The pelvic floor is made up of a series of muscles at the base of the pelvis. These muscles contract to help support your organs during daily activities, as well as relax to allow you to go to the bathroom. When these muscles aren’t functioning properly, you may start experiencing symptoms such as pain or incontinence. This is where physical therapy can help.
A pelvic health physical therapist is someone who has pursued specialty training and expertise on the muscles and bones of the pelvis. There are many conditions that a pelvic health therapist could help you with, including the nine listed below:
- Incontinence – Incontinence is the unintentional loss of urine, feces or gas. There are multiple types of incontinence, including stress incontinence, urge incontinence and a mixture of the two. Stress incontinence is involuntary leaking when pressure occurs, such as when you cough, sneeze, laugh or jump. Urge incontinence is when you have a strong impulse to use the bathroom with limited urine production or when you find yourself using the bathroom more frequently.
- Constipation – Chronic constipation that lasts longer than a few weeks can be caused by tight or dysfunctional pelvic floor muscles. If the pelvic floor muscles do not relax appropriately, you may notice straining and difficulty passing stool.
- Pelvic pain – The joints of the pelvis (referred to as the SIJ, coccyx and pubic symphysis) can cause pain with sitting, getting up from a chair, walking and using the stairs. Some people can also have abdominal, groin or genital pain related to the pelvic floor muscles and nerves.
- Pain with sexual activity – Painful erection, difficulty tolerating penetration or feelings of painful cramping in the hours after sexual activity can be an indication of pelvic floor muscle spasm.
- Prolapse – Muscle weakness or the loss of connective tissue supports of the pelvic organs can cause prolapse, or dropping of the pelvic organs. The most common symptoms are feelings of heaviness or something “falling out” of the body.
- Pregnancy and postpartum – The body changes dramatically during pregnancy, including changing posture, a shift of the center of gravity and hormone changes to ligaments. This can lead to back pain, hip pain or sciatica. Childbirth, whether vaginal or cesarean delivery, can affect the core and pelvic floor muscles, which can cause diastasis recti, a separation of the abdominal muscles. It can also cause incontinence, prolapse or pain with sexual activity as mentioned above. A physical therapist can help with these issues, as well as pains that may come from caring for a newborn in the fourth trimester – like lifting mechanics, breastfeeding posture or blocked milk ducts.
- Cancer – After a mastectomy, it is common to have difficulty raising your arms. After a prostatectomy or hysterectomy, it is common to have issues with incontinence. Both of these surgeries carry a risk of lymphedema or persistent swelling.
- Gynecological surgery – Any type of surgery, including hysterectomy, bladder or prolapse repair, laproscopy for endometriosis, or infertility issues can lead to scar tissue within the pelvic bowl. This can be a part of pelvic floor dysfunction including pain and incontinence.
- Athletic and orthopedic issues – The pelvic floor is part of a system. Orthopedic issues like back pain, hip labrum tears and ACL tears may be influenced by pelvic deficits.
This is by no means an exhaustive list of conditions treated by a pelvic floor physical therapist, but it’s a start. If any of this seems relevant to you, you may benefit from an evaluation with a pelvic floor physical therapist. They will be able to assess your pelvic floor muscle strength, coordination, and find any pelvic floor muscle trigger points that may be causing pain. They will then work with you to address any issues found at the evaluation, including correcting posture or movement issues, and set personalized goals to get you back to the activities you enjoy!
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The Athletico blog is an educational resource written by Athletico employees. Athletico bloggers are licensed professionals who abide by the code of ethics outlined by their respective professional associations. The content published in blog posts represents the opinion of the individual author based on their expertise and experience. The content provided in this blog is for informational purposes only, does not constitute medical advice and should not be relied on for making personal health decisions.