If you have pelvic floor dysfunction, you may have symptoms like urinary or bowel incontinence, pain, pressure, or problems with sex. One of the first treatments your gynecologist or urogynecologist may suggest is pelvic floor physical therapy (PT). This special kind of PT helps people with pelvic floor muscles that aren't working properly.
Pelvic floor physical therapy (PT) helps treat pelvic floor disorders. It is individualized therapy that can help you learn to strengthen or relax your pelvic floor muscles, depending on your symptoms and concerns.
These issues can affect people of all ages and aren't just a normal part of aging.
Like traditional PT, pelvic floor PT is about helping you function better. The area you’ll be working on includes your pelvic area and may also include your abdomen, lower back, and hips.
Pelvic floor PT can include different types of therapy, such as:
Pelvic floor physical therapists have specialized training. Your therapist will work with you one-on-one to ensure you’re comfortable with therapy. They will also determine which type of therapy is best for you.
To receive pelvic floor PT services, you'll need a referral, which your gynecologist, urogynecologist, or primary care doctor can give you.
UPMC offers pelvic floor PT in multiple locations throughout Pennsylvania.
Pelvic floor dysfunction happens when your pelvic floor muscles aren't working right. The muscles can be too weak or too tight.
There are different causes of pelvic floor dysfunction. Pregnancy and childbirth are a common cause, and we have a special program specifically for postpartum pelvic floor healing.
Sometimes, people have pelvic floor dysfunction without a specific reason. As you get older, you’re more at risk for pelvic floor disorders, but that doesn’t automatically mean you’ll have pelvic floor problems as you age. Genetics and lifestyle also play a role.
People often feel embarrassed to talk about pelvic floor disorder symptoms, which involve peeing, pooping, sex, and private areas of the body. Know that pelvic floor physical therapists are experts at having these conversations and helping you feel comfortable.
Yes, men can have pelvic floor issues. People born as males, or those without female reproductive organs, can have pelvic floor problems, along with anyone with female reproductive organs.
You might need pelvic floor PT if you have:
Your gynecologist is a good place to start if you’re having problems you think are related to your pelvic floor muscles.
Gynecologists treat pelvic pain, especially when it’s related to conditions like endometriosis. But if it’s pelvic floor dysfunction, they'll often refer you for pelvic floor PT. Pelvic floor physical therapists work closely with gynecologists and urogynecologists.
Some pelvic floor dysfunction is more severe than others, but it generally doesn’t improve on its own.
When you are suffering, it can be hard for you to know exactly what’s causing your symptoms. That's why you should speak to your gynecologist or see a urogynecologist.
Some people struggle to feel comfortable with the exercises during pelvic floor PT. But you always get to decide if you want to proceed. Open dialogue with your therapist during PT sessions is important.
If you’ve experienced sexual trauma in the past, mention it to your pelvic floor physical therapist. They understand these concerns and deal with them often.
It’s natural to have questions about what happens at pelvic floor PT; many people we see are nervous when they arrive.
Everything we do, we explain. And we always make sure we have your consent before any treatment.
During your first pelvic floor PT session, you’ll talk to your therapist in a private treatment room.
They’ll take a complete medical history and spend time learning about your issues. They’ll ask questions to try to see how your pelvic floor is functioning. And they’ll ask you about your goals and what you hope to get from therapy.
Your therapist will explain the nerves, muscles, and tissues of the pelvic floor. Understanding what the pelvic floor does and how everything works together can be empowering.
They’ll perform a physical exam to check the muscles around your pelvis, including your lower back, abdominals, and piriformis, to look for tender spots or tightness.
Your therapist may ask to do an internal exam at the first visit to assess your pelvic floor. During the internal exam, they’ll insert one or two gloved fingers into your vagina or rectum. This helps them determine how tight or weak your pelvic floor muscles are and how much control you have over these muscles.
You can decide if you want to proceed with this part of the exam.
What to know:
After assessing your pelvic floor, your therapist will work with you to make a plan. You'll be given exercises to do at home and a recommendation for how often you should come to pelvic floor PT.
Most people need four to six PT sessions, each lasting around 45 minutes. The number of sessions will depend on your problem and its severity.
Doing your exercises at home (which your therapist will explain) can help you be more successful with your PT.
There are many techniques we can use during therapy to help improve pelvic floor function. Remember, everything is optional, and you don’t have to do any internal work. The type of techniques will also depend on the therapist and your symptoms.
Therapy techniques can include:
Your physical therapist will likely lead you through exercises for you to do at home.
Exercises may focus on squeezing or relaxing the pelvic floor muscles. You may be asked to do them at various intervals and speeds.
They may also suggest a series of core strengthening exercises, such as hip lifts and planks. They’ll make sure you understand how to do each exercise and what muscles each targets.
You may also receive recommended posture exercises and stretches. Again, they'll make sure you understand how to do each move and why you’re doing it.
Pelvic floor physical therapy can help decrease pain and improve bladder and bowel problems, pelvic organ prolapse, and other issues. When you improve symptoms, you can improve your quality of life. You can get back to doing things you enjoy without worry.
There’s also an educational component. Most people don’t understand how the pelvic floor works or its importance. When you do pelvic floor PT, you learn to identify the muscles and see how they all work together.
Pelvic floor PT is a great first-line treatment for many conditions that cause pain and urinary problems. Some people may need additional treatments, including devices, medicine, and surgery.
Various studies have examined how pelvic floor therapy can help improve symptoms and quality of life.
A recent review study assessed several years’ worth of studies. The authors found that pelvic floor physical therapy can improve quality of life for people with pelvic floor
Last reviewed by Lauren Elizabeth Giugale, MD on 2024-09-05.
