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When Should I See a Pelvic Health Physical Therapist?

Jun 15, 2012 | 2 Min Read

When Should I See a Pelvic Health Physical Therapist?

Pelvic health physical therapists are knowledgeable resources to help treat pelvic floor-related health conditions. If you’re experiencing bladder leakage, pelvic pain, have given birth or undergone surgery that impacted your pelvic floor, it is a good idea to set up an appointment with a licensed pelvic health physical therapist.

Common Reasons for Seeking Treatment:

Urinary leakage/ incontinence
Postpartum
Pregnancy
Pelvic pain
Painful intercourse
Hip or low back pain

Pelvic health physical therapists can offer solutions safer than surgery, can reduce or eliminate pelvic pain and types of urinary incontinence, as well as recommend the right products to manage leaks, such as Poise® Ultra Thin Pads with Wings.

Safer than Surgery: Unlike surgery, pelvic health physical therapy offers a lower risk option and is less invasive, since the treatment focuses on muscle strength, endurance, and coordination.
Mitigate Pain: A pelvic health physical therapist improves pelvic pain symptoms that may be caused by a weakened pelvic floor or tight pelvic muscles. Further, pelvic health physical therapists can reduce pain during intercourse by increasing blood flow in the pelvis, releasing nerve tension and/or improving pelvic floor muscle strength or relaxation.
Address Incontinence: I recommend that anyone with bladder leaks or other forms of incontinence try pelvic floor physical therapy before medication or a more serious alternative, like surgery.

What to expect from a pelvic health physical therapist:

Pelvic health physical therapists can help you maintain a well-functioning pelvic floor, build muscle, correct postural problems, and maintain a healthy weight. I use the “Four S’s” to describe the function of the pelvic floor.

Support of organs (protects bladder)
Sphincteric function (prevents bowel/bladder leaks)
Sexual function
Support of posture (works with your core)

Pelvic health physical therapists assess how well the pelvic floor muscle contracts and relaxes, plus how well it coordinates in isolation and with larger muscle groups. Wondering what to expect from pelvic floor physical therapy? We treat patients through pelvic floor biofeedback, muscle coordination training, breathing techniques, behavioral retraining and progressive loading exercises, a technique that gradually increases intensity over time.

What are the most common conditions pelvic floor physical therapy treats?

One of the most common conditions we treat is bladder leaks. When I sit down with new patients, I typically ask what preceded their leaks, such as childbirth, increased activity or a change in general health.

I recommend different exercises for different types of incontinence and general health.

For bladder prolapse, I advise quadruped exercises which includes placing your hands directly below your shoulders while aligning your head, neck and back and tightening your abdominal muscles. Next, you alternate raising your right and left arms and holding for three deep breaths and then alternating raising your right and left legs and also holding for three deep breaths. To make this exercise more challenging, raise one arm and the opposite leg at the same time and hold it. This exercise puts patients in a position that uses their pelvic floor muscles against the added weight of gravity on their bladder.
For stress urinary incontinence, it’s best to activate fast-twitch muscle fibers, such as quick pelvic floor contractions (hold 1-2 seconds and perform 10-15 repetitions to start).
For building general pelvic floor strength, I typically encourage patients try a chair pose (while lying on their back). It builds endurance in the pelvic floor and transverse abdominus muscle.

Postpartum care is another very common life stage for experiencing bladder leakage and other pelvic floor dysfunction. No matter whether you had a vaginal delivery or a cesarean section, just being pregnant increases your risk of pelvic floor dysfunction. This includes bladder leakage, painful intercourse and prolapse which is when the pelvic floor muscles and ligaments weaken causing the uterus to slip down into or protrude out of the vagina.

If you are leaking urine at three months postpartum, research says you will still be leaking at 5 years. A common belief is that bladder leaks will get better when you stop breastfeeding, but research and clinical practice do not support this. Pelvic floor physical therapy is a great way to address this issue head on.

Licensed pelvic health physical therapists are here to help you maintain wellness and have the confidence to live your best life with minimal pain or leaks. It’s important to start these conversations early and take action to ensure pelvic floor health.

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Author Summary: Dr. Heather Jeffcoat,DPT, Pelvic Health Physical Therapist is the founder of Fusion Wellness & Femina Physical Therapy(FeminaPT.com).Her work focuses on pelvic and sexual health education for all, and she lectures internationally on Female Sexual Dysfunction and chronic pelvic pain. She is also the author of Sex Without Pain: A Self Treatment Guide to the Sex Life You Deserve.

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