Everything that you NEED to know about Pelvic floor therapy!

What is Pelvic floor therapy?

Pelvic floor therapy means physical therapy for the pelvic floor muscles. Just like any other body part, pelvic floor muscles need to be addressed and treated, if there is tightness/weakness/restriction/incoordination/injury. Most people are not sure what exactly it is and who needs it. Extensive research has been done in this field over the past few decades and the awareness is gradually increasing to the importance of the pelvic floor for the normal function of the body and for physical fitness.  

Who benefits from pelvic floor therapy?

There have been numerous studies that emphasize the benefits of pelvic floor therapy in those who have pelvic floor issues like leakage/incontinence, prolapse, diastasis recti (doming due to separation at the abdominal wall, mostly postpartum), hernia, painful intercourse, constipation, abdominal pain, difficulty with urination/bowel movement, endometriosis, interstitial cystitis, painful menstruation and many other diagnoses. Pelvic floor therapy is also commonly indicated in those who have core weakness, pelvic pain, those recovering from childbirth, and those suffering from chronic muscular fatigue, low back pain, hip/groin pain, chronic myofascial pain, gut disorders and sometimes even those with breathing difficulties and/or neck/jaw related dysfunctions. 

No matter what your age - you can improve your quality of life!

Pelvic floor therapy empowers women - pregnant, post-partum, elderly - all women of any age, to understand their body, their pelvic health, their core fitness and their connection/awareness to the mind and breath, and works at a deeper level to strengthen the foundation of your body, to function to its full capacity without having repeated setbacks/injuries/aches and to improve their quality of life to another level, to be independent and to be the nurturing source for their family!  

Anatomy and function of your pelvic floor:

Let’s talk about what “Pelvic floor” means. Pelvic floor is made of layers of muscles that form a sling between the two “sit bones” on either side, pubic bone in the front and the tailbone in the back. It stretches like a “hammock” and supports the bladder, uterus (in women) and the rectum. Pelvic floor is connected to the internal organs/blood vessels through “fascia” (a thin, dense, interconnected web of connective tissue which forms an envelope around all the cells of the body and has millions of nerve endings and sensory receptors). The muscles attach to the bone via tendons and the joints have ligaments that hold it together and provide stability. All the muscles are supplied by blood vessels, and nerves just like all the other muscles in the body. These pelvic floor muscles assist in the bowel/bladder control and sexual function. The pelvic floor muscles form the base of the group of muscles commonly called the ‘core ’. These muscles work with the deep abdominal (tummy) and back muscles and the diaphragm (breathing muscle) to support the spine and control the pressure inside the abdomen. Pelvic floor is an extremely important part of your core and works in sync with other core muscles as you move and perform your daily activities. The joints and muscles above and below can have an indirect impact on the pelvic floor via the kinetic chain, as everything stacks on top of each other and when you move/walk the forces that go through your foot will transmit up based on how your kinetic chain functions. 

Are you pregnant?

If you are pregnant, it is very important to understand how your pelvic floor and other core muscles work together and take steps to correct any muscular imbalances that you may have,to better prepare your body for child-birth. Pelvic floor therapy during the prenatal period includes a variety of techniques that you can utilize to decrease the aches/pains during pregnancy based on your presentation, and to reduce the chances of severe perineal tears during childbirth. You’re empowered with knowledge and techniques so that you have more control over your body and so that you can enjoy the precious moments during your pregnancy without having to deal with any miserable symptoms while preparing for the little one’s arrival. Studies show that having prenatal pelvic floor therapy has a great impact on your recovery postpartum -  very similar to the situation where you have a prehab before a knee surgery for better recovery after surgery. Prenatal pelvic floor therapy makes the childbirth process slightly easier because then you have better muscular flexibility, improved strength, optimal alignment and joint mobility, improved muscular balance, coordination and improved biomechanics, which aid the childbirth (a physiological process) and can have a big impact on the duration of labor, complications and recovery. It is a good time to check in with a pelvic floor therapist around the 24 week timeline during your pregnancy and address any concerns or previous injuries that you may have had, as those can have an indirect effect on your pelvic/core fitness through altered gait, movement patterns and fascial restrictions. This would be the right time to talk about your exercise regimen with a movement specialist - a physical therapist/pelvic floor therapist who is an expert in that. Many countries now advocate pelvic floor therapy for pregnant and postpartum moms to prepare them and help them recover quickly and safely after childbirth (vaginal or C-section) to get them back to their full potential and prior level of function. Afterall, the tremendous work of creating another human being and caregiving right after that, definitely calls for more attention, care, before childbirth and a carefully guided recovery afterwards, instead of jumping back to regular workouts after the 6 week mark.

Postpartum pelvic floor therapy - why is it a must?

Pelvic floor therapy is equally important, if not more, during the postpartum period. Postpartum pelvic floor therapy is crucial for systematic regain of balance, alignment, awareness, mobility and strength. As you’re going to be taking care of the little one for the next year or two as they grow and gradually start weighing more (increased physical demands will probably include repetitive bending, twisting, lifting baby + car seat, and possibly breastfeeding), it is going to be physically challenging, if your pelvic and core health is not restored to optimal function while doing all that. Studies show that women who have had pelvic floor therapy after their 6 week postpartum checkup (if not earlier) tend to heal faster and in a safe manner to be able to care for their baby without getting injuries and aches/pains from all the physical challenges that your body has to go through. It probably is not a coincidence that a lot of women who deal with chronic low back pain, pelvic pain, abdominal pain, incontinence, chronic fatigue, prolapse, sciatica-like pain, hip pain and many other symptoms say that their symptoms first started after childbirth. It is not surprising considering the fact that your body goes through a major change and it is a trauma for the pelvic floor and the core muscles, just like it would be for other muscles after a surgery. If the symptoms get ignored, the muscular imbalances start building up as the body adjusts to the high demands placed on it and makes it prone to other injuries in the future. Diastasis recti and perineal tears/ C-section scars which are common after pregnancy/child-birth need to be addressed for optimal healing of your core. Our pelvic health experts at Quintessence Physical Therapy can help you through our ‘pelvic health and core restoration program’ to get you back safely to taking care of all your responsibilities and caring for your baby without suffering through pain/limitations and be the nurturing source while creating happy memories of those precious moments! If it has been a while since you delivered your baby, and if you’re still struggling with the core strength/belly fat/pelvic pain/incontinence/painful intercourse or other symptoms and dealing with frustration and embarrassment; pelvic floor therapy and physical therapy with a holistic approach can get you back on track to reach your fitness goals!

