The term pelvic floor refers to the sling of muscles, ligaments, and fascia which spans from the front of the pelvis at the pubic bone to the posterior pelvis at the tail bone. This musculature supports the pelvic organs (uterus, colon, and bladder), allow for control of the outlets (urethra and rectum) and provide tone for sensation for the sexual functions. It is important for this area to have proper muscle tone. Excess tone of the muscles can cause difficulty sitting, pain during intercourse, hip and low back pain or retention. Diminished tone may lead to incontinence, organ prolapse and possibly decreased sexual response.
Typically, people associate pelvic floor dysfunction with incontinence. However, there are a myriad of diagnoses that fall under this category such as overactive bladder, prolapsed uterus, pelvic pain, painful periods (dysmenorrhea), interstitial cystitis, coccyx pain, painful intercourse, and many others. The symptoms may limit a man or woman’s ability to perform daily activities, cause a change in exercise habits and create embarrassment. Problems in this area are often not discussed with medical professionals and therefore, go untreated.
Many physical therapists have specialized training that can benefit men and women with issues of the pelvic floor. These therapists utilize every aspect of their physical therapy training to evaluate patients and to provide intervention to overcome these dysfunctions. Treatments may consist of a combination of many techniques.
- Exercises such as “Kegels,” which are geared for this area, greatly enhance muscle function when performed properly.
- Relaxation techniques may be utilized to assist with decreasing tone and pain. Manual techniques, such as Myofascial Release and soft tissue massage are often used to relieve tension.
- Biofeedback is used to increase awareness of proper muscle recruitment or to quiet overactive muscles.
- Electrical stimulation may be used to recruit and train pelvic floor musculature or to relieve pain.
- Joint mobilizations are often utilized to restore pelvic alignment and motion. In addition, patient education can assist with prevention of dysfunction.
Physical therapy for the pelvic floor dysfunction is relatively new and not widely known by many medical professionals in the USA. Even though common, there are only a handful of Physical Therapists who are trained in Pelvic Floor therapy in Northern Nevada. Just look at the number of commercials from the pharmaceutical industry promoting drugs aimed at treatment of these issues. Numerous surgeries are advocated as an answer for many pelvic floor issues. Many are unsuccessful. Physical Therapy can provide tremendous relief for Healthcare consumers who want to take control of their symptoms and overcome them without long term use of drugs or surgeries.
When choosing a physical therapist for treatment of a pelvic floor dysfunction, it is important to inquire of their training, experience and outcomes with this area to ascertain if they are qualified to treat this area. The Section on Women’s Health of the American Physical Therapy Association offers training and mentoring leading to a certificate program called the Certificate of Achievement in Pelvic Physical Therapy (CAPP). Approximately 150 PT’s have received the CAPP to date. To find a Physical Therapist who is trained to work with Pelvic Floor Dysfunction, one can contact the Section on Women’s Health of the American Physical Therapy Association. The web site is http://www.womenshealthapta.org/. The website provides articles and resources for consumers to learn more.