Pelvic Health
At FYZICAL Therapy & Balance Centers of Oklahoma City, we recognize that your pelvic health is a sensitive topic. When it comes to pelvic health physical therapy treatment, whether it be for women’s health or men’s health related issues, you want to feel confident in your provider’s knowledge and understanding of the issues you are facing. Our Physical Therapists have undergone advanced training to best treat your pain, incontinence, or prolapse and to do it with the respect and understanding you deserve.
What is Pelvic Floor Physical Therapy?
Pelvic Floor Physical Therapy is the section of physical therapy that deals with the muscles and joints that make up your pelvic floor (the base or foundation of your core). Pelvic Floor Physical Therapy is still sometimes referred to as “Women’s Health Physical Therapy” because its origins were in treating primarily women. However, the field has evolved to recognize that men need pelvic floor physical therapy too.
What is My Pelvic Floor?
Your Pelvic Floor is the foundation of your core. Primarily, the muscles of your pelvic floor include those of your vagina, penis, and buttocks. Other muscles associated with your pelvic floor include your low back and your abdominal muscles. Pelvic Floor Physical Therapy helps regain flexibility and strength of your pelvic floor because these muscles are vital in so many of your daily functions. Without a healthy pelvic floor you may have difficulty with standing, going to the bathroom, back pain (up to 95% of people with low back pain have some form of pelvic floor dysfunction), pain with intercourse, erectile dysfunction, or prolapse.
What do Pelvic Floor Physical Therapists Treat?
Our Pelvic Floor Physical Therapists are experts in treating musculoskeletal concerns, but they are specially trained to identify and differentiate between pelvic floor weakness and overactivity of the pelvic floor, which may present as weakness or pain. We treat pelvic floor dysfunction in four primary areas:
Bladder Control & Urinary Continence: Bladder control problems affect 35% of all Women, 50% of Women over 65 years, and 25% of all Men
- Urinary Incontinence: including stress urinary incontinence, urge urinary incontinence, and mixed urinary incontinence
- Urinary Frequency
- Incontinence During Pregnancy
- Post-Partum Incontinence
- Nighttime Incontinenence or Nocturia
- Post Prostatectomy Incontinence
- Post-Micturition Dribbling (Post-Void Dribbling)
- Incontinence after Menopause
- Difficulty Emptying the Bladder
Bowel Control & Fecal Continence
Pelvic Pain: Pelvic pain can be extremely challenging to manage. But it is rewarding to see our patients succeed and return to a pain-free life.
- Pelvic Pain or Pain with Sexual Intercourse: including dyspareunia and vaginismus
- Vulvar Pain: including vulvodynia and vestibulodynia
- Rectal Pain
- Back Pain
- Fibromyalgia
- Tailbone Pain or Coccydynia
- Pre- and Post-Partum Pain
- Perineal Pain
- Muscle spasm
- Pubic symphysis diastasis
- Interstitial Cystitis/Bladder Pain Syndrome (IC/BPS)
- Abdominal Pain
- Painful Abdominal scars or abdonimal adhesions
- Pain with Bowel Movements
- Post Surgical Pain after Hysterectomy or reconstruction
- Prostatitis
- Post-radiation rehabilitation
- Endometriosis
Pelvic Organ Prolapse
Pre- and Post-Partum Musculoskeletal Dysfunction
- Pain with Breastfeeding: inclusing neck, back, and wrist pain
- Episiotomy Scar
- Diastasis Recti
- Low Back Pain
- Pelvic Girdle Pain
- Sacroiliac (SI) Joint Pain
- Pubic Symphysis Dysfunction
- Cesarean Section (C-Section) Recovery
- Perineal Injuries
- Painful Intercourse
- Pelvic Floor Muscle Weakness
Other women’s health concerns include treatment for osteoporosis, Cervical Cancer.
How Do I Know if Pelvic Floor Physical Therapy is Right for Me?
