Pelvic Floor Physiotherapy

5 Things to Know about Pelvic Floor Physiotherapy

Pelvic floor physiotherapy aims to improve pelvic floor function through exercise, lifestyle modification, education, and hands-on treatment to reduce and eliminate symptoms. This therapy involves evaluating and treating a group of muscles associated with urinary, intestinal, and sexual functions. If these muscles are not working properly, it can lead to symptoms such as incontinence, increased urgency and/or frequency, retention (inability to empty the bladder or bowel), and pelvic pain.

The pelvic floor muscles are located in the lower part of the pelvis. There are superficial muscles and also deep muscles. Changes in their function and strength can contribute to pelvic floor dysfunction, such as urinary or fecal incontinence, pelvic prolapse, and pelvic pain.

What should I expect during my first pelvic floor physical therapy?

The pelvic floor muscles provide several important functions, such as supporting the pelvic organs, bladder and bowel control, and sexual function. The ability to properly contract the pelvic floor can be difficult. Proper pelvic floor contraction involves squeezing and lifting without contraction of other muscles, such as adductors and glutes.

Going to any test can be overwhelming, but the overall process of pelvic floor physiotherapy isn’t as extreme as most users realize. First, the physical therapist will have a complete history of bladder function, bowel function, sexual function, and medical history. They will also take notes on your fitness activities. From here begins the actual test, which lasts about 80 to 90 minutes. The test itself begins with an inspection of the pelvic floor by observing the kegel and cough. The physical therapist will also ask you to get off and look for tight spots throughout your physical body.

Once the test is complete, the physical therapist will work out a routine to improve you. The treatment itself can range from exercise, biofeedback, and manual muscle therapy. Physiotherapists will also advise on fitness, good bladder and bowel habits, and more.

When should one decide to see a pelvic floor physiotherapist?

There are many examples and reasons why someone should seek a pelvic specialist. Not only is this particularly important to one’s overall longevity, ignoring problems will only greatly aggravate all suffering for individuals. See a physical therapist if you have urinary incontinence, fecal incontinence, urinary urgency, painful sexual intercourse (dyspareunia), vaginal pain, interstitial cystitis, painful bladder syndrome, endometriosis, chronic pelvic pain, pituitary gland.

The pelvic floor is part of your core

The core involves a lot more than our abdominal muscles. The nucleus refers to the area that starts at the diaphragm and ends at the pelvic floor. The components of your core as such include the abdominal muscles, the lower back muscles, the pelvic floor muscles, and the diaphragm. Together, these muscles support the abdominal contents. That’s why we want all parts of your kernel to work properly. During pelvic floor physiotherapy, we will evaluate all parts of the core and work on exercises to build good core function.

Will it be painful?

A physical therapist’s goal is to improve symptoms, so while some treatment approaches can cause discomfort, the goal isn’t to create a painful reaction.

During the evaluation, the physical therapist will look for what may be causing the symptoms. For example, you might bend over in your lower back, and a physical therapist might ask you to observe this movement to assess how your back moves and why this movement can hurt. Although there may be some reproduction of pain symptoms, this should not worsen or cause further pain after a session.

During treatment sessions, some techniques may be used to provide symptom relief, which may cause mild discomfort but should not be painful.

In fact, it’s very unique and can do great things that other muscles can’t

This is due to its orientation and position in the body. The muscles that make up the pelvic floor act as a tent or hammock in the lower part of the pelvis. I like the image of the trampoline. As the muscles stretch and contract, they move from the pelvis into a domed position. They support the pelvic organs, help create internal stability for movement, act as a sump, and manage pressures from above. It also helps to allow the baby to pass easily when giving birth, contain sphincters that control bowel and bladder function, and have really amazing sex!

It is like any other muscle group in the body

All muscles can contract and relax; they can be short or long, tense or relaxed. They all have an ideal duration of rest. They can vary in the quality and structure of the tissue; they can be painful or have lumps. They are subject to joint position, general body alignment, fascial integrity, pressure gradients, and “things” that occur in adjacent and even distant areas of the body. They are controlled by the brain and nervous system. The pelvic floor is no exception. A healthy pelvic floor is well-positioned, flexible, elastic, strong throughout the range of motion, has good muscle tone and structure, and works in sync with other sister muscles. Many pelvic problems in men and women result from muscles that are too relaxed and stretched, too tight and immobile, or not forming the right nerve connection.

Bottom Line

There are several ways to assess the function and strength of the pelvic floor muscles. Real-time ultrasound and internal digital palpation are probably the most popular in clinical practice because they are the cheapest and most efficient examination tools. Manometry and dynamometry can provide more accurate force measurements. Manometry and dynamometry are reliable tools that can measure the contraction of the pelvic floor muscles and may be better than digital palpation as an objective measure of strength. When evaluating the pelvic floor muscle, it is important to correlate the results of different tests to ensure an accurate evaluation.

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