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What is Pelvic Physical Therapy?

spine, backbone, vertebrae

If you’ve ended up on this website, you probably have some idea of what pelvic physical therapy is about. Pelvic physical therapy includes physical therapy for the pelvic floor. It also includes therapy for women with osteoporosis or women going through menopause. Pelvic physical therapy is about the entire person, and not just her pelvic floor.

Some other common phrases that are related to pelvic physical therapy include:

  • Pelvic floor
  • Abdominopelvic health
  • Women’s health
  • Men’s health

Pelvic physical therapy is about optimizing the performance of the muscles, nervous system, and bony skeleton in the entire body, as related to the pelvis. A person with pelvic floor dysfunction may have impairments in her ankle or in her neck. Focusing on just the pelvic floor misses these other related body parts.

Pelvic Physical Therapy can help women with the following diagnoses:

Pelvic Floor

  • Dyspareunia (pain with intercourse)
  • Vaginismus
  • Pelvic Organ Prolapse
  • Episiotomy Site Pain
  • Constipation
  • Urinary Incontinence
  • Urinary Frequency/Urgency
  • Fecal Incontinence

Pregnancy/Post-Partum

  • Sciatica
  • Pelvic Girdle Pain
  • Low Back Pain
  • Diastasis Recti Abdominis
  • Scar Adhesions (i.e. Cesarean Birth)

Other Pelvic Health Conditions

  • Osteoporosis
  • Menopause

So what is the pelvic floor?

The pelvic floor is a sling of muscles, organs, and fascia at the bottom of the pelvic cavity. These structures are important for bowel, bladder, and sexual function. They are also a part of your four core muscles. These muscles work together to support your spine.

It is important for the muscles of the pelvic floor to be able to close when needed and release when needed. The muscles need to close to keep us continent with bladder (pee) and bowel (poo). The muscles need to release for intercourse, urination, defecation, and birth.

How does the pelvic floor relate to the rest of the body?

The pelvic floor muscles also work together with your abdominals, small muscles in your back (called multifidi), and your breathing diaphragm to support your spine. Dysfunction in the pelvic floor muscles can be correlated with any of these muscles. This may show up as back pain, indigestion, or core weakness.  

Pelvic floor dysfunction occurs when there is disruption in the relationship between the muscles, organs, and fascia. For example, if someone has dysfunction in the bowel (i.e. irritable bowel syndrome), they may start using their pelvic floor muscles to guard. This can result in overactive pelvic floor muscles, which can lead to pain or difficulty with urinating, defecating, or having sex.

So how can physical therapy help with this?

As explained above, dysfunction in one part of the pelvic floor can lead to dysfunction in another part of the pelvis. Therefor, it can be difficult to identify the culprit. A good pelvic physical therapist will take a detailed history to identify how to help your symptoms. Further details can be found in this blog post about what to expect with telehealth pelvic physical therapy.

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