Treating Chronic Pelvic Pain with Physical Therapy

Pelvic floor physical therapy is an evidence-based, non-surgical approach to treating chronic pelvic pain and pelvic floor disorders. Treatment starts with an assessment by a specially-trained physical therapist (PT), who has received specialized training in evaluating and treating pelvic floor disorders. The initial evaluation typically includes:

• Checking the motor control, strength, and endurance of core support muscles.
• Assessing your pelvic floor muscle coordination for different activities and positions.
• Other testing, as needed.

Based on the findings of this exam, the physical therapist creates a unique treatment plan to help you improve your pelvic floor function. The treatment plan may include working with you on behavioral approaches such as bladder re-training techniques. Plus, an individualized physical therapy regimen to help rehab your pelvic floor muscles. The physical therapist may use a variety of techniques. Specific treatments help to improve urinary and/or fecal continence.

Pelvic Floor Physical Therapy

To understand what pelvic floor therapy is, it is important to understand what it is not. Pelvic floor physical therapy is not:

• Just for women. Men, women and children suffer from pelvic floor disorders and could benefit from therapy.
• Just massage and kegels. A variety of techniques are used to treat patients.
• Evaluation or treatment involving speculums or stirrups. Neither is used in pelvic floor physical therapy.
• A "one size fits all" program. Treatment is uniquely designed to your specific needs.

How can pelvic floor physical therapy help me?

The treatments used by our pelvic floor physical therapists are designed to address issues with the structures of the pelvic floor (i.e. nerves, lymphatics, muscles, connective tissue, skin, and bones). Pelvic floor physical therapy exercises and treatments aim to improve:

• The leakage of urine or loss of bladder control.
• Painful sex and vaginal pain.
• Sexual dysfunction (male and female).
• Pelvic pain and discomfort in the vaginal area with or without sexual interactions.
• Pelvic organ prolapse (the dropping of the bladder, rectum or uterus).
• Constipation or incomplete bowel or bladder emptying.
• Back, hip or sacroiliac joint (SI) pain that has not improved with time or traditional treatment.

What should I expect when I visit the pelvic floor physical therapist?

Our certified and well-trained therapists welcome you in a comfortable and friendly environment. We also believe in a team approach to care so that you are in control of your treatment.

At your first visit, we'll do an initial evaluation that lasts about 60 minutes. This evaluation typically includes:

• A detailed discussion including an explanation of your medical history and your condition.
• Checking the motor control, strength and endurance of core support muscles.
• Assessing your pelvic floor muscle coordination for different activities and positions.
• An external and external and internal assessment of your pelvic floor function including strength, coordination, tone and sensation.

Based on the findings of this exam, we'll create a unique treatment plan to help you improve your pelvic floor function. The treatment plan may include working with you on behavioral approaches such as bladder re-training techniques. Plus, an individualized physical therapy regimen to help rehab your pelvic floor muscles. The physical therapist may use a variety of techniques specific to your needs.

Available Therapies for Pelvic Health

Pelvic floor physical therapist may utilize a number of different therapies to treat chronic pelvic pain and pelvic floor disorders, including:

• Stretching exercises, massage and other relaxation techniques.
• Kegel exercises: Regular, daily exercise of pelvic muscles can make the pelvic floor muscles stronger and improve, and even prevent, urinary incontinence.
• Biofeedback: Uses different types of devices to give information on how well pelvic muscles are contracting. The message or "feedback" can help improve awareness and control of pelvic floor muscles. This is often used along with kegel exercises to help patients gain awareness and control of the pelvic muscles.
• Vaginal weight training: Small weights are held within the vagina by tightening the vaginal muscles.
• Pelvic floor electrical stimulation: Mild electrical pulses stimulate muscle contractions. This may be done along with Kegel exercises.