Pelvic Floor Therapy

Working with your provider, our certified therapist can help diagnose and develop a treatment plan for those with pelvic floor dysfunction (PFD).

The “pelvic floor” refers to a group of muscles that attach to the front, back and sides of the pelvic bone and sacrum (the large fused bone at the bottom of your spine, just above the tailbone). Like a sling or hammock, these muscles support the organs in the pelvis, including the bladder, uterus or prostate and rectum. They also wrap around your urethra, rectum, and vagina (in women).

Coordinated contracting and relaxing of these muscles controls bowel and bladder functions - the pelvic floor must relax to allow for urination, bowel movements and, in women, sexual intercourse.

PFD is usually related to the presence of too much tension (or high-tone) or the opposite - a too-relaxed state (or low-tone) that contributes to incontinence. However, sometimes patients with PFD can have a combination of muscles that are too tense and too relaxed.

Symptoms of PFD include:

• Urinary urgency, frequency, hesitancy, stopping and starting of urine stream, painful urination, or incomplete emptying
• Constipation, straining, pain with bowel movements
• Unexplained pain in the low back, pelvic region, genital area, or rectum
• Pain during or after intercourse, orgasm, or sexual stimulation
• Uncoordinated muscle contractions causing the pelvic floor muscles to spasm

Side effects of certain medicines commonly used, such as tricyclic antidepressants (amitriptyline, imipramine, and others), may worsen PFD symptoms. Ask your health care provider if your medicines may be contributing to your symptoms.

The diagnosis of pelvic floor disorder starts with a careful history regarding your symptoms, medical problems and a history of physical or emotional trauma that may be contributing to the problem. Next a physical examination to identify any abnormality will be conducted.  Using external and internal “hands-on” or manual techniques to evaluate the function of the pelvic floor muscles, your ability to contract and relax your pelvic floor muscles will be assessed. Because bones and muscles of your lower back, hips and sacroiliac joint can also stress your pelvic floor muscles, your exam will likely include an assessment of those areas.

The goal of PFD therapy is to relax these muscles and avoid stressing them. Treatment usually combines self-care, medicines, physical therapy and home exercise.