The Pelvic floor is a very complex system of muscles, tendons, nerves and blood vessels. When any one of these parts become injured, damaged or overused it creates pelvic floor dysfunction. This dysfunction will either lead to the pelvic floor becoming very weak or very tight. The state of the pelvic floor muscle is very important because it affects an individual's bowel, bladder and sexual function.
For instance, individuals with pelvic floor muscle tightness or spasm dysfunction may have problems that lead to various diagnoses such as Pudendal Neuralgia, coccygodynia, proctalgia, vaginismus, vaginal stenosis, constipation, urinary retention or hesitency, Overactive Bladder (OAB), Painful Bladder Syndrome, Gastrointestinal or visceral dysfunction, and painful sex/dysparunia. Sexual pain may include vaginal pain with penetration or rectal, penis and testicular pain before, during and after orgasm.
Pelvic floor tightness dysfunction can also be caused by the following medical diagnoses such as Vuvodynia, Vulvar Pain Syndromes, Interstitial Cystitis, chronic UTIs, prostatitis, hemorrhoids and fissures, birth trauma such as episiotomies or perineal tears, vaginal dermatological issues such as vaginal atrophy, infections and lichens sclerosis.
So, if you have ever been labeled with these diagnoses then you have pelvic floor dysfunction and pelvic floor dysfunction physical therapy should be an integral part of your medical team. When seeking this type of specialized physical therapy you will need to look for a practitioner that specializes “Pelvic Health” PT.
Pelvic health physical therapy involves a physical therapy evaluation and should be performed by a physical therapist with specialized training in the pelvic health of men and/or women. The therapist should be certified as a Pelvic Rehabilitation Practitioner Certification (PRPC), Pelvic Health Certification (PHC), Board Certified Women's Health Specialist (WCS) or at least be closely supervised by a certified therapist. As a potential patient you should inquire if the therapist specializes in treating the pelvic floors of men, women or both. Not all pelvic health therapists treat both.
Pelvic health physical therapy involves performing a thorough musculoskeletal evaluation. This means assessing a patient's specific bowel, bladder or sexual problems by evaluating the muscles and bones of a patient's back, hip and pelvis. This of course includes the pelvic floor muscle system.
The therapist will come up with an individualized treatment plan. This will often include specific manual therapy techniques that involve palpation and release of muscles as well as mobilizing bones that are out of alignment. Treatments may be performed on muscles on the outside of their bodies or inside, meaning inside the vagina or anus.
The therapist will also help a patient's muscles relearn how to move correctly or come up with a completely new movement strategy. This will be necessary to make weak muscles strong and tight muscles relaxed depending on what the therapist has determined the problem is.
The pelvic therapist may also use modalities such as cold laser, electrical stimulation, biofeedback and ultrasound to achieve their patient goals.
The most critical component of good pelvic health therapy is educating a patient on an individualized home program of exercise and self release that facilitates what manual therapy has achieved. This involves strengthening a weak muscle or relaxing a tight muscle. For tight pelvic floor muscles, a patient will usually benefit from being able to perform internal release.
In summary, Pelvic Health Physical Therapy is a multifaceted program to heal pelvic floor dysfunctions involving a specialized PT evaluation and treatment program. The goal is to heal your body in the most natural way possible using manual therapy, self-release and exercise.