What exactly does pelvic floor therapy entail?

During the evaluation, your physical therapist who’s specialized in all the issues related to pelvic floor function, will ask questions to get detailed history about your symptoms, triggers, limitations, goals and will perform a full assessment of the pelvic floor externally and/or internally (based on presentation and patient’s comfort level), in addition to comprehensively assessing the low back, hip and other body parts for any other related injuries/dysfunctions while looking at the kinetic chain function with gait/posture and movement patterns to get to the root cause of the problem. This is the crucial step to establish an exact care plan for your specific needs and for optimal recovery. An orthopedic physical therapist who is specialized and experienced in pelvic floor therapy and who has a holistic background can put all the pieces of the puzzle together by understanding the causative factor for the symptoms as most often the cause of the pelvic floor symptoms can be local or it could be related to a previous orthopedic injury, incorrect movement patterns, gait abnormalities and even scar tissue/incorrectly healed tissues/fascia. Instead of just putting a bandaid on the symptoms, it is important to find the cause for the symptoms to prevent recurrent flare ups and to promote a lasting recovery. 

Get your life back!

At Quintessence Physical therapy, we specialize in just that and the outstanding outcomes that we get with quick and lasting results is due to the fact that strive to give each patient the time and attention to detail and listen to their specific needs while looking at the big picture for the indications of the root cause through our holistic lens. We understand that this is a sensitive area to talk about for most people and it is important to find a therapist whom you can trust. We take great effort to make sure that you feel safe, comfortable and in control during your sessions and we provide you with all the guidance, assistance and education to get the relief that you need and deserve.

Pelvic floor therapy entails manual therapy techniques that are specific for your needs as established by your expert pelvic floor therapist. It may include correction of alignment, myofascial release, soft tissue mobilization, joint mobilization/manipulation, muscle energy techniques, neuromuscular reeducation, cupping, kinesiotaping, trigger point release, biofeedback. It could also include use of certain tools/products to help you perform certain techniques at home. Pelvic floor treatment sessions include a combination of hands-on manual techniques that are performed externally as well as internally based on the clinical findings during the evaluation. You’ll be provided a complete explanation of the techniques that’ll be utilized during your treatment sessions and how it will help with your condition. You may discuss with your provider if you’ve any questions/concerns and if you need alternate options. You’ll be empowered by understanding how your muscles work in relation to each other and certain specific self-release techniques you can utilize if it recurs, so that you can help your body heal and get stronger.

How is Quintessence physical therapy and pelvic floor therapy different?

At Quintessence Physical Therapy, we utilize a holistic (whole body) approach to evaluate and then to establish the individualized corrective exercise program based on a patient's presentation and modify it with ongoing assessments for quick results that carryover. We utilize neurokinetic therapy, biointegrative/biodynamic fascial techniques, craniosacral techniques, and a variety of other tools to accurately prescribe corrective exercises that are specific to you and those that complement the manual therapy techniques utilized during the hour long one-on-one treatment sessions with your therapist. We successfully treat complex cases who have previously tried traditional approaches and multitude of treatments without results. We help you heal and recover quickly so that you can get back to doing the activities that you love with your loved ones  without limitations again! The impact that it can have on the quality of your life is outstanding!

What can you do?

Are you or your loved one suffering from pelvic pain and associated symptoms? Well, you should know that pelvic pain or leakage, no matter how little, is not normal (even though it’s common) at any time and getting early treatment is crucial. The longer you experience chronic pain, the more likely that your nerve receptors will get sensitized to it. As a result, your body will develop a heightened reaction to pain, making it more severe and difficult to treat. Having said that, we have also treated a lot of patients successfully even post 20-30 years of having symptoms. So, even if it has been a long time since your symptoms began, you must know that there is help out there! You do not have to live with it! So, if you and/or your loved one is experiencing unexplained chronic pelvic pain/related symptoms, consult a specialist in pelvic floor disorders as soon as possible to get timely diagnosis and treatment. Share this information with whoever you know could benefit from this.

Do you know -  you can go to a physical therapist or a pelvic floor therapist directly without a referral?

You DO NOT have to wait and let your symptoms worsen before getting the care that you need. In Texas, as per the “Direct access law”, you do not need a doctor’s referral to see a physical therapist/pelvic floor therapist for the evaluation of your symptoms. It’s a great way to seek the care that you need right away without having to jump through hoops and waste precious time to get relief from your symptoms. At Quintessence Physical Therapy, we’ll make sure you’re a good fit. If not, we’ll guide you in the right direction. 

If you’ve any questions, we’d love to help you. 

 Call us at 512-200-3945 or email at info@quintessence-pt.com

Always remember - Holistic approach is the key to your wellness!

References: 

• AI assistance in developing this article.

• NeuroKinetic Therapy®