What is Pelvic Floor Therapy?
Many people are familiar with Kegels as the main treatment for incontinence or weakness of the pelvic floor.
However, Kegels are not for everyone and can make certain conditions worse. On top of that even when indicated are often not done properly!
Incontinence and pelvic pain are common symptoms of pelvic floor dysfunction. Pelvic Floor Dysfunction can be caused by:
- HYPOTONICITY (Weak pelvic floor muscles): contributing to stress incontinence, urge incontinence and pelvic organ prolapse. Incontinence is NOT a normal part of aging
- HYPERTONICITY (Tight pelvic floor muscles): contributing to Urinary and Fecal Urgency, Urge Incontinence, Chronic Pelvic Pain, Dyspareunia, Vaginismus, Vulvodynia, Pudendal Neuralgia, Interstitial Cystitis and Chronic Prostatitis
A lot of people are familiar with hypotonic dysfunction and think that is the only problem. These are treatable by Kegels but only if they are done properly. Many men and women are unable to properly visualize and activate them.
Many people with pelvic pain have dysfunction from hypertonic muscles. This is why trying to strengthen Kegels makes the pain worse. Contracting muscles that are tight just makes everything tighter.
How do we tell the Difference between Hypertonic and Hypotonic Muscles?
It isn’t possible to see if your pelvic floor is hyper or hypotonic just from looking. The majority of them are hidden in the pelvis. This is why an internal palpation is necessary to assess muscle tone.
Any therapist who performs this therapy is a highly trained, sensitive professional who will discuss these issues with you thoroughly before carrying out the treatment. Internal palpation is an integral part of treating the pelvic floor and is the gold standard. Accept nothing less.
What to Expect from Pelvic Floor Therapy?
What to expect during an initial session
During the assessment, your therapist will take a detailed history. This will be followed by an external exam which commonly includes assessing posture, flexibility and strength around your low back, hips, and pelvis.
Afterwards, an external and internal exam may be completed to assess the pelvic floor muscles. This will be done vaginally and/or rectally with women, and rectally with men. While an internal exam will likely be recommended it is not necessary if you are experiencing acute pain or are uncomfortable with the procedure. However, there is a lot of information that cannot be obtained without it. Your informed consent is always the priority.
Based on the assessment findings, an individualized treatment plan will be implemented. Treatment may include advice and education, exercises, and manual therapy.
What to expect during a follow-up session
During follow-up sessions, the focus will be on treatment for your symptoms. Common treatments include going through exercises, advice and lifestyle modifications, manual therapy, and relaxation techniques. There may be other assessments that the therapist will complete during follow-up sessions. These tests will allow the therapist to get a full picture of your concerns and to follow the progression of your symptoms.