The other day I was speaking with a friend who has chronic constipation. When she asked me for advice I suggested pelvic floor therapy. She said that she was already doing it, and 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.” While this is a fantastic start to getting in touch with some of the pelvic floor muscles, what I was referring to is a medical treatment from a physical therapist.
Pelvic floor therapy is a treatment provided by a licensed physical therapist trained to treat pelvic floor dysfunction. 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. Typically this is a hands-on, or manual therapy. It may involve working vaginally or rectally.
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 still 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.
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.
Pelvic floor dysfunction is often a component of the following medical issues:
I go to a practice here 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.
Several years ago, I went 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.
Although we have little power in this odd health care system, I do my best to avoid practices with negative gate keepers. When I do 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.
If you have any of the issues listed above it may be worth consulting with a physical therapist specializing in pelvic floor treatment.
Comments
61 responses to “What is Pelvic Floor Therapy”
Dear Elana,
I want to thank you for this post. I have experienced some of these symptoms for years and had no idea that there was a therapy that would help. I am recently seeing a qualified individual who is helping me on my way to recovery. It has been slow but I’m looking ahead. I cannot write this without sharing with you how beneficial all of your recipes have been to me and I have been sharing your website with my friends. Thank you again.
Kind Regards,
Carol
Carol, thanks for your fantastic comment and for being on this healing path with me!
Hi Ruth,
I had posterior repair after the birth of my second child. It was definitely an unpleasant recovery in terms of going to the bathroom. I actually went to the doctor because I had to urinate so often and she was shocked that I wasn’t their for posterior. I thought I had food allergies and that’s why I was running to the bathroom. I also need anterior repair, but I would not have been able to pick up my daughter for 6 months! It’s been 11 years and I am still not ready to commit to the recovery time. The surgery is less successful if it has to be done a second time. I definitely need to set aside the time to see a therapist—maybe I won’t need surgery. Thanks for posting this information, Elana.
Jenny, thanks so much for sharing your information and experience here on such a vulnerable topic. Sending hugs :-)
Elana, I’ve had an ongoing problem with UTIs and have been treated medically with antibiotics. Do you know of a dietary method to prevent these recurrences? I’m post-menopausal and I know I’m dry. Three times a week I apply a vaginal moisturizer so it’s less frequent but still happening. Can you help me?
Barbara, I’m so sorry to hear about this, I know how awful it is. I’ve been using Traditional Medicinals Weightless Cranberry Tea as a prophylactic with some good results. Happy to help and LMK if you have other questions.
D-mannose has worked wonders for me. This is the only treatment that stopped my reoccurring UTIs. I hope this helps!
Thanks E. Roma!
Barbara, you may have interstitial cystitis, not a UTI. Check out ic-network.com. There’s a lot of helpful info there. Good luck.
Thanks Kristin!
I have prolapse and am fearful of having to address this surgically someday. Has anyone had this surgery done? The whole thing scares me with all of the issues with mesh recall. I have heard of leakage after surgery also. Thank you for any input.
Ruth, thanks for sharing your story here and I hope some other readers will chime in about this!
I think first line of defense against prolapse is pelvic physical therapy. I would highly suggest going that rout before even thinking about surgery. (Also, I’m not sure if you self diagnosed or a doctor did, but sometimes it’s not actually prolapse but more like a tightening or misalignment of muscles that a PT can help with.)
Ruth, There is much you can learn regarding prolapse from a pelvic floor PT. One of the main things you will learn is how to manage intra-abdominal pressure with tasks you do throughout your day. This is a start to reducing strain on weakened supportive tissues and activating other sources of stability. Learning this is a process but is very helpful whether you decide to have surgery or not. Obviously, pelvic floor PT offers much more than this. Good luck!
Thanks a million Wendy! Well said :-)
Thank you for bringing this to us!
You have a wealth of experiences and resources and are wonderful to share with us all.
John F Barnes, PT of MyofascialRelease.com has developed training programs for therapists using the gentle, sustained techniques of his MyoFascial Release Programs.
I am a patient of one of his therapists and can attest to the success of these techniques.
Pelvic Floor therapy is for all ages, male and female.
Thanks Melanie!
What does an episiotomy have to do with the pelvic floor? That area is not a muscle. (I’ve had lots of pelvic floor PT, but my episiotomy scar never had anything to do with it.) Curious! Thank you!
Elizabeth, thanks for your question! There are numerous studies documenting the effect of episiotomy in terms of creating chronic pelivc floor dysfunction, but having an episiotomy does not necessarily mean you will have this problem. Any episiotomy is an incision of the perineum which has the pelvic floor as its superior border. LMK if you have any other questions! :-)
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