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Pelvic Therapy FAQs

What is the pelvic floor?

The pelvic floor consists of the muscles, ligaments, nerves, and connective tissue (fascia) that provide support for the organs in the pelvic region. They include the bladder, uterus, vagina, prostate, and rectum. The muscles of the pelvic floor assist in bowel, bladder, and sexual function.

What is pelvic floor dysfunction?

Pelvic floor dysfunction is a general term for a wide range of complications that can occur with the organs, muscles, nerves, and connective tissue in the pelvis. Contributing factors can include shortened or weakened muscles, trauma, chronic holding patterns, underlying disease, prolapse, disuse, or sexual dysfunction.

What are the signs and symptoms of pelvic floor dysfunction?

Individuals with pelvic floor dysfunction may experience urinary frequency and urgency, difficulty initiating a urine flow, pain in the pelvic area during urination, difficulty having bowel movements or the inability to fully empty, and constipation. Individuals may have pain with prolonged sitting, during intercourse, with tampon insertion, or during gynecological exam.

What if I am uncomfortable discussing my condition?

Our therapists are sensitive to this and understand the intimate nature of pelvic floor complications. With over 22 years combined experience our therapists have had many discussions with men, women, and couples regarding many different conditions. Our therapists will help to ease any concerns you may have.

How many sessions will I need?

Most patients are seen between 6 to 14 visits. However, each patient is different and the number of treatment sessions can best be determined after your evaluation. Several factors can contribute to the number of visits required for success in the program. Your therapist will educate you about this and your condition, provide you with self management techniques, and develop a home program. Home program compliance is essential in improving your pelvic health.

Do you work with men?

Yes. All of our therapists have advanced training to assist both men and women with pelvic health concerns and complications.

What should I bring?

All you need to bring to your initial evaluation is a photo ID (preferably a driver’s license), the prescription from your physician, a list of current medications, and your current medical insurance card.

What should I wear?

Any type of clothing is appropriate.

What if I am menstruating?

We are able to complete evaluations and treatments if an individual is menstruating.

Do you perform internal pelvic examinations?

Yes. The pelvic floor muscles can be a contributing factor in pelvic dysfunction. An internal pelvic floor exam allows the therapist to accurately assess the strength of the pelvic floor muscles. In addition, the therapist can also determine if tension or scar tissue may be contributing to your symptoms. The exam is done by inserting a gloved finger into the vaginal or rectal canal and assessing the surrounding muscles. The assessment can greatly assist the therapist in determining a proper plan of care. This typically lasts just a few minutes (there are no stirrups or speculum involved). The internal pelvic assessment is not required to participate in pelvic physical therapy, but it can help you to meet your goals more quickly.

I have urinary leakage; can’t I just do Kegel exercises at home?

Kegel exercises were designed to assist with the strengthening of weakened pelvic floor muscles (by performing a controlled contraction). These exercises are very beneficial for some patients with pain, incontinence, or pelvic organ prolapse. If done incorrectly or when the pelvic floor muscles are shortened or tightened they can actually inhibit your progression and worsen your symptoms. A proper evaluation of the pelvic floor muscles can be completed to determine if Kegel exercises are appropriate.

I have experienced physical or sexual trauma and I am concerned this may affect my ability to progress in the program. Can I still be seen?

Yes. Our therapists assist each patient in meeting their goals on an individualized basis. Great care and time is taken in understanding a patients needs and the appropriate means to assist in improving pelvic health. Patients who have experienced physical or sexual trauma can greatly benefit from simultaneous pelvic physical therapy and mental health therapy.

I am pregnant, can I still be seen?

Yes. There are many musculoskeletal changes that occur in the body during a pregnancy. Pelvic physical therapy can assist with pubic symphysis dysfunction, low back pain, pelvic pain, and leg pain. Your therapist can also offer assistance with pregnancy belts that provide support for the abdominal or SI joint regions. Therapeutic exercises are also important for improving pelvic floor and core strength during pregnancy. Increased strength can also improve postpartum recovery.

Is urinary leakage after pregnancy normal?

Although urinary leakage is common after pregnancy, it is not normal. Pregnancy and delivery can weaken pelvic floor muscles. When these muscles are weak it can be difficult to hold back urine when the urges occur. Pelvic floor muscle strengthening exercises can assist in improving urinary leakage. It is important to know how to perform these exercises correctly. Many women have difficulty isolating the pelvic floor muscles and they tend to compensate with hip, abdominal, and leg muscles.

Isn’t urinary or fecal leakage just a normal part of getting older?

No. Urinary and fecal incontinence is not normal. Unfortunately, many men and women will experience this at some time in their lives. Addressing this early will drastically improve overall outcomes. Even a few “drops” of urine or feces that is unintended is incontinence. The earlier the complication is addressed the easier the leakage is to control.

What is stress incontinence?

Stress urinary incontinence is the most common type of incontinence and it is not related to psychological stress. Stress incontinence occurs when the pelvic floor muscles are weakened and there is an unintended loss of urine during physical activity. This commonly occurs during coughing, laughing, getting into a vehicle, or during exercise. Child birth and pelvic surgeries can contribute to the weakening of pelvic floor muscles which can lead to stress incontinence. Therapeutic exercise including down training and strengthening of the pelvic floor muscles can decrease and/or eliminate leakage.

What is urge incontinence?

Urge urinary incontinence is the involuntary loss of urine associated with an abrupt and strong desire to urinate. Urge incontinence is characterized by sensations to urinate that cannot be postponed. Other symptoms often include a need to urinate frequently and waking often during the night to urinate. The condition is also known as overactive bladder.