Recover and Restore: The Benefits of Pelvic Floor Physical Therapy

Discover how pelvic floor physical therapy can help recover and restore pelvic health.

Understanding the Pelvic Floor: A Key Element of Women's Health

What is the Pelvic Floor?

The pelvic floor is a crucial region in the human body for both males and females. The pelvis and pelvic floor refers to an area of the body as well as a group of muscles, ligaments, and tissues that create a sling/hammock like structure to support several structures above. 

The pelvic floor plays several essential roles:

1. Supporting Pelvic Organs: Imagine your pelvis as a house, and the pelvic floor muscles are its foundation. These muscles, along with surrounding tissues, hold organs like the bladder, urethra, intestines, and rectum in place, ensuring they function correctly. 
2. Urinary and Anal Continence: The pelvic floor is responsible for maintaining urinary and anal continence. It helps control the release of urine and feces, preventing leakage and allowing you to voluntarily start and stop these processes as needed. 
3. Sexual Function: Additionally, the pelvic floor contributes to sexual function by supporting the organs involved in reproduction and sexual pleasure. Pelvic floor muscles are active in arousal and orgasm. Increased or decreased tone in these muscles can negatively impact one’s sexual function physically, as well as intimacy and relationships emotionally. 
4. Muscular Structure: The pelvic floor consists of both skeletal and smooth muscles, as well as ligaments and fascia. Like any other area of the body, we want this area to be able to both contract and relax as well as tolerate different loads and demands we may encounter throughout the day.

When functioning properly, the pelvic floor allows you to go about your daily activities without issue. However, pelvic floor dysfunction occurs when these muscles fail to contract or relax and coordinate correctly. This condition can lead to symptoms such as:

• Frequent bathroom visits
• Straining during bowel movements
• Leaking urine, stool or gas
• Pain during intercourse 
• Erectile dysfunction in males

What causes changes in the pelvic floor?

Changes to the pelvic floor can occur due to various factors affecting both men and women. Some of the factors include:

1. Pregnancy and childbirth
   • During pregnancy, the pelvic floor experiences increased pressure due to the growing uterus and increased weight of the baby.
   • Vaginal delivery can also stretch and weaken pelvic floor muscles, leading to issues like urinary incontinence (leaking) and pelvic organ prolapse. 
2. Aging
   • As we age, pelvic floor muscles naturally weaken. We can see this loss of strength and difficulty to gain strength across all areas of the body, not just the pelvic floor.
   • Hormonal changes during menopause can also impact the pelvic floor. 
3. Obesity
   • Excess weight puts additional demand on the pelvic floor muscle to function.
4. Chronic constipation
   • Straining during bowel movements can stress the pelvic floor. We want our posterior pelvic floor to be able to relax and lengthen with voluntary voiding. 
5. High-impact exercise
   • Activities like running and heaving lifting can place more stress and impact on the pelvic floor. These activities by no means are “bad”, we just need our pelvic floor to be able to hold up its end of the bargain.
6. Surgery or trauma
   • Surgeries in the pelvic floor area (e.g.hysterectomy) can affect pelvic floor.
   • Trauma may damage these muscles
7. Lifestyle factors
   • Chronic coughing can strain pelvic floor
   • Caffeine intake and medication use
   • Heavy lifting without proper technique and awareness can contribute to dysfunction.

The Importance of Pelvic Floor Health

Benefits Pelvic Floor Strength

Maintaining a strong and healthy pelvic floor is crucial is being able to participate in and return to desired activities. The pelvic floor provides stability and support to the core, enabling proper movement and preventing injuries. Additionally, a strong pelvic floor can enhance sexual satisfaction and intimacy.

Risks of a Weak Pelvic Floor

By prioritizing pelvic floor health, you can minimize the risk of experiencing issues such as pelvic pain, urinary leakage, and pelvic organ prolapse during exercise. It is important for everyone to understand that pelvic floor health goes beyond the pre- and postpartum period. 

