As a pelvic health physical therapist, I often see people after they've visited countless other healthcare providers who have overlooked the muscular system. As they come in, I hear them say things like:
- “I have no idea why I’m here.”
- “I’m only here because my doctor told me to.”
- “So what exactly is pelvic health PT?”
- “Are we just going to do some Kegels?”
Pelvic health isn't a new type of physical therapy, however it is finally gaining some traction in the health and wellness industry. Physicians are now realizing that it’s not just for pregnant and postpartum moms. Pelvic health is for people of all genders, ages, and activity levels. Everyone has a pelvis, and therefore we all could benefit from better pelvic health. So let's discuss what pelvic health physical therapy actually is and how it can help you.
Pelvic health is an area of specialty within the field of physical therapy. It is typically not a significant part of a physical therapist’s education. Rather it is a specialization requiring much further study, training and practice following graduation from PT school. A pelvic health physical therapist holds both a degree in physical therapy as well as advanced credentials in the assessment and treatment of people with diagnoses that involve the pelvic floor musculature. Some pelvic health physical therapists take their education a step further by specializing in orthopedics, pediatrics, pregnancy and postpartum care, women’s health and/or men’s health. Having this additional knowledge gives them an even greater understanding of how to go beyond the pelvic floor to help you from head to toe.
The pelvic floor is made up of muscles and fascia that form a sling spanning across the bottom of your pelvis. It consists of 14 muscles in people with female genitalia, and 12 muscles in those with male genitalia. All of these muscles, in combination with your “core” muscles, must be functioning properly to ensure a healthy pelvis. Together they provide a foundation to the pelvic musculoskeletal structure for upright posture, support of your internal organs, and help regulating urinary and fecal continence as well as sexual function (erections, ejaculation, and orgasm).
Just like any other muscle in your body, the pelvic floor muscles can succumb to injury. And, similar to a torn ACL or a rotator cuff injury, the pelvic floor also responds very well to strength training or vice versa, to downtraining and relaxation.
Pelvic Floor Dysfunction is defined as an impaired ability to control (tighten and relax) your pelvic floor muscles. It can happen for a number of reasons, such as a sports injury, surgery, pregnancy, childbirth, inactivity, and cancer/radiation related dysfunction. Some common symptoms include:
- Sudden urges to urinate
- Leaking with exercise
- Frequent or painful urination
- Low back pain
- Painful sexual intercourse
- Abdominal pain or weakness
- Pelvic pressure and heaviness
- Erectile dysfunction
- Premature ejaculation
While these symptoms are common, they are absolutely not normal and could be a sign of Pelvic Floor Dysfunction. A physical therapist can help determine if you have this, based on your symptoms and the findings of a pelvic exam and movement screen.
Having a qualified physical therapist by your side who fully understands the relationship between your pelvic floor and how the body moves as a whole is key to attaining optimal pelvic health. Through a comprehensive assessment, I search for the underlying source of your musculoskeletal and movement limitations. I assess your symptoms and objective impairments to create a treatment plan personalized for you and your specific needs and goals. From there, each session is guided to ensure symptom reduction and goal-oriented success. I go beyond the symptoms and look at your whole body to help you recover from pain and injury, and safely return to a fulfilling life of sport, activity and wellness.
Each pelvic health treatment session is private and typically one hour long. They include a variety of skilled methods such as manual therapy, requiring internal and/or external techniques depending on your diagnosis. Some examples of manual therapy I employ include soft tissue and joint mobilizations, trigger point release, dry needling, and connective tissue manipulation. Treatments may also involve neuromuscular re-education and activation exercises with tools like Redcord suspension and Pilates, therapeutic exercise for general strengthening, breathing and relaxation techniques for downtraining, as well as education regarding anatomy, physiology, neural connections, and pain science. Your plan of care is established after the initial evaluation, and based on your diagnosis and complexity of symptoms.
Check out our Pelvic Health page to learn more about this topic.
Disclaimer: The views expressed in this article are based on the opinion of the author, unless otherwise noted, and should not be taken as personal medical advice. The information provided is intended to help readers make their own informed health and wellness decisions.