Despite how popular physical therapy is for addressing neuromusculoskeletal system issues like tendonitis and joint replacement recovery, relatively little is known about pelvic floor physical therapy. Likely, when we think of therapy, we associate it with repetitions and sets of exercises like lifting weights or stretching. It may seem confusing that physical therapy is often recommended for pelvic pain, dyspareunia (painful sex), and other conditions that involve relaxing or stretching the pelvic floor muscles.
Pelvic physical therapy helps with a variety of conditions, including:
- Urinary problems such as incontinence, urgency, and frequency
- Bowel problems such as straining or pain while producing bowel movements
- Unexplained pain like pelvic pain, pain during sex, and pain in the genital area
- Pregnancy/post-pregnancy pain or incontinence
In Milli’s Peer & Pro Tips, Shelby Hadden of Tightly Wound and Stephanie Prendergast, MPT and co-founder of Pelvic Health and Rehabilitation Center, explain what a typical pelvic floor physical therapy session looks like.
Peer Shelby Hadden speaks from the perspective of a patient during pelvic floor physical therapy. At the beginning of the appointment, the patient starts by discussing current physical and emotional health, and addressing any changes in her bladder and bowel function. After the initial evaluation is complete, the therapist will leave, so the patient can undress and drape in private. When ready, the therapist will return and start working externally, massaging the patient’s abs, thighs, and vulva (if applicable). The therapist will also perform some internal work, which usually involves inserting a finger into the vagina but only after checking to make sure the patient is comfortable with this approach.
Therapists are great at working at a comfortable pace with the patient. Shelby has never worked with a pelvic physical therapist she didn’t like. Having overcome vaginismus with help of vaginal dilators (vaginal trainers) and a pelvic physical therapist, Shelby highly recommends resources like this for anyone struggling with pelvic floor discomfort or painful sex.
Pro Stephanie Prendergast discusses how she leads a general pelvic floor physical therapy session at the Pelvic Health and Rehabilitation Center. Stephanie begins each session by reviewing her patient’s history. She discusses current symptoms, aggravating and alleviating behaviors, previous diagnoses, and previous treatments in order to understand the causes of her patient’s pelvic pain. After this, Stephanie will leave briefly to give her patients privacy to undress waist down and drape themselves. For the physical examination, she evaluates the muscles, nerves, and fascia of the pelvic girdle, the pelvic floor, and the legs of her patient. Lastly, she evaluates motor control and pelvic floor movements. She then leaves the room so her patients can change and returns after to discuss her assessment and proposed treatment plan.
Pelvic floor physical therapy can sound pretty daunting especially because most women are not even aware that it exists. We hope that Shelby and Stephanie’s experiences can help women realize that there is no reason to stress about pelvic floor physical therapy. Pelvic floor physical therapists will work one-on-one with you to create a personalized therapy session that is comfortable and safe, so you can achieve your pelvic health goals.
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Disclaimer: This blog is for educational purposes only but does not replace the guidance of your healthcare provider. The views and opinions in these videos are of the individual speaking in each video and intended to give the viewer general educational content. These viewpoints should not be attributed to Materna Medical or its affiliates like Milli.