When to Seek Pelvic Floor Physical Therapy

Pelvic floor physical therapy can be beneficial in various situations. If you experience any of the following, consider seeking professional advice and exploring pelvic floor physical therapy:

1. Urinary Incontinence: If you struggle with leaking urine, pelvic floor physical therapy can help strengthen the muscles responsible for bladder control. Common triggers include coughing, sneezing, or exercising (lifting, running, etc). 
2. Pelvic Organ Prolapse: If you feel a bulging sensation in your pelvic area or notice that your organs (such as the uterus or bladder) are descending, therapy can provide support and guidance.
3. Postpartum Recovery: After childbirth, the pelvic floor may be weakened. Pelvic floor therapy assists in rehabilitating these muscles both from a strength, coordination and timing aspect to address any issues related to delivery. Another reason to seek care postpartum is due to diastasis rectus. Diastasis rectus, which is also known as abdominal separation, is a very common condition that can occur during and after pregnancy. 
4. Pelvic Pain: If you experience discomfort in the pelvic region, therapy can help identify and alleviate the underlying causes, such as muscle tension or trigger points.
5. Preparation for Surgery: Before pelvic surgeries (e.g., hysterectomy), therapy can optimize muscle strength and coordination, leading to better surgical outcomes.
6. Sexual Dysfunction: Pelvic floor physical therapy can address issues like pain during intercourse, lack of sensation, or difficulty achieving orgasm.
7. Chronic Constipation: If you struggle with regular bowel movements, therapy can improve muscle function and coordination. It’s important to not strain and have the ability to lengthen as needed across the posterior pelvic floor.
8. Prostate Health (for men): Men can benefit from pelvic floor physical therapy to manage issues related to the prostate, such as urinary urgency or painful ejaculation.

How Pelvic Floor Physical Therapy Works

Pelvic floor physical therapy is a specialized form of therapy that focuses on assessing and treating pelvic floor dysfunction. It involves targeted exercises, manual therapy techniques, and education to restore optimal pelvic floor function.

What is Pelvic Floor Dysfunction?

Pelvic floor dysfunction is a common condition where you can’t correctly relax and coordinate the muscles in your pelvic floor to urinate or have a bowel movement. Think of your pelvis as being home to organs like your bladder, uterus, prostate, and rectum. Your pelvic floor muscles are the home’s foundation, supporting everything in place. Normally, your body tightens and relaxes these muscles effortlessly, just like any other muscular action. However, if you have pelvic floor dysfunction, your body keeps tightening these muscles instead of relaxing them or vice versa. The coordination problems may lead to various symptoms:

1. Trouble evacuating (releasing) a bowel movement
2. Incomplete bowel movements
3. Leaking
4. Pain during intercourse
5. Problems getting or keeping an erection

The exact cause of pelvic floor dysfunction isn’t fully understood, but several factors may play a role, including traumatic injuries, overuse of pelvic muscles, prior pelvic surgeries, and pregnancy and childbirth.

What to Expect During Pelvic Floor Physical Therapy

During a pelvic floor physical therapy session, a qualified therapist will evaluate the strength, coordination, and flexibility of the pelvic floor muscles. They may use techniques such as biofeedback, pelvic floor exercises, and manual therapy to address specific issues.

Once strength, coordination and flexibility of the pelvic floor muscles has been evaluated, a physical therapist will come up with a specified plan for the patient including exercises and/or manual therapies/manipulations to be able to work on the patient’s deficits. 

The therapist will also provide guidance on lifestyle modifications, bladder and bowel habits, and postural corrections to optimize pelvic floor health. The goal of pelvic floor physical therapy is to empower patients with the knowledge and skills to take control of their pelvic health.

The Pelvic Floor During & After Pregnancy

The Benefits of Pelvic Floor Physical Therapy Prepartum

Pelvic floor physical therapy can be very beneficial during pregnancy as your body approaches the big day: delivery. It can be confusing and uncertain as to how to train as your body is changing throughout your prepartum journey. Staying active during your pregnancy is not only good for you, but also your baby. Regular exercises can help ease the aches and pain you feel as your body is going through changes and prevent excessive weight gain. 

Seeing a pelvic floor specialist during your pregnancy journey can help keep you active for as long as possible. It’s normal to need to make changes to your frequency, duration and load of training/working out as you get closer to your delivery. However, a physical therapist trained in pelvic floor can assist you in knowing when and where to modify and scale activities and movements.

The Benefits of Pelvic Floor Physical Therapy Postpartum

Pelvic floor physical therapy postpartum offers numerous benefits. It can help in the recovery and restoration of the pelvic floor after childbirth, improve bladder and bowel control, alleviate pelvic pain, improve diastasis recti, and enhance sexual function. After childbirth, whether a vaginal or cesarean delivery, the pelvic floor has gone through some degree of trauma from the weight and pressure placed on it during pregnancy. After going through this “traumatic” event to the pelvic floor, the body needs proper healing and restorative care. 

Regain Bladder Control

While some see it as a “right of passage” as a mom to experience leaking when they sneeze, cough, jump or exercise, this phenomenon should not be accepted as the new normal for a new mom. When the pelvic floor has been weakened by the experience of childbirth, it now has a harder time helping with controlling the bladder, one of the main organs the pelvic floor supports. 

