By: Allison Weder
When your doctor refers you for pelvic floor physical therapy, you may feel nervous because you do not know what to expect. These feelings are common, and you can take comfort in the fact that you are not the only person who has these issues and has been to physical therapy for pelvic floor dysfunction. In fact, many women suffer from this condition.
Physical therapy for pelvic floor dysfunction is designed to help manage your day-to-day symptoms and the pain that is associated with pelvic floor dysfunction. The typical treatment process includes an initial evaluation, a treatment protocol, and a home exercise program. During the initial evaluation, past medical history is taken to find out more about the condition, a quick assessment of lumbar, pelvis, and sacral spine is performed to rule out any mechanical hip dysfunction problems that may affect strengthening the pelvic floor muscles, then finally, a pelvic floor assessment is completed to evaluate strength, painful areas, and muscle tightness. The treatment protocol may include therapeutic exercises for strengthening the core, abdominal, postural, and pelvic floor muscles. Other treatments may include education of behavioral changes, ultrasound, soft tissue mobilization, manual therapy, electrical stimulation, and biofeedback.
What is manual therapy?
Depending on your diagnosis, our women’s health physical therapist may insert a finger into the vagina or rectum and massage the muscles and connective tissue directly. If there is too much discomfort or the patient is uncomfortable with this type of treatment, the physical therapist may use external trigger point release to help relax the muscle, repeating the process until the muscle starts to release. Manual therapy takes time and patience, and may require one to three sessions per week, depending on the technique used and your response to treatment.
What is electrical stimulation?
With electrical stimulation, electrical energy is discharged through a probe inserted into the vagina. Electrical stimulation can slowly desensitize the nerves in the pelvic floor muscles or cause muscle contraction and then relaxation. Typically, this type of electrical stimulation is used at home after instructions are given by our therapists.
What is biofeedback?
Essentially, it is hard to read your own body and know how it works. Biofeedback is a teaching tool to help you identify and learn to control the correct muscles to decrease the sudden urge to urinate, decrease incontinence, and lessen certain types of pelvic pain. There are various types of biofeedback. The equipment can range from a simple, inexpensive device such as a blood pressure cuff to a highly expensive EMG machine. The advantages of using simple devices versus expensive, high-tech biofeedback units are that you get more carryover after therapy outside of the clinic setting. These simple devices can be used at home on your own and can include a perineometer, blood pressure cuffs as mentioned above, Swiss ball, and vaginal cones.
Home pelvic floor exercises
One of the main goals of therapy is to learn to control and, especially, relax the pelvic floor. Our therapists will teach you techniques at home to build on the therapies we do in our offices. This usually begins with general relaxation, stretching the leg and back muscles, maintaining good posture, and visualization of learning to sense your pelvic floor muscles and to relax them. “Kegel” exercises for the pelvic floor muscles are also used but with the emphasis on control and relaxation rather than strengthening.