Pelvic floor physiotherapy has only recently come to the attention of mainstream healthcare practice. For years, the only exercise and rehabilitation designated for the pelvic area were the odd stretch and, of course, Kegels.
This modality is designed to strengthen and rehabilitate the pelvic floor muscles. Your pelvic floor muscles are an essential part of your core muscle group and go hand in hand with bladder health, digestive health, and chronic pain management.
In recent years, many practitioners have seen enough attention and interest in this niche form of physiotherapy to open clinics and practices solely dedicated to pelvic health.
This article will discuss how pelvic floor physiotherapy works, the benefits, and the different health concerns that it may help to improve.
How it works
Pelvic floor physiotherapy can be approached internally or externally – usually both. External work is normally focused on the abdomen, the groin, and thighs. Thigh rollers, connective tissue massage, breathing exercises, and even acupuncture are utilized for external treatment.
Internal treatment is accessed via the vaginal opening or the rectum and involves direct contact and manipulation of the pelvic muscles.
Your physiotherapist should be able to provide a preliminary diagnosis based on your history, symptoms, and an external exam. Bear in mind, however, that the most optimized pelvic floor physical therapy plans include internal exams and treatment.
Select a physiotherapist that takes care to put you at ease and who is confident in their abilities. This form of physiotherapy is very personal and can have emotional implications, so choosing the right practitioner will be instrumental in your healing.
Some regions require a doctor’s referral, and others do not, so be sure to check with both your primary physician and your insurance carrier for details on eligibility and coverage.
The Kegel myth
For many years the recommended treatment for bladder issues such as pain, incontinence, hesitancy, and other complaints was often light stretching and Kegels several times a day.
A kegel is a pelvic stretch that is best described as a focused clenching or tightening of the muscles, almost as if you were trying to stop an active stream of urine.
Now, Kegels do have their place. With many pelvic pain conditions, the root issue may be either a hypotonic or hypertonic pelvic floor. A chronic loosening or tightening of the pelvic floor muscles, respectively.
If you suspect or have been advised that you have a hypertonic pelvic floor, Kegels are likely not improving your situation – quite the opposite. Those with a hypertonic pelvic floor should take care to relax the pelvic muscles, not tighten them.
However, if you have a hypotonic pelvic floor, your physiotherapist may use Kegels as a part of their regimen. Always ask for clarification!
Pelvic floor physical therapy is useful for a variety of different pain conditions, including but not limited to:
- Interstitial Cystitis
- Hypertonic pelvic floor
- Hypotonic pelvic floor
- Pelvic Pain Syndrome
- Bladder Pain Syndrome
- Overactive Bladder
- Vaginal Prolapse
- Vaginal birth aftercare
- Urinary and fecal continence issues
- Painful sexual intercourse
Be aware that It’s not uncommon for more conservative doctors or general practitioners to be unfamiliar with pain conditions around the pelvic floor. Be sure to advocate for yourself and be firm and clear when describing your symptoms.
Once you establish a relationship with your pelvic floor physiotherapist, they will work with you to establish a regimen that not only brings you relief from current symptoms, but that will helps to heal the root issue going forward.
Pelvic floor physiotherapy and you
The benefits of pelvic floor physiotherapy will vary from person to person. One individual may find that pain increases before it improves, and others will see benefits straight away.
Pelvic physiotherapy will always start with a thorough assessment and intake exam. This will help your practitioner identify issues with posture, breathing, muscles, connective tissue, and more.
Subsequent treatments can be as frequent as 2 to 3 times per week, and will generally taper off once you are able to self-manage at home and see improvement in your symptoms.
If you reside in the Peterborough area and suffer from any of the above-listed conditions or have other pelvic concerns, do not hesitate to contact the pelvic health professionals at Trent Health in Motion.
Your pelvic floor physiotherapist may recommend lifestyle changes to improve your quality of life and strengthen your pelvic floor. Changes may include ‘donut’ seat cushions, standing desks, yoga, low-impact exercises like walking or swimming, diet adjustment, and dilator use.
Use of dilators should only occur with the express advice of your pelvic floor physiotherapist, who will demonstrate proper use techniques and frequency guidelines.