If you are having difficulty with movement, then Physical Therapy can probably help. When it comes to Pelvic Floor Physical Therapy specifically, there are a few things you should consider:
Do you have difficulty with daily activities like
- Sitting
- Standing
- Rising from a Chair
- Walking
Do you have pain in your
- Back
- Buttocks
- Groin
- Low Back
- Hips
- Sacroiliac (SI) Joint
- Abdominals
Do you ever leak urine or have an urge to go?
(For a quick annual self-screener for bladder leaks, Click Here)
If you answered yes to any of these questions, it is likely that your pelvic floor is not as healthy as it should be. In that case, Pelvic Floor Physical Therapy may be exactly what you need to regain strength, confidence, and your independence.
What Happens During Pelvic Floor Physical Therapy?
We provide a private, therapeutic environment for all patients. Initially, your PT will examine abdominal muscles, neck, back, hip, SI joint and pubic symphysis to identify your issues. Your challenges are unique, so your treatment plan has to be unique in order to meet your needs. While treatment will vary for each patient, we can break your treatment into 3 phases, each with three goals:
Phase I: Get You Out of Pain
Phase I is to get you out of pain. Whether your pain is physical like with endometriosis or dyspareunia, or the embarrassment of bladder leaks. We understand what you are going through. Our initial evaluation is going to help us understand your challenges and will allow us to set you on a path to success. Our goals for Phase I will be to
- Educate: Engage in patient education about your condition and lifestyle modifications that can help improve symptoms quickly. A big first step for most pelvic floor physical therapy patients is learning proper diaphragmatic breathing, that is learning to coordinate your breathing when completing a pelvic floor contraction and the associated muscle relaxation.
- Stretch: Provide some stretches when appropriate to help you relax your pelvic floor
- Mobilize: Provide some Manual therapy to help mobilize your soft tissue (get your pelvic floor muscles moving properly)
Phase II: Improve Your Flexibility and Range of Motion
Phase II is to Improve Your Flexibility and Range of Motion and begin to Strengthen. You will probably have some homework after your first visit or two and you should be well on your way to being out of pain. But there will still be work to be done. Depending on your diagnosis and needs, we will begin to
- Educate: We may teach you urge suppression techniques and how to quiet your autonomic nervous system (responsible for the urge to go). We may also incorporate biofeedback to help re-educate your muscles. This will allow us to ensure that you can properly coordinate contraction and relaxation of your pelvic floor muscles (“Kegels”). This is also where instruction on posture, body mechanics, and appropriate breathing will occur.
- Stretch: Part of increasing your range of motion is going to be addressing any underlying musculoskeletal dysfunction or movement imbalance. In order to do that stretching your muscles so that they can move properly becomes hugely important. For those who need it (particularly with vaginismus or dyspareunia), the use of vaginal dilators will be explained and support will be provided.
- Strengthen: Once you understand the mechanics of a proper pelvic floor contraction (“Kegel”), you have proper breathing coordination, and you are not co-contracting with your buttocks. We can work on strengthening your pelvic floor muscles so that you don’t have to worry about your problem on a day-to-day basis. As part of strengthening, body mechanics become really important. Using proper toileting posture and mechanics will allow you to make the best use of the strength you have, while also preventing further injury.
Phase III: Help you Love Your Life!®
Phase III is to help you Love Your Life by getting you back to doing the things you love doing. When you are in pain, or you lack the strength or flexibility to do the things you want, it can really set you back. We want you to be back to full strength and functioning at your optimal level.
- Educate: We want to make sure you have all of your exercises down without needing any cues or feedback. Having your exercises down will allow you to do all of your daily activities with the least likely chance of reinjuring yourself.
- Strengthen: At this point, strength becomes your key. But strength in the wrong areas is not going to benefit you. So, we must make sure that you are properly applying all that you have learned and that you are using the right muscles for the activities you want to get back to enjoying, free of pain, free of leaks. We will also make sure that you have a doable, but advanced strengthening program.
- Establish Optimal Functioning: Once you feel like we have met your initial goals we will revisit your personal best and make sure there isn’t anything that is keeping you from loving your life.