What Is Physical Therapy for the Pelvic Floor? Who Can Benefit and Other Frequently Asked Questions

Sexual dysfunction … urinary problems … pelvic organ prolapse.

Nightmares or part of your daily life? 

If you are someone who experiences difficulty with your pelvic floor muscles, you understand the pain and embarrassment that comes along with it. All you want is relief but are unsure of where to turn. 

That’s where physical therapy for the pelvic floor comes in. 

Keep reading because this article will teach you: 

  • What is pelvic floor physical therapy
  • What is done during pelvic floor physical therapy
  • Benefits of pelvic floor physical therapy
  • And much more
what is involved in pelvic floor therapy

Table of Contents

What Is Pelvic Floor Physical Therapy?

The goal of pelvic floor physical therapy is to restore function and improve stability in the pelvic floor muscles. 

This specialized therapy includes exercises that can help relieve symptoms such as: 

  • Pain
  • Discomfort; and
  • Disruptions to your quality of life

How Does Pelvic Floor Therapy Work?

To restore function and stability of the pelvic muscles, pelvic floor therapy may involve various methods. 

Some methods used include:   

  • Targeted stretching and strengthening exercises such as Kegels
  • Weighted cones
  • Vaginal dilators
  • Electrotherapy (such as electrical stimulation); and 
  • Biofeedback

Who Can Benefit From Pelvic Floor Therapy?

Pelvic floor therapy may benefit anyone experiencing conditions such as urinary or bowel dysfunction or diminished sexual function.

What Conditions Can Pelvic Floor Therapy Improve?  

It is common to use pelvic floor physical therapy to treat issues affecting the pelvic floor muscles.

This treatment targets conditions such as:

  • Chronic pelvic pain
  • Constipation
  • Pelvic organ prolapse
  • Vaginismus
  • Vulvodynia
  • Irritable bowel syndrome
  • Pelvic pain
  • Painful intercourse before or after pregnancy
  • Urinary and bowel incontinence; and
  • Endometriosis

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Urinary Incontinence

Urinary incontinence, the inability to control your bladder, is a common and embarrassing problem.

Urine leakage can range from an occasional leak when coughing or sneezing to an unexpected and strong urge to urinate that prevents you from reaching a toilet in time.

With pelvic floor therapy, a physical therapist can address physical and behavioral changes appropriate to your needs to reduce unwanted leakage.

Some exercises they will utilize include: 

  • Pelvic floor detraining
  • Bladder retraining
  • Strengthening; and
  • Improving mobility through specific exercises
what is involved in pelvic floor physical therapy

Bowel Leakage

A bowel leak occurs when fluid leaks from the bowel without warning.

The pelvic muscles help manage waste removal from the bowels. A pelvic floor physical therapist is an expert at understanding these mechanics and keeping your pelvic floor muscles functioning at their best.

Some techniques the physical therapist will incorporate into treatment include: 

  • Biofeedback training
  • Balloon training
  • Myofascial work including abdominal massage
  • Diaphragmatic breathing; and
  • Patient education

Sexual Dysfunction 

From difficulty getting aroused to pain during intercourse, sexual dysfunction encompasses a broad range of issues.

Several aspects of sexual function are directly affected by pelvic floor dysfunction. For example, as well as in sexual arousal, muscle contraction also plays a role in orgasm. 

There are several pelvic floor physical therapy interventions for sexual dysfunction, including:

  • Exercises designed to teach patients how to contract and relax their pelvic floor muscles. 
  • Using breathing exercises to relax and improve exercise performance.
  • Hands-on therapy, such as massage or stretching. In some cases, manual therapy involves a provider putting fingers inside the vagina or rectum to reach the affected muscles.
  • Biofeedback can be done by connecting a computer to a probe placed in the vagina or anus. Using the computer, the person can see how their movements affect their muscles.
  • Using an electrode near the ankle, percutaneous tibial nerve stimulation stimulates the bladder's nerves through electrical stimulation.  
  • Using vaginal dilators to help patients relax their pelvic muscles.  

External Sphincter Incompetence

External sphincter incompetence occurs when the muscles that protect the bladder and bowel from accidental leakage become weak or ineffective.

The internal and external sphincters help control your bowel movements by wrapping around your anus. A condition called fecal or bowel incontinence occurs when people lose control of their bowel movements. 

