Pelvic Floor Physical Therapy
The pelvic floor consists of three layers of muscle, nerves, ligaments and connective tissue anchored within the bowl of the pelvis. The pelvic floor functions to support the pelvic organs against gravity and intra-abdominal pressure, close openings of the urethra, vagina and rectum to prevent leakage, increase blood flow for sexual function, and assist in stability of the sacroiliac joint, lumbar or lower back and hip region. Pelvic floor problems affect bladder, bowel and sexual function and can cause pain. The problems may be poor muscle coordination, muscle weakness, muscle spasm, entrapped nerves, and/or scar tissue restrictions which could cause pain.
- Internal vaginal or rectal examination of the pelvic floor muscles
- Strengthening of weak muscles
- Re-training of muscle activation
- Relaxation of hyperactive or muscles in spasm
- Soft tissue mobilization to relieve tightness
Vulvar pain (Vulvodynia, Vulvar vestibulitis): Common symptoms include burning, stinging, irritation, pain, and/or rawness to the opening or external region of the vagina.
Vaginismus: Persistent or recurrent difficulties in allowing vaginal entry of a penis, finger or any object despite the woman’s expressed wish to do so. There is often an involuntary contraction of pelvic floor muscles.
Dyspareunia: painful vaginal penetration such as with sexual intercourse and/or tampon use in the absence of disease or infection
Painful Bladder Syndrome (Interstitial Cystitis): Chronic and often severe inflammation of the bladder wall. Common symptoms include urinary urgency with pain, pressure or burning, urinary frequency greater than 8 times per day, pain in the pelvic region, and/or pain with sexual intercourse. Urinary tract infection has typically been ruled out.
Coccygodynia: pain in the coccyx or tailbone area usually brought on by sitting.
Pudendal Nerve Entrapment (Pudendal Neuralgia): a condition in which the pudendal nerve in the pelvis is entrapped or compressed resulting in chronic pain in the perineal area. Symptoms are worsened in sitting and may include difficulties with urination or defecation and numbness of the sexual organs.
Chronic pelvic pain: This is pain that can be lower abdominal or pelvic and has been felt for greater than three months. It may be related to endometriosis, scar adhesions or be muscular in nature. Typically other visceral causes of pain have been ruled out.
Urge Urinary incontinence: involuntary loss of urine accompanied by or immediately preceded by a strong desire to urinate.
Stress Urinary Incontinence: Involuntary loss of urine with physical exertion such as with coughing, sneezing, laughing, lifting, position change, running, etc.
Fecal Incontinence: Involuntary loss of solid or liquid stool or mucus from the rectum.
Symptoms may include the all or some of the following for greater than three months: Straining or pushing to have a bowel movement, lumpy or hard stools, sensation of incomplete emptying of bowels, sensation of bowel obstruction and/or fewer than three bowel movements per week.
Types of prolapse include cystocele (bladder), rectocele (rectum), urethrocele (urethra), enterocele (small intestine) and uterine (uterus) prolapse. This is where the respective organ loses its connective tissue support and descends. Common symptoms may include urinary leakage, feeling of incomplete bladder or bowel emptying, difficulty in defecation, feeling of pressure or heaviness in the vagina, pain in the vagina, sensation or awareness of protrusion from the vagina, low back pain, and/or abdominal or pelvic pressure.
You have the right to choose where you go for treatment, and to tell your doctor or insurance company where you would like to receive treatment.