The other day, I was speaking with a friend who has chronic constipation. When she asked me for advice, I suggested pelvic floor therapy.
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 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.
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.
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.
Pelvic Wand
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 pelvic floor massage 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.
Therawand
The brand of wand I use is called Therawand, and it is made of a medical-grade polymer blend of ABS and Polycarbonate.
TMT Pelvic Wand
Alternatively, when the above wand is not in stock, you can use the TMT Pelvic Floor Wand. I have also used this wand with good results.
How to Use: Pelvic Wand
Above is a video with instructions for how to use a pelvic floor wand at home.
How to Relax Pelvic Floor Muscles: Online Pelvic Floor Therapy
If you’re not interested in pursuing the wand, you can try online pelvic floor therapy.
My friend Lauren, who can be found on Instagram at thelaurenohayon, is a genius when it comes to pelvic floor education and rehabilitation.
Lauren states that the constant external rotation from yoga and Pilates can tighten the pelvic floor. I began teaching yoga over 30 years ago, and we were very external rotation focused.
I’ve found that Lauren’s philosophy and exercises are effective in providing relief and opening for my pelvic floor while strengthening my core.
My Pelvic Floor Injury
Lauren’s work, along with hands on treatment from a pelvic floor therapist for a few years prior, has helped with 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.
Episiotomy Pain
Strangely, a midwife gave me the episiotomy during an otherwise natural, totally un-medicated childbirth.
Vaginal Pain
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.
Silent Suffering
Thanks to a growing number of pelvic floor physical therapy practices, women can be treated for our pain.
And thanks to the resource Lauren has created we have a place to learn, gather, and discuss what was once taboo.
Pelvic Floor Therapy for Men
Because pelvic floor injuries also occur in men, pelvic floor therapy can also be beneficial for them.
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.
Linda says
So glad you are talking about this therapy! For several years I suffered from severe vaginal pain. I went to numerous doctors and even Mayo Clinic to find out what was wrong. I received several diagnoses, but no treatment was offered except anti-depressants (which surprisingly are commonly prescribed for this kind of pain). Not interested, I continued to scour internet blogs to find answers. I finally went to a gyno-urologist who immediately told me what was wrong. I had given birth to a 9lb 3oz baby over 25 years earlier and the birth damaged a pelvic muscle on one side. The pain I was experiencing was referred pain from the atrophied muscle. He recommended pelvic floor therapy. I could have kissed him just for giving me a diagnosis and suggesting that I would not have to live with the pain. I started therapy, which I must say was very embarrassing at first; but I was in so much pain I would have done anything. After just a few treatments, the pain I had endured for three years stopped! I literally cried in front of my therapist and told her she was my hero. While doing my research (circa 1992) I never ran across this type of therapy so I’m not sure how long it had been around. I would strongly encourage anyone suffering pelvic pain to try it.
Elana says
Linda, whoa, what a journey you’ve been on. I can’t understand why anti-depressants would be offered for vaginal pain –perhaps increasing free serotonin in the body is thought to reduce pain? Hmm. So frustrating to not have our female issues treated seriously and looked into thoroughly. I love hearing about the outcome you have had and the proper treatment you finally received. I feel like I can walk better from having PFPT. I hope you’ll keep me posted on how you continue to do! :-)
Nannette Silvernail says
Wow, I just finished pelvic floor PT started in February for pudendal pain. I’d never heard of it before my search for answers to my weird & very painful & confusing symptoms. I had a 3rd degree (rectal) tear & broken coccyx in childbirth in the 90’s also. My PT practice here in the Atlanta area is as wonderful as yours sounds.
As I’ve followed you over the years (since 2009 or so..?) it amazes me how similarly broken yours and my bodies are. You seem to mention a therapy or environmental concern virtually at the same moment it comes on my radar in my own family’s healing process. I save many of your posts as starting points for information and sometimes as affirmation that I’m not crazy, and to keep on keeping on. :-) In our house, if I start a conversation with “Elana says…” my husband never asks “Elana who?” He knows you’re like…my supportive, super wise sister I keep in my iPad. :-D.
Most recently we’ve added mold toxicity to our latest health mountains to climb. Thankfully, professionals we’re working with take MCS very seriously and we will likely seriously address the EMF’s in our home, too (more so than putting phones on airplane mode or off at bedtime, which is pretty much all we’re doing so far). We can handle only so much at a time on this journey. I have a 27 yo daughter who’s non-verbal, profoundly challenged by autism and we’ve been so very slowly, but so very steadily, making her suffering less & her life healthier and happier since her Dx 26 years ago. I credit you with some of that better life she gets to enjoy.
Keep on keeping on my “sister-like friend in my phone.” I have so much to share with the world, but am unable to in my around-the-clock caregiver role. I count on a few people like you to be my voice. You make my world a better place, and probably millions’ like me. Love to you and your family from my little family in Georgia.
