Between painful sex, bladder leakage, and bowel issues – pelvic problems can be embarrassing and confusing. When things go wrong ‘down there’ it can bring up a lot of shame and make you hesitate to get help.
But you don’t have to suffer in silence, and there is hope. So, if you’ve tried Kegels and are still struggling, it may be time to visit a pelvic floor physical therapist.
Curious about pelvic floor therapy but nervous about trying it? Trust me, I get it! In this post, I’ll cover what pelvic floor physical therapy is, what to expect, and how to tell if it’s a good fit for you.
But first, let’s cover some basics…
Pelvic Floor 101
The pelvic floor is a group of muscles and connective tissues that help to support your bladder, bowel, and uterus. These muscles stretch like a hammock from your pubic bone to your tailbone and side to side.
Your pelvic floor has many jobs. It helps keep your pelvic organs in place and helps with bodily functions like peeing, pooping, and sex. Your pelvic floor muscles also work with your core and back muscles to stabilize and support your spine.
In short, your pelvic floor does a lot! So, when these muscles don’t relax or respond the way they should, it can be uncomfortable, painful, and even embarrassing.
What is Pelvic Floor Physical Therapy?
Many women talk to their doctor about their pelvic issues and are often told to “just do your Kegels.” Unfortunately, Kegel exercises are not the answer for most women – and can often make matters worse.
Pelvic floor therapy is so much more than Kegels. It’s a specialized form of physical therapy designed for people with pelvic floor dysfunction. Pelvic floor disorders are extremely common, affecting roughly 1 in 4 American women.¹ So if you’re suffering, know you’re not alone.
Pelvic floor dysfunction (PFD) is when the muscles of the pelvic floor don’t relax or respond the way they should. It can lead to conditions like a leaky bladder, painful sex, and constipation – all of which can limit your life.
Treatment involves exercises and methods to help relax and coordinate the pelvic floor muscles. The goal is to ease symptoms and relieve pain so you can get back to living life again.
Why Would You Need Pelvic Floor Therapy?
As mentioned, your pelvic floor helps to support your pelvic organs, including your bladder, bowel, and reproductive organs.
So when these muscles go haywire, it can cause a wide range of pelvic health issues. Here are a few reasons you may want to try pelvic floor therapy:
Urinary issues
Your pelvic floor muscles contract and relax to control the flow of urine. When these muscles don’t work as they should, it can show up as urination problems, such as:
- Bladder leakage
- Sudden urges to urinate
- Trouble emptying your bladder
- Needing to pee frequently
Some women with pelvic floor issues are diagnosed with interstitial cystitis (also known as painful bladder syndrome). This is a bladder disorder that can cause pain and pressure on the bladder wall.
Yet the latest research shows that as many as 87% of these cases are due to pelvic floor dysfunction, instead of an issue with the bladder lining. Translation: pelvic floor PT can be effective for up to 87% of interstitial cystitis cases!²
Bowel issues
Bowel problems are also common with pelvic floor dysfunction. This can manifest as:
- Constipation
- Bloating
- Irritable bowel syndrome
- Painful bowel movements
- Fecal leakage
- Bowel urgency
Pelvic organ prolapse
Pelvic organ prolapse is when one or more of the pelvic organs drops into the vagina. When this happens, it can make the uterus, bowel, or bladder bulge into the vagina. Understandably, this often leads to pressure and discomfort.
The hormonal and bodily changes of pregnancy and childbirth are the most common causes of pelvic organ prolapse. But menopause and having a hysterectomy can increase your risk as well.³
Pelvic floor physical therapy is essential to restore normal function after a pelvic organ prolapse. You may need pelvic floor muscle strengthening, relaxation, or coordination training. You may also benefit from wearing a pessary temporarily. This is a soft, removable device you place in your vagina that helps lift the prolapse into its normal position.
Sexual dysfunction
If your pelvic floor muscles are tight or overactive, it can cause pain during sex, known as dyspareunia or vaginismus. This can make it hard to orgasm or experience pleasure with intercourse. It can also make speculum exams particularly painful and make it difficult to use tampons.
Pelvic pain
When the pelvic floor muscles remain tight, instead of relaxing and contracting as needed, it can lead to ongoing pelvic pain. The pain may be in your pelvic joints, nerves, ligaments, tailbone, groin, vagina, lower abdomen, lower back, or your buttocks.
