Diagnosis, evaluation and treatment of pelvic floor problems
Pelvic floor dysfunction refers to weakened or damaged muscles, ligaments and/or nerves in the abdomen (belly) and pelvic floor. Pelvic floor conditions affect men and women although women are particularly vulnerable to pelvic floor disorders, often due to pregnancy or menopause. Pelvic floor problems may also come about as a result of cancer and cancer-related treatments.
Our team of pelvic floor physical therapists (PT) at locations throughout the western suburbs of Philadelphia are certified in treating pelvic floor disorders. With this advanced team training, we are able to offer more comprehensive treatments for these sometimes complex conditions.
Types of pelvic floor dysfunction
Pelvic floor dysfunction may affect your life in various ways. Most commonly, symptoms may include:
- Pain in the pelvis, hip, buttock, abdomen, thigh or lower back, and/or pain in the tailbone
- Pain at the external genitalia, vaginal opening, vaginal canal, rectum, penis, and/or testicles
- Bowel or bladder dysfunction, including constipation, incontinence (fecal or urinary), overactive bladder, and pelvic organ prolapse
- Sexual dysfunction such as erectile dysfunction or dyspareunia
Pelvic floor dysfunction symptoms are also common in pregnancy or postpartum.
Some common pelvic floor diagnoses include:
- Low back, pubic symphysis, hip, sacroiliac dysfunction
- Pelvic organ prolapse – when there is inadequate support for the pelvic organs, which contributes to a feeling of pressure, heaviness and incontinence
- Vaginismus – an involuntary protective tightening of the vaginal muscles, which contributes to pain when using tampons, having intercourse, or undergoing gynecological exams
Pelvic floor physical therapists also treat interstitial cystitis, vulvodynia, and conditions such as diastasis rectus abdominus (abdominal wall separation), which sometimes occurs as a result of pregnancy, as well as postsurgical pain or weakness, such as patients might experience after a hysterectomy or prostatectomy.
Working with pelvic floor therapists
Our pelvic floor physical therapists take a holistic view of pelvic floor dysfunction and apply a combination of safe, effective therapies to help improve your symptoms and quality of life. It all starts with a consultation during which one of our qualified therapists will ask you a number of questions about your symptoms. Some of these questions may seem personal but your answers will help us better understand what’s going on. Your therapist will then conduct a physical examination. This may include an internal exam, either vaginally or rectally, and a comprehensive musculoskeletal assessment in order to determine your condition and the plan of care that’s right for you.
What is pelvic floor therapy?
Depending on your diagnosis, pelvic floor therapy may include:
- Biofeedback – using special sensors and a computer monitor to provide information about muscle activity helps patients better understand how to use and train pelvic floor muscles
- Core stabilization – strengthening and training the abdominal (core) muscles to contribute to overall strength and control of pelvic floor muscles
- Joint mobilization – hands-on therapy used to improve joint mobility and flexibility in low back, hips and pelvis
- Myofascial release – soft tissue therapy performed manually to help stretch tight muscles, restore blood flow and relieve pain
- Trigger point release – identifying specific points that trigger pain (sometimes transferred to another area of the body) and applying pressure and release to relieve the pain and restore energy flow
Your pelvic floor treatment may also include pelvic muscle dilation with relaxation training along with therapeutic exercise, functional activities or electrical stimulation to support overall muscle strength and function. Your pelvic floor rehab therapist will also educate you on:
- Bowel habits and defecation mechanics (ways to poop comfortably)
- Bladder and urgency retraining
- Diet modifications (e.g., fluid and fiber intake, things that irritate the bladder)
- Muscle relaxation and diaphragmatic breathing techniques
- Ways to minimize discomfort and modify risk factors