The other day I was speaking with a friend who has chronic constipation. When she asked me for advice I suggested pelvic floor therapy.
Pelvic Floor Therapy Equals Kegels?
She said that she was already doing it, so I asked, “where do you go?” and she replied, “I do it at home. I found out about it on the internet and now I do kegels.”
Pelvic Floor Therapy?
While this is a fantastic start to getting in touch with some of the pelvic floor muscles, what I was referring to is generally considered a medical treatment from a physical therapist.
This can often involve learning to relax and release overly tight muscles in the pelvic floor, though like any therapy, it is customized to the individual.
What is Pelvic Floor Therapy
In essence, pelvic floor therapy is a treatment provided by a licensed physical therapist trained to treat pelvic floor dysfunction.
Pelvic Floor PT
This therapy may include stretching and or strengthening of the pelvic floor muscles as well as those of the hip, low back, thighs, and more.
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Pelvic Floor Massage
Typically this is a hands-on, or manual therapy. It may involve working vaginally or rectally.
Pelvic Floor Dysfunction: Home Treatment
While it is fantastic to be able to see a pelvic floor therapist for treatment, not everyone has insurance that covers pelvic floor injury.
When I am not able to make the time to get to a pelvic floor therapist and am suffering from discomfort I use a pelvic wand that can reach up and into the pelvic floor muscle area.
What is a Pelvic Wand?
Wondering what is a pelvic wand? It’s a tool for relaxing and releasing the pelvic floor muscle team.
These muscles are located deep in the pelvis and the pelvic wand is designed so that you can reach them more easily to do soft tissue massage and trigger point release on yourself.
The brand of wand I use is called Therawand and it is made of a medical-grade polymer blend of ABS and Polycarbonate.
How to Use Pelvic Floor Wand
Above is a video with instructions for how to use a pelvic floor wand at home.
My Pelvic Floor Injury
I have a severe scar from an episiotomy that has caused me pain over the years.
My boys were born in the late 1990s and over the past decades, I had been suffering from discomfort due to the episiotomy.
Strangely, a midwife gave me this during an otherwise natural, totally un-medicated childbirth.
I still don’t understand why and would have preferred not to have it. It took a long time to heal and caused me severe post-partum pain for months.
I never spoke about it with anyone, thinking it was normal that it hurt to sit down for a year after my son was born. It especially hurt when I was sitting and nursing.
Is Pelvic Floor Therapy for Men?
Because pelvic floor injuries also occur in men, thankfully, pelvic floor therapy is also available for men.
I cannot speak from personal experience, obviously, but the practice I go to in Boulder says that 35% of their patients are male.
What is Pelvic Floor Dysfunction?
Pelvic floor dysfunction is often a component of the following medical issues:
- Pelvic Pain
- Low Back Pain
- Hip Dysfunction
- Bowel Issues
- Bladder Dysfunction
- Functional Incontinence
- Uterine Prolapse
- Painful Intercourse
- Episiotomy Damage
- C-Section Scarring
Pelvic Floor Physical Therapy
I have gone to a practice in Boulder called Pelvic Therapy Specialists.
They take most forms of insurance which I think is amazing. The experience is lovely from the moment you call them on the phone.
Pelvic floor therapy takes place in such a vulnerable part of the body that I would only recommend going to a place where all of the employees are incredibly pleasant, personable, and thoughtful.
Finding the Right Pelvic Floor Specialist
Several years ago, I went to a pelvic floor therapy practice where the receptionist was not a happy person.
I felt crushed every time I called and set up an appointment over the phone.
I also brought a friend with me to each appointment just to have someone to keep me company and to act as a buffer in dealing with the animosity that emanated from behind the front desk.
This was not a good long term arrangement and required way too much effort on my part so I stopped going there even though the pelvic floor therapist was great.
Bedside Manner That Works
Although we have little power in this odd healthcare system, I do my best to avoid practices with negative gatekeepers.
When I encounter an efficient, pleasant person who answers the phone at one of my physician’s offices, I am sure to let the doctor know how grateful I am for that person.
When we’re sick or in pain there’s no need for nasty bureaucrats to pile it on and further distress us.
Do You Have Pelvic Floor Dysfunction?
If you have any of the issues listed above it may be worth consulting with a physical therapist specializing in pelvic floor treatment.
Do you have pelvic floor issues? Leave a comment and let me know.
This post is an oldie but goodie from the archives. I first shared Pelvic Floor Therapy in 2019.