Pregnancy
Carrying a baby puts extra weight on your pelvic floor muscles. For many women, this causes pain, urinary and fecal incontinence, and pelvic organ prolapse.
The hormonal changes of pregnancy can also lead to constipation. And straining to pass stools can set the stage for hemorrhoids and painful tears. Vomiting and diarrhea are common during pregnancy as well. This puts extra pressure on your pelvic floor, which can trigger symptoms.
Luckily, there’s a lot you can do to help your body stay strong and pain-free throughout your pregnancy. Pelvic floor therapy uses a unique combo of techniques to support your body through the ongoing changes of pregnancy and prep for childbirth.
This includes techniques like:
- Perineal massage
- Postural training
- Mobility
- Breathwork
- Strengthening exercises
Pregnancy brings so many changes. It can feel like a lot is out of your control. But the more you prepare your body for what’s to come, the more empowered and confident you’ll feel.
Postpartum
As your hormones change to prepare your body for birth, so does your pelvic floor. The ligaments in the pelvis become more flexible and your cervix softens, which can lead to pelvic floor dysfunction.
Vaginal delivery can also put considerable strain and stress on your pelvic floor muscles. Yet having a c-section affects your pelvic floor too. Since the incision is made through your abdominals, it impacts your entire core, including your pelvic floor muscles.
Luckily, pelvic floor physical therapy can help address all of the issues above and help you find relief.
Pelvic Floor Therapy: What to Expect
At your first session, we always start with a detailed health history. We’ll dig deep to get a full picture of what may have led to some of the pelvic floor symptoms you’re experiencing.
From there, we’ll do a full body examination. Since the entire body interacts in some way with the pelvic floor, this helps identify any other issues that may play a role in your pelvic floor dysfunction.
Depending on your comfort level, we may or may not do an internal pelvic floor exam. If we do, it can be done transvaginally or transrectally. Depending on your health history and symptoms, we may do one or both, always with your consent.
Keep in mind, we don’t have to assess everything on your first visit. We just need enough information to have a starting point and begin putting the pieces together. For a complete walk-through on what to expect on your first visit, check out this video.
After the examination, we’ll have a much better idea about which areas we’d like to work on. We’ll then set some goals together for what you’d like to achieve through pelvic floor therapy.
Then, based on your exam, I’ll create a customized treatment plan. This will look different for everyone, but may include things like:
- Massage
- Trigger point therapy
- Exercises to train the core and pelvic floor
- Myofascial release with cupping
- Education
- Kinesio taping and other modalities to relieve symptoms
Some pelvic floor physical therapists also use biofeedback and electrical stimulation. In the past, I used them as well. And while they can be helpful at times, between technical glitches and set-up times, they can really eat up your session.
My clients have had much better success and long-term results with the manual therapy and exercise-based methods covered above.
Is Pelvic Floor Therapy Painful?
Pelvic physical therapy is meant to help resolve pain – not cause it! We go slow and communicate during your sessions, so it shouldn’t be painful.
Since we are working on sensitive areas, there can be some minor discomfort at times. But it’s short-lived and we always stay within your comfort zone.
How Many Sessions Do Most People Need?
Most people need between 6 to 12 sessions on average.⁴ But it all depends on your unique health situation. Typically, the more chronic or complex your condition, the more sessions you’ll need.
Get Relief with Pelvic Floor Therapy in Tucson, AZ
Pelvic floor therapy may seem intimidating at first. But I promise you, it’s not scary and can actually be quite fun. And I can tell you both personally and professionally – it works!
Pelvic floor issues are deeply intimate. Having a pelvic floor therapist who’s been in your shoes (that’s me!) can help ease your fears and let you know that healing is possible. So, if you’re tired of letting your pelvic floor issues limit your life, I’m here for you.
If you live in the Tucson area and are ready to get to the root of your pelvic floor dysfunction, book your first appointment here. My holistic approach to pelvic floor therapy helps me see the big picture underlying your symptoms, so you can feel better faster.
I also offer women’s health coaching and private yoga sessions to help boost your results. Nutrition and yoga were integral in my own healing, and I’ve seen the same in many of my clients.
Have a question that wasn’t covered here? Shoot me an email or check out my FAQ section at the bottom of this page. I look forward to working with you!
References
Dr. Emily Mason
Contact Me