Elana says
Nannette, I am so glad to be the sister in your iPad! I love that you say “we can handle only so much at a time on this journey” because when we have a lot going on we really need to pace ourselves! I am so amazed to be on this healing path with you, your husband, and daughter, and I hope you’ll keep me in the loop on how you’re all doing. Love to your and your family in Georgia! ❤️
Deborah says
Opps, those book links didn’t come through. Here they are again.
https://smile.amazon.com/Heal-Pelvic-Pain-Strengthening-Incontinence-ebook/dp/B001FA0O96/ref=sr_1_1?crid=1CW2GMJJP977D&keywords=amy+stein+heal+pelvic+pain&qid=1556199919&s=gateway&sprefix=amy+stein%2Caps%2C150&sr=8-1&fbclid=IwAR2mduztRpho34UIPXVngx_uLn-CS0WOdfFIFxxAdlVI6C2BllnASjj9Zgo
https://smile.amazon.com/Pelvic-Pain-Explained-What-Need-ebook/dp/B0195PY09W/ref=sr_1_6?crid=1CW2GMJJP977D&keywords=amy+stein+heal+pelvic+pain&qid=1556199964&s=gateway&sprefix=amy+stein%2Caps%2C150&sr=8-6&fbclid=IwAR2WcEdOf4X9_Vjkv-2FOlLh08wzXW7ehCualpLAdje1ziYtPi6l-rCTHwE
Elana says
Thanks Deborah!
Deborah says
YES! Pelvic floor PT has helped me come back to life after bad injuries from a car accident that led to severe pelvic floor imbalances.
Two excellent articles on pelvic floor dysfunction.
https://www.girlswhopowerlift.com/…/blog/tagged/pelvic-floor
https://www.teamusa.org/…/2018/A…/01/Supercharge-Your-Pelvis Tamra Wroblesky is one of my PTs.
Two excellent books are:
https://smile.amazon.com/Heal-Pelvic-Pain-Str…/…/ref=sr_1_1…
https://smile.amazon.com/Pelvic-Pain-Explaine…/…/ref=sr_1_6…
Elana says
Thanks Deborah!
Sheila Perl says
Since I had a hysterectomy several years ago I have had bladder leakage and outright uncontrollable urination, I wear Poise pads which has caused chafing (or diaper rash), my ND suggested Pelvic Floor Therapy, I have not done it but I am going to make an appointment now!! Thank you, Elana for sharing this information!
Elana says
Sheila, thanks so very much for sharing your story here, it will help so many others!
Terri says
This type of exercise does work for anyone who has constipation. And also make sure your drinking good quality water all day long.
Elana says
Thanks Terri.
Raye says
Elana,
Thanks for bringing this issue to the attention of your readers. I have just completed pelvic floor PT, and the difference between starting and now is amazing. No more symptoms associated with prolapse, no more pelvic pain, no more dyspareunia. I would recommend PFPT to anyone who has any symptoms or has ever had a baby.
Elana says
Raye, it is amazing, isn’t it?! Thanks for participating in this important discussion :-)
Brenda says
So glad you are addressing this often silent epidemic. Just want to add to your wonderful post that many pelvic floor issues can be improved learning through proper breathing mechanics along with improvement in body alignment & learning proper ways to move. We are blessed in our day & age to have lots of good folks out there online including Julie Wiebe (PT), Brianne Grogan (PT), Katy Bowman & Lauren Ohayon just to name a few. Personally, I have been able to 95% heal a prolapsed bladder.
Elana says
Brenda, well said! This is a silent epidemic. Thanks so much for sharing your story here :-)
Christine T. says
I have been having Pelvic floor therapy since October. I have had issues with incontinence since I was a child, having accidents in school. I have had three episiotomies and a c-section with two somewhat stressful birth experiences. My last birth experience was the easiest and I was 43 years old.
Now, as a menopausal woman, I also experience discomfort due to hormonal issues. I am making progress, but it is slow and steady, especially since I have had issues for so many years now. This isn’t something that will be an overnight cure, but at least it is covered by insurance. The front desk people are very friendly at the physiotherapy clinic that I go to. The clinic doesn’t specialize in it, but there is a physiotherapist who does and she is great. I would definitely recommend it as part of your overall plan for good health because it is natural.
Thank you, Elana, for spreading the word about this important issue. I never knew about it until another mom told me last fall. I could have been experiencing therapy and healing a long time ago.
Elana says
Christine, thanks so much for sharing your story here! PFPT is so helpful to so many of us :-)
Carolyn says
Does your facility recommend practices in Arizona?
Elana says
Carolyn, feel free to reach out to them to see if they do!
Marianne Kleminski says
I have gone in Scottsdale and really liked my therapist. If you want info you can reply here and we can try to connect.
Elana says
Marianne, thanks so much!!! I love it when the EP community connects and supports each other :-)