A few months ago I discovered that my chronic constipation is due to pelvic floor dysfunction, specifically dyssynergia. The therapy for this (which I first was taught at the Mayo Clinic, and have since worked on with an amazing pelvic floor physiotherapist in Toronto) is actually the OPPOSITE of kegels! People with this problem need to re-teach their pelvic floor muscles to relax, rather than strengthen them, because the problem is that the muscles are hyper tense when they should be relaxing. Maybe let your friend know that she could be making her condition worse by doing kegels? It’s been amazing for me to learn to feel and connect with these muscles that at first I couldn’t even sense; muscles that are a kind of foundation in our bodies, a hammock to the bowel, bladder and uterus (in women), that can affect the movement of our entire digestive systems. It’s powerful to get to know these muscles, whether or not you’re suffering from pelvic floor issues :)
Alisha, totally agree. Squeezing and tightening muscles that are already hyper-tonic leading to chronic constipation would not be a great strategy for this condition, but, just thinking about the pelvic floor muscles is a fantastic start for some folks :-)
I bet it took some bravery on your part to put this out there- thanks for your inspiration to deal with a much needed personal issue!
Christine, thanks so very much for your support! It was challenging to figure out how to talk about this. I hope we can all talk about it more and am so grateful for your engagement :-)
Dvora Krevat says
I don’t know where you are all located, but there is a FANTASTIC PFPT in Fairlawn New Jersey. Her name is Bella, from Bella Physical Therapy. She takes insurance. And she’s wonderful! Very knowledgable and into alternative health solutions. She’s helped me a lot! Shame I didn’t know about PFPT when I was younger, after I gave birth. I hope this information helps a lot of people!
Dvora, thanks for sharing this here!!!
What is the oldest patient seen in a successful pelvic floor therapy program?
Marty, I don’t think there’s an age limit :-)
How timely this article is! I just finished listening to a two hour seminar on pelvic floor health. I see a naturopath, eat healthfully, listen to all manner of health blogs, and yet this is the first time I’ve really heard this discussed in such detail. The woman who gave the talk was Isa Herrara. She has a program that entails life-time access, incorporates up to 20 different types of kegels for different problems, exercises, massages of one’s lady bits (who knew), and has served several thousands of women for everything from prolapse to leaking to painful sex. She sounds like the real deal, and I would have loved to have joined her program, but for $500 I just couldn’t swing it right now. She has a practice in New York(?) I believe, and charges big bucks for her patients so this web access is actually quite reasonable. I believe her program begins on the 24th of June so if interested you would need to commit soon. She does this once a year. Very enthusiastic woman, and lots of happy graduates of her program. Highly regarded and very high success rate for women who NEVER thought things could change. She also has a book regarding healing female pain. Not sure of title. Just google. I plan on getting her book for starters and will revisit in 2020 when she offers program again.
Thought this might be helpful….
Jody, thanks so much for sharing this info, it may be very important for those who cannot get hands on PFPT!
Patty Smith says
Whoa good timing that I came across your article. I have been pushing out of my mind making an appointment with a pelvic floor specialist my Chiro recommended. I will be making that call very soon.
Patty, I hope you’ll keep me posted on how it goes!
Anne Young says
I had a similar experience with a gatekeeper (and the medical system in general) re: PF therapy… My injury from 16 years ago and still causes issues.. especially as I age. Is there a network of caring, effective PF therapists out there?
Anne, I would start by checking in with the practice I link to and finding out if the owner has friends/colleagues in your area who she trusts :-)
Is this therpay appropriate for vestibual vulvodynia?
June, I think it might be worth speaking with a PFPT about this :-)
Elana, call it serendipity. I was at my oncology gynecologist yesterday and this is what she suggested. I am an occupational therapist and have known about PT pelvic floor therapist’s for a long time, however they are hard to find near me. I have radiation damage due to cancer that is causing lots of trouble. I’ve also had a radical hysterectomy and have internal scars at vaginal cuff. Ouch! For me, anytime I feel weirdness or pain, I get “cancer brain” and worry “it” has snuck back to haunt me. I love all you do and thanks for the reminder to cut out that gluten (love your recipes). I used to be a pastry chef , heal my gut and find myself a pelvic floor therapist today!!!
Lisa, those internal scars sound so painful. Ouch! Thanks for bravely sharing your story here, you are amazing and I hope you’ll keep me posted on how you’re doing :-)
Wish I’d known about this before getting a hysterectomy 10 yrs. ago!
Cindy, thanks for joining this conversation!