Through pelvic floor physical therapy, a specialized physical therapist will discuss this area of weakness and give recommended exercises and therapies in order to improve the patient’s ability to control their “urge to go”. 

Alleviate Pelvic Pain

After the pelvic floor has undergone trauma from childbirth, it is not only weakened from the additional weight and pressure from the pregnancy, it is now also dealing with the organs shifting back into place and getting reorganized now that the pregnancy is over. With this reorganization period, the body’s center of gravity is still more forward than it was pre-pregnancy, and this shift in where the pelvic region carries weight can cause pressure, which can present in feelings of “heaviness” or pain. 

Pelvic floor physical therapy helps strengthen the pelvic floor muscles, which will help strengthen the core, and return the body’s center of gravity around the pelvic region to be less forward. This shift in the pelvic region’s load will decrease pressure on the pelvic floor, reducing those feelings of heaviness or pelvic pain.

What is Diastasis Recti

Diastasis recti, also known as abdominal separation, is a common condition that occurs during and after pregnancy. 

• Diastasis recti refers to the separation of the rectus abdominis muscles (commonly known as the “six-pack” muscles) along the front of your abdomen.
• These muscles run vertically, and they meet at the midline of your stomach.
• During pregnancy, as your uterus expands, the abdominal muscles are stretched, and a band of tissue called the linea alba (which runs down the middle) thins and pulls apart.
• Pregnancy puts significant pressure on the abdomen. As the baby grows, it can really only move in one direction. The left and right abdominal muscles, along with the linea alba, are pushed outward and stretched to accommodate the growing baby. If the linea alba is overstretched and doesn’t come back together properly, diastasis recti occurs.
• Diastasis recti is most common in pregnant and postpartum women (though it can also occur in men and infants). It usually develops in the third trimester due to increased pressure on the abdominal wall as the baby grows.

Enhance Sexual Function

Pelvic floor muscles contract rhythmically during sexual arousal to help reach orgasm. Pelvic floor physical therapy can help improve sexual function in several ways. Those ways include:

1. Strengthening to pelvic floor: strengthening pelvic floor muscles can improve control over orgasm and increase the intensity of orgasm.
2. Relieving pelvic pain: manual therapy, myofascial release, addressing lower back and hips can all help alleviate pain and improve sexual function. 
3. Improving breath work: breathing if heavily integrated into the movement of our pelvic floor. Changing and coordinating breathing patterns can improve orgasm. 
4. Improving blood flow: increasing awareness, strength, and coordination to the pelvic floor can assist in improved blood flow, thus enhancing sexual sensation and ability to achieve orgasm. 

Dysorgasmia, which is painful orgasm, can be caused by pelvic floor muscle disorders and prostate issues along with several other factors such as mediation, infection, inflammation, or sexual trauma. Seeing both a physical therapist and/or a mental health counselor may be beneficial to improve sexual function and quality of life. 

Higher Quality of Life

By addressing pelvic floor dysfunction, new moms can regain confidence in their bodies and enjoy a higher quality of life. Pelvic floor physical therapy also provides an opportunity for moms to connect with other women who may be experiencing similar challenges and concerns.

It is important to note that every woman's experience with pelvic floor physical therapy may vary. Working with a qualified therapist ensures personalized care and an individualized treatment plan tailored to specific needs and goals.

Taking the First Step: Finding a Qualified Pelvic Floor Physical Therapist

Not Every Physical Therapist Can Do Pelvic Floor Physical Therapy

Finding a qualified pelvic floor physical therapist is essential for both women or men seeking to improve their pelvic health. It is recommended to consult with a healthcare provider or obstetrician for recommendations or referrals.

When choosing a pelvic floor physical therapist, consider their experience, credentials, and specialization in women's health. It is important to feel comfortable and supported during therapy sessions, as open communication is key to success.

Remember, taking the first step towards pelvic floor physical therapy is an investment in your health and well-being. Embrace the journey towards recovery and restoration, and celebrate the progress along the way.

Kinetic Specializes in Pelvic Floor Physical Therapy

At Kinetic Sports Medicine and Performance, we are specialized in pelvic floor physical therapy, which means we have the proper training, experience and passion to help anyone who wants to see a change in their pelvic floor strength. We work with women and men of all ages who are experiencing a variety of symptoms in their pelvic floor. We want you to do the activities you love without pain, heaviness, or leaking! 

If you’re curious how we can help your specific situation or set of symptoms, set up your free 15-minute consultation with one of our doctors of physical therapy today. We can lay out what a plan for you would look like to get you back to where you want to be!