Pelvic floor physical therapy includes strengthening, manual therapy (both internally and externally), muscle re-education and coordination training, education for specific pelvic floor disorders, dietary changes, home exercise programs. This is an overview of common questions associated with pelvic floor physical thearpy, whether you should seek expert help at one of our Washington, DC locations, and some frequently asked questions about pelvic floor dysfunction.
What is pelvic floor physical therapy?
The pelvic floor is the group of muscles lining the pelvis and they support your organs, control bowel and bladder and provide sexual function for women and men. Like all other muscles in the body, the pelvic floor can lose motor control, become weak or tight resulting in a variety of issues.
Women’s health or pelvic floor physical therapy involves the evaluation and treatment of the pelvic floor. The evaluation of the pelvic floor involves taking a history and both an external and internal examination. The internal exam may or may not occur within the first visit. The main things that we are assessing during an internal portion of the exam are the overall health, muscle trigger points, strength, coordination and prolapse.
Something I hear quite frequently from clients is that they didn’t realize this part of the body could be treated, or that what they were experiencing was “normal”. Just because something is “common” does not make it “normal” and for most issues of the pelvic floor there is help.
What Is Pelvic Pain?
Pelvic pain can be caused by:
- Pregnancy and childbirth, which affect pelvic muscles and cause changes to pelvic joints
- Pelvic joint problems from causes other than pregnancy and childbirth
- Muscle weakness or imbalance within the muscles of the pelvic floor, trunk, or pelvis
- Changes in the muscles that control the bowel and bladder
- Tender points in the muscles around the pelvis, abdomen, low back, or groin areas
- Pressure on 1 or more nerves in the pelvis
- Weakness in the muscles of the pelvis and pelvic floor
- Scar tissue after abdominal or pelvic surgery
- Some diseases or illnesses
- A shift in the position of the pelvic organs, sometimes known as prolapse
Does pregnancy cause pelvic floor dysfunction?
Pregnancy is a common cause of pelvic floor dysfunction. Often women get experience pelvic floor dysfunction after they give birth. Your pelvic floor muscles and tissues can become strained during pregnancy, especially if your labor was long or difficult.
Is pelvic floor dysfunction hereditary?
Pelvic floor dysfunction can run in your family. This is called a hereditary condition. Researchers are looking into a potential genetic cause of pelvic floor dysfunction.
When is it time to see a pelvic floor physical therapist:
- Urinary Leakage or incontinence
- Small or large leakage of urine often occurs with exertion such as getting up from sitting, jumping, coughing, sneezing, running, lifting weights
- Frequent urination or nocturia
- Constantly needing to use the restroom, always using the bathroom before leaving the house, before meetings or long care rides
- Getting up during the night to use the bathroom
- Feelings of incomplete emptying
- Having just gone to the bathroom and still feeling the urge to pee
- Pelvic pain including vaginismus or dyspareunia
- Constant or intermittent pain in the pelvic region, pubic bone, pain with penetration, tampon insertion or gynecological examinations
- Feeling of heaviness or bottoming out sensations
- Feeling as if something is falling out of your pelvis with or without activity
- Unresolved hip or low back pain
- Hip or low back pain which has been treated unsuccessfully in physical therapy may have pelvic floor involvement
- Diastasis recti, C-section scar, pelvic floor scarring following tears during labor or episiotomy
- Testicular pain and pain with ejaculation
Is pelvic floor dysfunction different for men and women?
There are different pelvic conditions that are unique to men and women.
Pelvic floor dysfunction in men:
Every year, millions of men around the world experience pelvic floor dysfunction. Because the pelvic floor muscles work as part of the waste (excretory) and reproductive systems during urination and sex, pelvic floor dysfunction can co-exist with many other conditions affecting men, including:
Male urinary dysfunction: This condition can involve leaking urine after peeing, running to the bathroom (incontinence) and other bladder and bowel issues.
Erectile Dysfunction (ED): ED is when men can’t get or maintain an erection during sex. Sometimes pelvic muscle tension or pain is the cause, but ED is a complex condition so this may not be the case.
- Prostatitis: Pelvic floor dysfunction symptoms closely resemble prostatitis, which is an infection or inflammation of the prostate (a male reproductive gland). Prostatitis can have many causes including bacteria, sexually transmitted infections or trauma to the nervous system.
Pelvic floor dysfunction in women:
Pelvic floor dysfunction can interfere with a woman’s reproductive health by affecting the uterus and vagina. Women who get pelvic floor dysfunction may also have other symptoms like pain during sex.
Pelvic floor dysfunction is different than pelvic organ prolapse. Pelvic organ prolapse happens when the muscles holding a woman’s pelvic organs (uterus, rectum and bladder) in place loosen and become too stretched out. Pelvic organ prolapse can cause the organs to protrude (stick out) of the vagina or rectum and may require women to push them back inside.
Is pelvic floor dysfunction related to interstitial cystitis?
Interstitial cystitis is a chronic bladder condition that causes pain in your pelvis or bladder. Pain from the bladder can cause pain in the pelvic floor muscles and then loss of muscle relaxation and strength which is pelvic floor dysfunction. So, having one of these conditions increases your risk of having the other.
If you’re taking certain medications for interstitial cystitis, including antidepressants, these might cause constipation. Constipation can lead to worsening of your pelvic floor dysfunction symptoms. Check with your provider in case your prescription might be causing this problem.
Do not allow pelvic floor dysfunction to continue, see a Rose physical therapist immediately.
Just as with any muscle group it is important to see a physical therapist immediately upon noticing a disorder. By making an appointment at Rose to seek expert advice on pelvic floor dysfunction, you will increase your likelihood for speedy recovery. It is important to not allow for pain pathways to develop, or inappropriate use of musculature to continue, and these are things an expert physical therapist at Rose can help you to address. If you are suffering from pelvic floor dysfunction that you cannot ignore, then please give us a call to make an appointment immediately as well.
Rose Physical Therapy Group has long provided the best, expert pelvic floor treatments in the Washington, DC area. We also work with other area experts in this specialized field of care, however it is the unique skill acumen possessed by Rose therapists, who are skilled in not only understanding of the pelvic floor but have specialized training in many other treatments that may not seem related but often are, which makes Rose the gold standard of care in the Washington, DC area. When choosing a physical therapist for pelvic floor, you need to find someone who is an expert with years of experience or speicalized training, both of which exist at Rose.
If you are experiencing pelvic discomfort, please reach out to our team to schedule an appointment at either our downtown Washington, DC office near Dupont Circle, or at our Navy Yard location just a few blocks from Capitol Hill. Both our locations have physical therapists who are experts in Women's Health and pelvic floor health for both men and women.