Pelvic Health 101
By Molly Bachmann PT, DPT
You probably have heard of physical therapy for knee injuries while playing sports or back injuries from sitting too long at work. Did you know there is also pelvic floor physical therapy for urinary, bowel and sexual dysfunction as well as pelvic pain?
Let’s start with what the pelvic floor is. The pelvic floor is 3 layers of muscle that sit at the base of the pelvis. Their most important job is to keep our organs in place and keep us upright as they work with other postural muscles. They are unique in that they surround the urethral opening, go up to the base of the penis and clitoris, surround the vaginal opening, and surround the rectum. These muscles are part of what keeps us peeing and pooping regularly and what allow us to experience pleasure with intercourse.
Physical therapists undergo advanced post-graduate education in pelvic floor anatomy and physiology to help meet the pelvic health needs of patients. Considering the field of physical therapy as a whole, pelvic floor physical therapy is a more recent, but a quickly emerging field.
We can help people recover from symptoms that stem from impairments in the musculoskeletal, nervous, reproductive, urologic, and gastrointestinal systems. Pelvic health symptoms generally fall into a few categories: bladder, bowel, and sexual dysfunction and pelvic pain. The symptoms may develop for many different reasons, including injury, trauma, surgery, medication-induced, pregnancy, stress, menopause, overuse . . . just to name a few.
The pelvic floor and pelvic girdle muscles undergo significant changes during pregnancy and labor and delivery. Optimal pelvic health during pregnancy can help reduce musculoskeletal pain and dysfunction, ease labor and delivery, and help reduce postpartum complications. In 2018 the American College of Obstetrics and Gynecology issued a statement acknowledging that postpartum care in the United States needs to be improved, suggesting the term “4th Trimester” should be used for the immediate postpartum period and that postpartum women need more care than what is currently being offered. All pregnant and postpartum women can benefit from pelvic floor physical therapy given the crucial role these muscles play during delivery and how prevalent dysfunction is after birth. Pelvic floor physical therapy reduces the risk of pelvic organ prolapse, urinary, bowel, and sexual dysfunction and pelvic pain. Similar to other diagnoses we treat, many of our patients tell us they wish they knew about us sooner.
During pregnancy, our bodies undergo significant changes as the pregnancy progresses. Many women experience symptoms that pelvic floor physical therapy can address. Fortunately, some women tolerate pregnancy very well and experience no unwanted symptoms. For these women, pelvic floor physical therapy can help with the following: Optimize pelvic floor motor control to aid in labor and birth, improve pelvic floor and pelvic girdle neuromuscular function to reduce pain and dysfunction in the postpartum period, education and support throughout the pregnancy and during the postpartum period.
All new birthing parents should undergo an evaluation with a pelvic floor physical therapist. Ideally, this evaluation would take place in the first year following delivery; however, it is never too late to see a pelvic floor physical therapist. Postpartum pelvic floor physical therapy can help with:
- Urinary retention, urgency, frequency, hesitancy, pain and incontinence (leaking)
- Constipation, difficulty with bowel movement, fecal incontinence
- Painful sex, diminished or absent orgasm
- Diastasis Rectus Abdominis
- Restoring core function and strength: abdominals and pelvic floor
- Pelvic floor and pelvic girdle, low back, and hip pain
- Cesarean section and episiotomy scar tissue and pain
- Pelvic organ prolapse prevention and/or treatment
- Eliminate pain from perineal and/or levator ani trauma
- Reduce pain from pelvic neuralgias
At Pelvic Health and Rehabilitation Center, we work with patients across the gender spectrum and with children as young as 4. Check out our website to learn more!
