspecialty has made it's way into hospitals, outpatient clinics, and private practices alike. Many people are now recognizing the importance of pelvic floor physical therapy, but what IS it? You may have heard about it on social media, maybe were referred by your OB/Gyn, or possibly had a friend who couldn't stop raving about the results they got after having finally tried it. Let's dive in!
Your pelvic floor is made up of muscles.
This may seem like common sense, but it can be an easy thing to forget! The pelvic floor-the three layered sling of muscles that line your pelvis and connect your pubic bone to your tailbone, is made up largely of muscles! These muscles have several functions, including sexual, support for internal organs, sphincteric (closing sphincters), and stabilization of bony joints! That is a ton of functions for a handful of small muscles. These little powerhouses can get injured, weak, or tight, just like any other muscle in the body, and when that happens, physical therapy can be a huge key in correcting any issues that arise!
"Common" pelvic floor symptoms
Have you ever heard a group of women joking before your workout class about needing to pee before the workout, "just in case", to make sure they don't leak? While urinary leakage, like many other pelvic floor symptoms, is common, it is not NORMAL! As a society, we have normalized the idea that after having kids women should just deal with peeing or feeling like their vagina will fall out when they cough, laugh, or sneeze. While these symptoms may be common, they aren't normal and can be treated with pelvic floor physical therapy!
-Pelvic, vaginal, or rectal fullness or pressure
-Pelvic pain
-Urinary, fecal, gas leakage
-Painful penetration
Men have pelvic floors, too!
While oftentimes people think only ladies are lucky enough to have pelvic floors, men have the same muscles as women, although admittedly they aren't shaped quite the same at all layers. Men can also benefit from physical therapy as well, for similar conditions to women (pelvic pain and incontinence), or completely unique issues such as pain with erection!
The pelvic exam isn't what you think.
For many women, the word "pelvic exam" sends images of speculums and uncomfortable PAP smear exams. While these annual check ups are integral to our health and thus valuable, a pelvic floor physical therapy exam isn't anywhere near as involved. Your pelvic floor physical therapist often will use one gloved finger inserted vaginally or rectally to assess the strength, tone, and quality of the muscles in your pelvic floor. Often, this will include your therapist locating different muscles and identifying potential "trigger points", as well as asking you to perform several series of muscle contractions in order to assess the strength and endurance of the muscles. It is important to note that YOUR CONSENT is needed along every step of your exam. If at any point you feel uncomfortable, it is within your right to cease treatment and decline further intervention!
Can't I just do some kegels and call it a day?
Not quite. Kegels are obviously wildly popular, and everyone tells everyone to do them. The thing is, kegels can be REALLY hard to perform correctly for some women. On top of that, if you have too much tone in your pelvic floor already (imagine you are walking around clenched all day), and then try to do a contraction on top of that, not only will you not be successful in strengthening anything, but you also may end up making your symptoms worse! Imagine if someone's answer to you saying you wanted stronger arms, was to do 200 bicep curls a day, or even worse, walk around carrying a 20# dumbbell halfway curled, all day, constantly. You would look at that person like they were nuts! The same principle of strengthening applies to the muscles in our pelvic floor as it does to the muscles in the rest of our bodies! While not EVERY treatment session involves internal work, the internal exam does provide a very large piece of the picture in terms of the true cause of the dysfunction!
What kinds of exercises do you do in pelvic floor physical therapy?
Pelvic floor physical therapy expands beyond just the muscles in your pelvis. While there is typically an early phase focusing on things like breathing, pelvic floor, and lower abdominal work, eventually the goal is to progress to functional movement! We truly mean it when we say performing a back squat with a barbell or walking lunges in and of itself can be pelvic floor strengthening exercises when you learn how to coordinate the components properly!
Who is pelvic floor physical therapy for?
Everyone. No, seriously, everyone! If you are reading this right now, odds are you have a pelvic floor!
All joking aside, there are so many groups of people other than the typical groups you'd think of that could benefit from pelvic floor physical therapy, including postpartum women, menopausal women, cancer survivors, weightlifting athletes, runners, cyclists, and the list goes on!
If you have ever been unsure of whether or not pelvic floor physical therapy can help you, please reach out! I would love to chat with you and determine what the best game plan is for you!
Were there any other questions you have about pelvic floor rehab? Drop them below!