Pelvic Floor Rehabilitation
Pelvic floor problems can occur in many forms for both men and women. Fecal or urinary leakage and pelvic pain—are all common pelvic floor problems. The pelvic floor encompasses the muscles, ligaments, and connective tissue surrounding the organs in your pelvis (such as the bladder, rectum, and in the case of women, the uterus and vagina). Given the area of the body where pelvic floor problems occur, they can feel particularly embarrassing or uncomfortable to talk about and experience.
At University of Utah Health, our pelvic floor physical therapists are highly trained to diagnose and create customized treatment plans for your pelvic floor condition. Our dedicated providers are committed to helping you get your pelvic health back on track.
Finding Your Pelvic Floor Physical Therapist
Having a pelvic floor physical therapist is a personal relationship, where you will be discussing some of the most intimate things in your life. It's important that you find a therapist whom you feel comfortable with and can commit to working with to improve your condition.
Treating Common Pelvic Floor Dysfunction Issues
The common conditions of pelvic floor physical therapy we treat include:
- Urinary incontinence
- Fecal incontinence
- Pelvic and vaginal pain
- Pelvic nerve injuries
- Endometriosis
- Prostate inflammation
- Inability to pee (urinary retention)
- Constipation
- Irritable bowel syndrome
- Pre- or post-pregnancy related pain in the pelvis or back
- Pelvic organ prolapse
- Orthopedic issues like pain in the hip, lower back pain, joint pain, tailbone pain, or pubic bone pain
- Post-trauma pain or weakness in the pelvis
- Pelvic recovery from transgender surgical procedures like vaginoplasty
- Sexual trauma
Pelvic Floor Physical Therapy: What to Expect
In many cases, pelvic floor physical therapy is the only or best option for treatment of pelvic conditions. In instances where surgical options exist, and your health and condition qualify you for surgery, pelvic floor physical therapy can still be helpful both before and after surgery.
During your initial exam, your pelvic floor physical therapist will review your medical history and ask you questions about your health and behaviors that may impact your condition, such as:
- how much fluid you drink daily,
- what’s your diet, or
- how often you have sex.
The exam will take place in a private room and will last one hour. If you are comfortable proceeding with a pelvic exam, your pelvic floor physical therapist may also perform this examination during your initial consultation.
What Is Involved in an Internal Pelvic Floor Muscle Exam?
Most patients with pelvic floor conditions will need to get an internal exam of their pelvic floor muscles. The exam, performed by a pelvic floor physical therapist, can help identify any muscle, strength, or coordination problems you have that are causing you pain, discomfort, or functional impairments.
As part of an internal exam of your pelvic floor muscles, your pelvic floor physical therapist will need to place his or her finger into either your rectum or vagina to assess your pelvic floor muscles.
An internal exam of your pelvic floor is important for developing an accurate treatment plan. However, we can assess your pelvic floor muscles using other techniques such as:
- Pelvic girdle assessments — Your pelvic floor physical therapist will examine the health of your pelvic girdle, which is a complex ring of joints, ligaments, and muscles that connect the skeleton to the lower limbs as well as on the pelvic floor.
- Pre- and post-partum abdominal screening — We will examine your abdominal muscles to determine if there is a separation of the abdominal muscles (abdominal diastasis).
- Electromyography testing and biofeedback — We can use biofeedback sensors with a low-grade electrical current to stimulate a muscular response, which helps detect neuromuscular abnormalities.
These other assessments often aren’t as accurate at testing your muscle strength, tone, or coordination as an internal pelvic exam. It is your choice to decide which assessment is best suited for your needs and comfort.
Find a Provider
Pelvic Floor Dysfunction Treatment
We use a team approach when treating you for pelvic health conditions. Our pelvic floor physical therapists work closely with your gynecologist, urologist, urogynecologist, or other providers to ensure your care is coordinated and appropriate for the best pelvic floor rehabilitation outcomes.
Our treatment plans are highly individualized based on your condition and your personal goals, which may include:
- Behavior modifications to influence bowel/bladder habits, fluid intake, and diet habits.
- Body awareness and training to improve your posture and the movement of your joints and ligaments.
- Diaphragmatic “belly” or “chest” breathing techniques — These techniques will help with musculoskeletal pain.
- Exercises for you to do at home that strengthen, relax, or massage muscles, depending on your condition.
- Exercises that can help with bladder control, such as Kegels (repeatedly contracting the pelvic muscles that control the flow of urination).
- The use of biofeedback sensors with a low-grade electrical current to stimulate a muscular response.
- Manual manipulations — Your pelvic floor physical therapist will apply techniques such as kneading your muscles, joint mobilization, and joint manipulation.
- Muscle energy techniques — We apply a series of muscle contraction and relaxation exercises to mobilize a restricted joint by taking it through its full range of motion.
How Long Will You Need to Do Pelvic Floor Physical Therapy?
The length of treatment time will depend on your specific diagnosis as well as your own efforts to follow through with your treatment plan. Patients who consistently go to physical therapy and diligently follow their treatment plan can begin to see a reduction of symptoms within three months. However, they may need further treatments depending on their condition.
What Kind of Results Can You Expect?
The outcome of your treatment will depend on your diagnosis, motivation, and personal goals. Pelvic floor physical therapy will deliver the most success when you are committed to making lifelong habit changes that will strengthen your muscles and help alleviate symptoms.
Make an Appointment with a Pelvic Floor Physical Therapist
To schedule an appointment for pelvic floor physical therapy, you will need a referral from your gynecologist, primary care physician, urogynecologist, or other provider.
More Resources
What Is Prolapse? What Does It Feel Like?
If you're over 45 and like millions of other women, you may be suffering from pelvic prolapse. Pelvic prolapse is when the organs inside your pelvis (your bladder, vagina, uterus, cervix, & rectum) drop or fall--sitting lower than where they should.
Urge Incontinence Vs. Stress Incontinence
If your overactive bladder is getting in the way of your life, it can be helpful to know that there are different types of incontinence.
What Is a Pelvic Ultrasound?
A pelvic ultrasound is a test doctors use to see the organs inside your pelvis and make sure your reproductive organs are healthy. Getting a pelvic ultrasound can help you and your doctor rule out serious conditions that cause pelvic problems.
When Should You See a Urogynecologist
Do you have trouble with an overactive bladder, feel pressure in your pelvis, or feel like your vagina, bladder, uterus, or rectum has dropped, causing a bulge or pressure? You do not have to suffer through these symptoms. They are treatable symptoms.
