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Pelvic Health – Men and Women

pelvic floor and incontinence rehab

Pelvic health encompasses issues of the gastrointestinal, urologic, gynecologic, and musculoskeletal disorders surrounding the pelvis.  Treatment helps to improve function and limit pain associated with these systems in the body

What is Pelvic Floor Dysfunction?

Pelvic floor dysfunction (PFD) is a muscular condition of the pelvic floor.  These muscles assist in bladder and bowel control as well as sexual function.  If coordination or muscle control is compromised, you can experience urinary or bowel incontinence and painful intercourse.  These pelvic floor muscles can present either too tight or too loose each leading to pain or dysfunction.

Causes:

  • Prostatectomy
  • Poor postural habits
  • Pregnancy and delivery
  • postpartum
  • Interstitial cystitis (painful bladder)
  • Low back or sacral iliac dysfunction
  • Hip pathology

How does it feel?

You may begin to notice urinary urgency, frequency or leakage.  You may begin to deal with constipation, abdominal cramping, diarrhea, or fecal leakage.  Some may struggle with pain during sexual intercourse.  Sometimes you may have pain in your genitals, pelvis, rectum, abdomen or low back. 

How can Physical Therapy Help?

Your Physical Therapist will evaluate your posture, low back and hip motion, core strength and specifically the muscles of the pelvic floor as needed.  Treatment may include:

  • Postural education.  Assessment of standing or sitting position can determine if your muscle around your pelvis are too tight (causing adaptive shortening) or too loose (contributing to prolapse or weakness).  Your physical therapist can educate you on awareness of muscular use and help to normalize muscular tone.
  • Improving hip and spine movement:  Your physical therapist (PT) can use hands-on techniques (manual therapy) to gently increase movement of your muscles and soft tissue and relieve pain.  The PT can teach your stretches and exercise to promote flexibility and strength surrounding your pelvis, hips and low back.
  • Core strength: Your PT can educate you in specific abdominal, low back, hip and pelvic floor exercises to restore stability around your organs and pelvis and promote improved function of your bladder and bowel.  The Pt may use biofeedback which is a noninvasive tool to allow you to visualize how the muscles of the pelvic floor are working.  These muscles are “out of sight” and at times difficult to feel or determine if you are using them correctly.  If the muscles have been traumatized d/t delivery or surgery or have become weakened over time, electric stimulation may be used to provide stimulation to assist the muscles to contract.
  • Special pain treatment:  Your PT may use therapeutic ultrasound or electric stimulation to reduce inflammation or promote blood flow to reduce pain.