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The 411 on Pelvic Floor Therapy

This weeks question

I saw that Perfect Ten Physical Therapy started offering pelvic floor PT. Can you tell us about some myths surrounding this?

My answer

1. Pelvic Floor PT is Women’s Health

-Pelvic floor PT is not just for women - everyone has a pelvic floor! The pelvic floor supports your organs, controls sphincters for urination/defecation, provides stability to the trunk, is involved in sexual function, and helps maintain circulatory homeostasis moving fluid from the legs back to the heart. Pelvic floor dysfunction can affect anyone - any gender, any age, any level of health, any level of physical fitness - anyone with a pelvic floor problem can benefit from pelvic floor PT.

2. Pelvic Floor PT is only for urinary leakage or after giving birth

-While urinary leakage is often one of the first symptoms that leads patients to pelvic floor PT, it is not the only condition that can be treated. Here is a list of some reasons why someone might seek out PFPT:

  • Pelvic pain - pain in or around the pelvis, including but not limited to the vulva, penis, scrotum, anal opening, deep hip muscles, or the areas around these structures

  • Urinary dysfunction - leaking, increased frequency, increased urge, or pain with urination

  • Bowel dysfunction - leaking, constipation, or pain with voiding

  • Pain with intercourse and/or sexual dysfunction - pain with penetration, toy use, orgasm, difficulty with attaining or maintaining arousal or erection

  • Pelvic organ prolapse - organs lowering into or through pelvic openings; sensation of bulging or herniation of pelvic floor tissues

  • Pregnancy or peripartum concerns - pain or dysfunction occurring during or after pregnancy or childbirth (including surgical birth)

  • Post-surgical concerns - pain or dysfunction occurring after surgery in the abdominal and pelvic regions, including post-prostatectomy 3. Pelvic Floor PT has to involve an internal exam/treatment

-While an internal exam can help your therapist identify dysfunction, tension, or strength deficits in the deeper pelvic floor muscles, it is not required. Each patient will have a conversation with their therapist about what they are comfortable with, which could include external palpation over clothes, external palpation and observation of the pelvic region with garments removed, internal examination via pelvic openings, or therapist-guided self-palpation of external or internal tissues. Consent is required for any physical examination and can be revoked at any time - the priority is the comfort of the patient!

4. Pelvic Floor PT is just doing kegel exercise

-If there was one magic exercise that fixed pelvic floor problems, no one would need pelvic floor PT. Kegels are one tool in a whole toolbox of things that are used to address pelvic floor problems, but they are often misunderstood, performed incorrectly, and not appropriate for the specific problem a patient is having! Performing kegel exercises incorrectly or for the wrong condition can actually make pelvic floor problems worse, which is why it is important to speak with a pelvic floor PT before beginning any exercise for the pelvic floor.

Treatment for the pelvic floor is customized to the needs of the individual and may include exercises to develop improved awareness of the pelvic floor muscles, table-based relaxation and/or strengthening exercises, and exercises that look a lot like those you might perform at the gym (with emphasis on correct integration of the pelvic floor). Treatment sessions may also include manual therapies, patient education and training about tools for home therapies, or other services deemed appropriate for the individual patient’s concerns.

5. Pelvic Floor PT is scary/uncomfortable

-It may seem scary or intimidating, but it doesn’t have to be! We understand that discussing problems related to urination or sexual function can be awkward and uncomfortable for many people, and strive to meet the patient where they are in terms of the language and approaches used to discuss the problems. When you come for a consultation the therapist will discuss all of the options available for examination and treatment and as a team you will decide what will work best for you. Consent for any examination or hands-on treatment in the pelvic region will be asked for at every session and can be revoked at any time for any reason without judgment. We value your trust in us and appreciate that your comfort and needs may change over the course of your care plan.

Now that we have dispelled some myths, we hope you feel that you have a better understanding of what pelvic floor physical therapy has to offer. Do you have some concerns about your pelvic floor? Give us a call at 973-556-8465 and schedule a free consultation to see if we can help!

Today's Friday Forum was written by our Pelvic Floor PT - Dr. Paige Dwight Dickman 

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