People with fecal incontinence or bowel leakage may be helped by doing specific exercises for the sphincter and pelvic floor muscles. Taking part in these exercises could boost sphincter and pelvic floor strength and improve bowel control.

Some therapy techniques to target external sphincter incompetence include: 

  • Kegels and other strengthening exercises
  • Biofeedback; and
  • Electrical Stimulation

Incontinence Due to Cancer or Other Treatments

The term "cancer" refers to a group of more than 100 diseases characterized by uncontrollable cell proliferation. Tumors formed by these cells can infiltrate and destroy healthy tissue, spreading to other organs.

Cancer symptoms vary depending on the type, but … 

  • Fatigue
  • Chronic pain; and 
  • Weight loss

… are common indicators. 

It is also common (but often overlooked) that incontinence occurs with cancer.

Additionally, many cancer treatments affect continence in different ways:

  1. Prescription drugs — Medications used in cancer treatment, such as antidepressants and sedatives, affect the muscles and nerves that control bladder and bowel movements.  
  2. Chemotherapy — To combat fast-growing cancer cells, chemotherapy uses powerful anti-cancer drugs. Chemotherapy often results in nerve damage, hormonal changes, and bladder irritation, three factors that increase the risk of incontinence.
  3. Radiation — Radiation targets and destroys cancerous cells. With advances in treatment, radiation can be minimized on healthy tissue. However, radiation increases the risk of scarring and fibrosis, two of the most common causes of incontinence.
  4. Surgery — The risk of incontinence increases during surgery on or near the pelvic floor muscles. 

Some types of treatments to strengthen the pelvic floor muscles include when impacted by cancer include:  

  • Relaxation techniques
  • Deep pressure treatment
  • Kegels; and
  • Biofeedback
what is done during pelvic floor physical therapy

Benefits of Pelvic Floor Therapy 

Pelvic floor physical therapy offers incredible benefits for those who participate. The benefits may be experienced by anyone, regardless of whether they are looking for all of them or just one.

The benefits of this type of therapy include: 

  • Strengthen the muscles in the pelvis — Any muscle in the body requires strength for it to perform its functions.
  • Increase coordination of the pelvic area — When these muscles begin to work together in a more productive manner, urinary control, pain, and any other issues you may be experiencing can also be resolved.
  • Find relaxation and pain relief — In addition to feeling more comfortable, you will know how to prevent the pain from returning.
  • Reduce the need for medication — Treating your condition with pelvic floor therapy can eliminate the need for pain medication. 
  • Treat urinary issues — Pelvic floor therapy can help solve many urinary issues.

Frequently Asked Questions About Pelvic Floor Therapy

Do you understand the benefits of pelvic floor therapy but want to know what is involved in pelvic floor physical therapy? Let’s take a look at some common FAQs about pelvic floor therapy. 

What Do They Do at Pelvic Floor Therapy?

The first line of treatment for weakness or tightness of the pelvic floor is often working with a highly trained pelvic floor physical therapist. The pelvic floor physical therapist will evaluate your symptoms and medical history at your first appointment. 

To determine strength and function, the therapist performs an external examination of the spine, hips, and core. 

Depending on the patient’s comfort level, a pelvic examination can be performed with consent. If you are not comfortable with an internal exam during the first visit, you can let your physical therapist know — it can always be performed at a later time. 

Following this comprehensive evaluation, treatment plans will be developed by the therapist. 

How Long Does Pelvic Floor Therapy Take?

During the assessment, it may take you between 60 and 90 minutes for your therapist to understand your symptoms and answer all your questions. 

Once you begin treatment sessions, you can expect them to last 30 to 60 minutes.

Some people want to speed up the process, and you might like to request longer sessions; however, over-exercising can cause muscle fatigue and increase urinary leakage.

What Is Pelvic Floor Therapy Like — Will It Be Painful?

During your external and internal treatments, you should only feel light pressure. 

Healthy muscles should not be painful to touch. If you feel any pain, tell your therapist, and they will be able to determine your symptoms more clearly, and they will be able to adjust the examination accordingly. 

Please remember: You should notify your therapist immediately if you experience pain during an exam. 

Is Pelvic Floor Therapy Covered by Insurance?

Physical therapy is considered pelvic health therapy, so coverage will be consistent with what your insurance covers for physical therapy. 

When you call to schedule an appointment, be ready to provide insurance information so that the staff can call and verify your insurance coverage for physical therapy. You should have any costs explained to you before you begin therapy.

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The content in this blog is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

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