How Does It Work? And Do You Need It?
The pelvic floor is an important group of muscles. They create a hammock stabilizing your pelvis, and are responsible for your continence, pelvic support, contract for orgasm and lubrication during sex, and play a major role in pressure management.
When your pelvic muscles are functioning well, you should be able to:
- Empty your bladder and bowel completely without straining
- Have no leakage of gas, urine or poop
- Experience pleasurable, pain-free sex
- Experience a pain-free core, low back, and pelvis
- When these muscles are dysfunctional we see:
- Constipation and incomplete emptying
Pelvic Floor Physical Therapy:
Pelvic floor therapists are a specialized section of physical therapy dedicated to treating all dysfunctions related to the pelvic floor muscles.
Who is pelvic floor therapy for?
Pelvic floor physical therapy typically treats patients ages four and up, as well as all genders. It is recommended for patients with bowel, bladder, sexual or pain dysfunctions in their pelvis (this includes low back pain).
During pregnancy, physical activity and strengthening is important to reduce the risk of complications and decrease pain related to hypermobility. If you do not feel confident in the type of exercises you should be doing, I recommend seeing a therapist. If you are having pain that limits you, it’s also recommended to see a physical therapist.
All postpartum patients should seek consultation with pelvic floor physical therapy to address physical recovery. During delivery and throughout pregnancy your body changes a lot and requires rehab to get back to proper functioning.
How to see a physical therapist dedicated to the pelvic floor?
Pelvic floor therapists are specialists. In Tucson, there are insurance-run providers (with over 4 week wait times), and there are out of network or self-pay providers (with about a 1 to 3 week wait time).
Physical therapy continues to become more and more accessible depending on your insurance or desire to pay out of pocket, and you can even be treated in the comfort of your own home if you desire.
What to expect during your first visit?
During your first visit you will be asked questions about your bladder control and frequency, as well as your bowel control and frequency. You’ll also be asked a series of questions regarding returning to intimacy, pain, scars, tears, strength and much more.
Your posture will be assessed as well as screening for several dysfunctions. If you have concerns or questions, this is a great time to bring them up to your specialist.
What about internal examinations?
Yes… internal examinations do occur if appropriate. Your vaginal canal is lined with pelvic floor muscles and your therapist will want to evaluate this following consent and clearance from your physician or midwife. We are evaluating muscle function, tone, strength, and assessing for decreased support or causes or pain.
Please do not delay treatment because you are uncomfortable with an internal exam; there is plenty to work on, and internal exams are not always necessary for full recovery.
Pelvic Floor Screening:
All postpartum pelvic floor physical therapy examinations should screen for:
- Pelvic floor strength and tone
- Perineal scar mobility
- C-section scar mobility
- Diastasis Recti (abdominal separation)
- Lumbopelvic strength and posture
- Pain with sex
Pelvic floor therapists are trained to screen and start treatment for all the conditions above. If you’re worried about pelvic floor therapy being embarrassing or painful, remember that therapy is meant to relieve your discomfort, never to make it worse.