If you’re experiencing pelvic floor dysfunction, it can be intimidating not knowing what to expect from physical therapy treatments and examinations. I’ve compiled this article to explain the disorder, its conditions, how physical therapy can help, and what to expect in an assessment and treatment.
What is pelvic floor dysfunction?
Pelvic floor dysfunction is abnormal functioning of the pelvic floor. The following conditions may occur as a result of pelvic floor dysfunction:
- Urinary incontinence (stress, urge, and mixed incontinence)
- Pelvic organ prolapse
- Sensory and emptying abnormalities of the lower urinary tract
- Sexual dysfunction
- Chronic pain syndromes
How prevalent are these conditions?
Of the pelvic floor conditions noted above, urinary incontinence is the most prevalent. According to the Agency for Healthcare Research and Quality (AHRQ), 13 million Americans are incontinent. Urinary incontinence is two to three times more common in women than men. In addition, high-risk groups for developing urinary incontinence include pregnant or menopausal women, women with vaginal prolapse, men treated for prostate disease, patients with rectal prolapse, and frail elderly and nursing home residents.
What is the PT’s role in the examination of pelvic floor dysfunction?
Physical therapists have training in the anatomy, physiology, and function of the lumbopelvic region’s neuromuscular and fascial support structures. They assess the core support muscles for motor control, strength, and endurance and the coordination of muscles for different activities and positions. The physical therapy evaluation may include postural assessment, manual muscle testing, internal muscle and fascial palpation, EMG testing, and evaluation of scar- and soft-tissue restrictions, gait, and movement patterns.
Patient examination results guide the identification of an individualized treatment plan to improve pelvic floor function. Treatment strategies may address increasing patient knowledge of bladder re-training techniques, decreasing postural asymmetries, reducing pain, normalizing tone,
increasing strength, reducing myofascial restrictions, and improving neuromuscular coordination. These treatments address functional goals such as enhanced continence, decreased painful voiding syndromes, and decreased pain with daily activities, including sitting, walking, prolonged standing, and sexual function.
What kind of PT services are available for pelvic floor dysfunction?
Therapeutic strategies for pelvic floor dysfunction have evolved beyond the traditional Kegel exercises for incontinence. Physical therapists customize treatment plans and select treatments based on the examination and evaluation. Pelvic floor muscle rehabilitation employs various strategies to improve the capacity of the muscles through neuromuscular re-education. This rehabilitation includes but is not limited to the following:
- Exercise
- Biofeedback
- Trigger point release
- Electrical stimulation for pain relief/control
- Myofascial release
- Soft tissue lengthening
- Dry needling
- Soft tissue manipulation
- Deep tissue manipulation
- Joint mobilizations
If you’re experiencing pelvic floor dysfunction, please schedule an appointment at our Central Tucson location and let our experts help you to achieve your health goals.
Elizabeth Galdi, PT, DPT, specializes in orthopedic physical therapy and pelvic health. She has over six years of experience treating pelvic floor dysfunction and did her initial training through the renowned Herman & Wallace Pelvic Rehabilitation Institute. Elizabeth focuses on the patient as a whole instead of just the diagnosis.
