Tiffany Nielsen
PT, DPT, OCS
Pelvic Floor Physical Therapy is a specialized treatment approach of the pelvis addressing a variety of issues many individuals experience but rarely talk about. Pain, weakness, and tightness are common symptoms that develop over a period of time that may lead to pain or dysfunction with intercourse, incontinence, and many other unnamed conditions.
First, let’s cover what the pelvic floor is and why these structures are important. The pelvic floor is made up of 3 layers of muscles that attach to the front, back, and sides of the pelvis. The function of these muscles provides support for the organs in the pelvis, including the bladder, uterus/prostate, and rectum. When running optimally, these muscles provide a coordinated contraction and relaxation for proper bladder and bowel function. In addition to these muscles, there are layers of connective tissue, nerves, blood vessels, and bones that move together, maybe moving too much, or not at all, contributing to those frustrating symptoms.
Another key area included in the pelvic floor complex is the core. Surprisingly, your core is not just the 6-pack abs you do hundreds of crunches to achieve. The core is made up of the diaphragm, front abdominal muscles, low back muscles, and the pelvic floor, covering all sides of the body. Your core works very closely with the pelvic floor complex to assist in the support and relaxation of specific body systems for proper bladder, bowel, and sexual function. For instance, taking a diaphragmatic or tummy breath allows stretching and relaxation of the abdominal and pelvic floor muscles which may be too tight causing pelvic pain or breath-holding. Looking at these movement patterns may display dysfunctional habits we need to address.
Lastly, the evaluation of the pelvic floor itself requires an internal exam. This usually includes manual palpation with one finger, vaginally or rectally. It’s very similar to a gynecological exam but we do not use instruments, such as a speculum. The purpose of this exam is to evaluate the strength, relaxation, and coordination of the pelvic floor muscles, as well as the tightness, trigger points, and painful areas. By performing this assessment, it gives us the best overall picture of what is going on, and how to create an appropriate plan of care.
A thorough assessment of past injuries, surgeries, hobbies, and lifestyle habits are reviewed to determine if they are interfering with those aggravating symptoms. It’s especially important to know when addressing the pelvic floor, we look at the body as a whole. Every person is different and no two patients are the same. We carefully consider those factors and treat each person with a specific treatment plan. Pelvic Floor Physical Therapy is a non-invasive, conservative first-line approach to treating many dysfunctions of the pelvic region.
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Tiffany Nielsen
PT, DPT, OCS