Pelvic Therapy is a field of physical therapy that helps patients resolve bowel, bladder and sexual problems. This may include bladder and bowel incontinence, difficulty releasing or emptying one's bowel or bladder, Overactive Bladders (OAB), Pelvic Organ Prolapse, Gastrointestinal and Visceral Dysfunction as well as Pelvic Pain, or Chronic Pelvic Pain Syndrome (CPPS). Pelvic pain may present a vaginal, rectal, penis or testicular pain. An individual may feel this pain all the time or just when they are sitting, standing, walking or during sexual activities.
Pelvic 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 practitioners 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 rectum.
The therapist will also have to help a patient's muscles actually ‘relearn’ how to move correctly or come up with a completely new movement strategy. This will be necessary to strengthen weak muscles and relax tight muscles 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:
For tight pelvic floor muscles, a patient will usually benefit from intensive manual therapy and use of an internal massage or trigger-point release device and/or a dilator at home. The therapist should help the patient determine the right size and shape of an internal massage device for individual use. The TheraWand and/or a dilator may be necessary to meet each patient's needs. The therapist will instruct you on how long and how frequent the self- therapy sessions should be for.
For weak pelvic floor muscles, you will be instructed in strengthening. This includes an internal assessment of your pelvic floor while performing a pelvic floor contraction, known as a Kegel. If you are completing one hundred Kegels a day and still have problems, then you may assume you have other muscle problems aside from just weakness and/or that you are performing the pelvic floor muscle contractions (Kegels) incorrectly. The therapist will be able to assess and correct this dysfunction. The therapist will also have tools at their disposal to supercharge the effectiveness of your kegel contractions with Internal Electrical Stimulation This is a powerful, effective and inexpensive tool!
In summary, Pelvic Therapy consists of 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.