6 Reasons You May Need Pelvic Floor Rehab

Harinder Bajaj, PT and Patient Pelvic Floor Therapy

November 23, 2021

Clinical Contributors to this story:
Harinder Bajaj, PT
Sharon Arditti, PT

The pelvic floor is a group of skeletal muscles in the base of your torso that are responsible for bowel and bladder function and sexual pleasure.

If your pelvic floor muscles are weak or are not working correctly, you may experience uncomfortable, inconvenient or embarrassing symptoms. But the good news is that a physical therapist specializing in pelvic floor rehabilitation may be able to help.

What do the pelvic floor muscles do?

These inner muscles of your core work with abdominal, hip and back muscles to provide support to your pelvic organs, including:

  • The bladder, which holds urine
  • The uterus and vagina in women
  • The prostate in men
  • The rectum, where your body stores solid waste

Why would I need pelvic floor rehabilitation?

Hackensack Meridian JFK Johnson Rehabilitation Institute physical therapists Sharon Arditti and Harinder Bajaj discuss six reasons why men and women may need pelvic rehabilitation:

You are experiencing urinary or fecal incontinence.

Problems with the pelvic floor muscles can sometimes result in urine or stool leakage, also called incontinence, because the muscles are stretched, weakened or relaxed at the wrong time. When sneezing, coughing or exercise causes leakage, it is called stress incontinence.

To treat constipation or difficulty urinating.

Chronic constipation — straining pain or the inability to have a bowel movement — and pain when urinating may be symptoms of pelvic floor dysfunction.

“When the pelvic floor muscles are not fully relaxed it may be difficult to empty the bladder or rectum,” says Sharon.

You are experiencing urinary or fecal urgency.

Sudden urges to urinate or have a bowel movement that sends you running to the restroom may signify a pelvic floor disorder.

You have pelvic organ prolapse.

Pelvic organ prolapse is a condition that occurs when the muscles and ligaments of the pelvic floor weaken, causing pelvic organs to drop lower in the pelvis. Similar to a hernia, this disorder may cause organs to bulge into the vagina or rectum. Pelvic organ prolapse commonly occurs in women after childbirth, a hysterectomy or menopause.

You have pelvic pain.

Ongoing pelvic pain, including pain in your genitals or rectum, could be a sign of a problem with your pelvic floor muscles. Some people may also notice pain in their groin, hips, lower abdomen or lower back, sometimes when sitting.

You are experiencing sexual dysfunction.

Because pelvic floor dysfunction can affect the uterus and vagina in women, it may cause symptoms such as pain during sex. Men with pelvic floor dysfunction may experience erectile dysfunction.

How is pelvic floor dysfunction treated?

Harinder Bajaj, PT and Patient Arlene Pelvic Floor Therapy

Evaluation & Exercise Plan from a Physical Therapist

Treatment for problems with the pelvic floor starts with a personalized evaluation by a specially trained physical therapist.

With the patient's consent, a physical therapist may conduct an intravaginal or intrarectal exam to determine the level of muscle strength. After the initial evaluation, patients typically attend one 45-minute physical therapy session a week for 6-8 weeks.

“If we find that a patient has a lot of muscle weakness, we will show them how to exercise starting in a lying down position, and eventually progressing to sitting and standing,” says Harinder.

Nerve Stimulation

Physical therapists also use a treatment modality (technique) called biofeedback/electromyography (EMG), which collects information from the pelvic floor muscle. This is displayed on a computer screen. The visualization helps patients to see what the hidden pelvic floor muscles are doing in a simple graph.

“When you are exercising your arm or leg, you can see your muscles working,” says Sharon. “You can’t see the pelvic floor muscles, which makes it hard to exercise them correctly.”

Proper Posture & Body Movement

Sharon says physical therapists also work on body mechanics, postural training and breathing.

“We help patients to strengthen their abdominal, back and hip muscles so they can move and lift with proper body mechanics,” says Sharon. “We also teach patients to use their diaphragm to breathe correctly, which can improve pelvic floor health.”

While “up training” refers to strengthening, “down training” is another technique physical therapists use to help tight or painful pelvic floor muscles to relax. And, just as with any physical therapy program, performing the exercises at home is crucial.

“We teach self-care so people can practice at home,” says Sharon. “It’s about educating and empowering our patients.”

Next Steps & Resources:

The material provided through HealthU is intended to be used as general information only and should not replace the advice of your physician. Always consult your physician for individual care.

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