Physical Therapy for the
Pelvic Floor
What is Pelvic Floor Physical Therapy?
Pelvic Floor physical therapy encompasses all the elements of traditional physical therapy with the addition of specialized evaluation and treatment techniques that address dysfunction in the pelvic floor. It can be very helpful for people of all genders and ages experiencing bowel, bladder or sexual dysfunction, low back pain, groin pain, and much more.
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The pelvic floor refers to a sling of muscles and fascia that stretches across the pelvis from the pubic bone in the front to the tailbone in the back.
These muscles are often ignored but serve many critical functions, including:
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Supporting the bowels, bladder and sexual organs
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Integration with the core to provide stability and strength to the entire body
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Control of urination and defecation
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Promoting sexual arousal and orgasm
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Just like other muscles in the body, these muscles can become too tight, too weak, develop trigger points, become incoordinated, or any combination of these traits. This can be caused by childbirth, sexual or physical trauma to the region, surgery, prolonged sitting and periods of high stress. Other times symptoms develop slowly over time with no known cause.
What Conditions Can Pelvic Floor Physical Therapy Treat?
Pelvic Floor physical therapy is highly effective at treating a variety of conditions, including:
Bowel and Bladder Dysfunctions
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Urinary Incontinence -"I pee every time I jump or cough", or "I just can't hold it!")
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Fecal Incontinence
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Urinary Frequency -"I have to go all the time!"
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Urinary Urgency -"As soon as I feel like I need to go, I have to find a bathroom!"
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Constipation and/or Diarrhea
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Urinary Retention -"I feel like I can't empty all the way"
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Interstitial Cystitis -"It burns in my lower abdomen when my bladder is full"
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Irritable Bowel Syndrome
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Acid Reflux
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Dribbling/leakage after urination
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Sexual & Pelvic Dysfunctions
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Pain with sex (with insertion or deep penetration)
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Pain with ejaculation or orgasm
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Pain with erection
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Difficulty with orgasm
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Erectile Dysfunction
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Premature Ejaculation
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Fear, anxiety or discomfort with sex associated with sexual trauma
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Testicular Pain
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Prolapse
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Painful Menstruation
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May Thurners Syndrome or Pelvic Congestion Syndrome
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Endometriosis
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Scarring from c-sections, episiotomies, or other abdominal surgeries
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Musculoskeletal Pain and Instability
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Pre/post partum pain and weakness
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Diastasis Recti (division of abdominal muscles after childbirth or weight gain)
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Low back pain
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Sacroiliac joint pain
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Hip pain
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Tail bone pain
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Groin or Pelvic Pain
C-section/Abdominal Scarring
Urgency & Incontinence
Bowel Pain
Groin or Testicular Pain
How Does Pelvic Floor Physical Therapy Help?
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Targeted stretches and exercises: These can involve the pelvic floor muscles as well as many other muscles in the body that support pelvic floor function.
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Note: Kegels are not always the right technique to use, and it is easy to do them wrong without supervision!
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Manual therapy: Used to relieve tension and trigger point in the muscles of the pelvic floor, hips and low back. This therapy can be administrated both internally and externally, depending on the patient's symptoms and preference. Can include tools such as cupping, skin rolling, and much more.
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Biofeedback: Advanced electromyography tools that allow patients to visualize when and to what extent their pelvic floor muscles are contracting and relaxing.
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Myofascial release: A specialized form of massage developed by John Barnes which addresses the connective tissue that surrounds the muscles, organs, nerves and blood vessels of the region. Releasing this tissue can also be an integrative part of healing from past trauma.
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Visceral massage: Specific manual therapy to realign and relieve compression/tension on the abdominal organs that can contribute to bowel and bladder dysfunction.
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Autonomic Nervous System Rebalancing: A variety of guided breathing, meditation, vagal nerve stimulation and muscular exercises designed to reset the subconscious nervous systems responsible for directing digestion, urination and stress response, among others.
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Myokinesthetics: Specialized neuromuscular retraining that works to reset the nervous system and postural imbalances that can contribute to pelvic floor symptoms.
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Microcurrent Point Stimulation: The application of microcurrent technology to release scar tissue and adhesions formed from c-sections, episiotomies, tummy tucks, or other procedures and traumas. In research, this modality has been shown to relieve 75% of chronic pain associated with scars 1.
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Trigger Point Dry Needling: Using fine acupuncture needles to directly penetrate trigger points, releasing tension and decreasing pain in a very efficient manner. This can be performed on the psoas, glutes, hip rotators, back muscles, or pelvic floor muscles. I use this in conjunction with microcurrent point stimulation for 2000% more neuromodulation compared to traditional dry needling.
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Mindfulness and Meditation Techniques: Specific tools useful for decreasing stress and anxiety, regulating the autonomic nervous system, and breaking the biopsychosocial cycle of chronic pain and tension.
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Bladder Retraining: Various techniques to decrease urgency, increase bladder capacity, reduce retention and/or decrease leakage.
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Dilator Protocols: Guiding you in the use of graded sizes of silicone devices at home to increase capacity for penetration, either rectally or vaginally.
At the first visit, we will discuss your symptoms at length. We will evaluate posture, muscle tension, strength, and motor control, among others, and will create an program for therapy and exercise customized to meet your needs and lifestyle.
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If you have any questions and want to discuss whether Pelvic Floor PT might be right for you, email or text to schedule a free 10 minute phone consultation!
Targeted Exercises
We have done extensive training in the pelvic floor field and have worked with male, female and LGBTQIA+ patients of all ages. We use a holistic approach that addresses how all parts of a person - their mind, nervous system, muscles, connective tissue, organs, and story. As such, we use a wide variety of techniques and tools to treat patients, based on their unique presentation. These include:
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Microcurrent Point Stimulation for Scars, Trigger Points, and Autonomic Regulation
