What Do Pelvic Health Physical Therapists Do?
This is a common question we get asked when we explain what we do as Pelvic (Health) Physical Therapists. So here is the answer to who, what, why and where of pelvic physical therapy.
Who Do We Treat?
We treat women of all ages and for a range of problems from pelvic organ prolapse to vulvar pain to hip or back pain. They are young athletes in their teens with incontinence and sedentary women with abdominal pain. Some women have painful intercourse after having babies or after menopause or surgery; others are unable to insert a tampon or have a doctor’s examination due to pain.
We also treat men. Yes, it’s true. Men have pelvic floor muscles too. Which means that they can suffer from many of the same problems that women experience. Men can have incontinence, abdominal pain, rectal pain, constipation, ejaculation problems, and painful intercourse. Prostatitis that does not respond to antibiotics may be a muscular problem that is responsive to physical therapy treatment. Even some physicians are surprised we treat men, because so often pelvic pain and incontinence discussions are geared toward women. So bear in mind that any of the treatments we address here may apply similarly to both women AND men.
What Type Of Pelvic Pain Do We Treat
Incontinence: Bowel or bladder leakage can occur due to muscle weakness, poor muscle coordination, and/ or an overactive nervous system. It’s not just for women after having babies, or a side effect of aging. Our incontinence patients range in age and activity, and not all women with incontinence have been pregnant or have had vaginal deliveries. Men also may experience leakage with or without a history of prostatectomy.
Constipation: No-one likes to talk about pooping. But everyone does it, and it is important that it is not painful and that there is no straining involved. Our patients come to us because their muscles are not coordinating correctly or relaxing enough to allow stool to pass, resulting in small stools, straining, incomplete evacuation, and sometimes abdominal or rectal pain.
Pelvic pain: Pain may be in the vagina, rectum, vulva, testicles or the tip of the penis. It may be more external in the perineum (the area between the labia and rectum on women and scrotum and rectum in men), the sitting bones or the hips, buttocks, abdomen, pubic region, groin, back…well, you get the idea. It may also be associated with the bladder, bowel, ovary, testicles and may feel better or worse after orgasm, intercourse or toileting. Some of our patients have other diagnoses, like endometriosis, interstitial cystitis/ painful bladder syndrome and pudendal neuralgia. Pain may only be during sexual activity, or may be triggered by pressure (touching the area with clothing or by sitting on a hard surface), or during exercise or other activities, or it may be during a combination of activities.
Hip/ back/ tailbone/groin pain: Yes, we see patients with other problems. They may be referred to us with pain in the pelvis that is related to another musculoskeletal problem. We don’t ‘just’ treat the pelvic muscles and structures- we treat the whole system.
Where Do We Treat Pelvic Pain
We assess and sometimes treat the pelvic muscles by touching them with a finger through the vagina or the rectum. But wait! There’s more. Pelvic treatment involves more than manual examination and treatment of the pelvic floor. Pelvic physical therapists do what other orthopedic therapists do: We take a detailed history. We watch how your body moves. We examine your breathing patterns, other joints and muscles in the spine and hips that work with the pelvic floor, and perform sensory and reflex tests. We do a detailed examination of the perineum and pelvic muscles and assess pelvic floor movement, strength and coordination. We consider all of these components to determine a physical therapy diagnosis and treatment plan.
Why Is Pelvic Health So Important
We love what we do. We believe that pelvic health is an important part of wellness. Our goal is to empower our patients to overcome a problem that is often embarrassing to discuss with friends, family or even their doctors. We educate our patients to ensure that they have the tools necessary to help themselves get stronger, reduce pain, go to the bathroom with ease or meet other personal functional goals. Our practice is designed to treat the individual and not the medical diagnosis. So spread the word- there’s help for people with pelvic problems. Contact Beth Dessner at [email protected] or Gina Yeager at [email protected] for more information.