Pelvic Floor Physio; What is it and Do I need it? 

Pelvic floor physio may not be well-known or widely talked about but can be an important practice for women, and even men, to help relieve and restore the muscles in their pelvic floor. Here are the symptoms of pelvic floor dysfunction and how physical therapy can help restore pelvic health.

Introduction

Pelvic floor physical therapy is often overlooked because pelvic floor dysfunction too often goes undiagnosed. This is a problem because pelvic pain is all too real and can lead to problems with bowel function, bladder issues, sexual dysfunction and other health conditions. Pelvic floor problems, though sometimes uncomfortable to discuss, can be managed and even cured if the problem is addressed. This is where therapy comes into the picture.

pelvic floor physio, pelvic floor
Pelvic floor pain is all too real and can lead to problems with bowel function, bladder issues, sexual dysfunction and other health conditions.

What is Pelvic Floor Physio?

Pelvic floor physio is physical therapy for your pelvic floor muscles. These muscles are located at the base of what we call our “core”. It stretches from the pubic bone to the tailbone. The muscles that make up the pelvic floor support urinary and reproductive tracts. In women, the pelvic floor has the very important job of keeping a woman’s bladder, vagina, and rectum in place. In men, it supports the bladder and bowels because both the urethra and anus pass through the pelvis.

What does a pelvic floor physiotherapist do?

“Physiotherapists are experts in the structure of the human body and its movement.”

ahpa.com.au/allied-health-professions/physiotherapy

A pelvic floor physiotherapist focuses on the pelvic floor muscles; they assess your body, determining whether those muscles need strengthening or relaxing. After examination, your physiotherapist will make a plan specific to your health and needs.

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When should you seek pelvic floor physio?

You may need to seek pelvic floor physio for a number of issues: urinary incontinence, constipation, pain during sex, pain during menstrual cycles, Vaginismus, vaginal repair after surgery/childbirth, and problems post prostate surgery, to name a few. Many women who have given birth experience issues with their pelvic floor, and the Australian Physiotherapy Association also describe how women who do heavy lifting, whether work-related or not, can experience issues with pelvic floor function.

Problems such as bedwetting and bladder/bowel control aren’t just issues for children; pelvic floor physiotherapists can work with adults and children to figure out what is going on and what needs to be done about it.

How does a physio assess your pelvic floor?

A physiotherapist can assess your pelvic floor in two ways. The first is through an ultrasound, just like you’d receive during pregnancy. This approach, however, is not as helpful because it can’t determine how strong or weak the muscles are in that area. The second approach, and better to assess the state of your pelvic floor, is through an internal vaginal exam. This is more invasive, as the physiotherapist will use their finger to feel inside your vagina to test your muscles’ ability to relax and tighten; however, though uncomfortable, an internal vagina exam can actually help determine the state of your pelvic floor muscles.

pelvic floor physio exam
A physiotherapist may need to do an internal exam to assess the health of your pelvic floor but this will be discussed with you first

How long does pelvic floor physio take to work?

As with every therapy, results may vary regarding how long it takes to see improvement with your pelvic floor. However, Medline plus gives us hope that results can be seen in as early as 4 weeks. If you don’t see results that quickly, though, don’t give up! It could take months before your pelvic floor is responding or restored.

What can I expect at a pelvic floor physio appointment?

At a pelvic floor physio appointment, the therapist will get a detailed history of your bladder and bowel movements. They’ll also ask sexual, medical, and surgical history. After gathering all of your information, a physical therapist will assess the strength of your core. An internal exam may also take place, though that might be put off for a later date if you’re not comfortable with that step initially.

Can I do pelvic floor therapy at home?

You can most definitely do pelvic floor therapy at home! In fact, one of the most common exercises associated with this type of therapy is Kegels. Other exercises, and possibly a suggested dietary plan, will be given to you depending on your health needs and what health professionals advise.

pelvic floor physio exercises
There are many exercises you can do at home to improve the strength of your pelvic floor but make sure you check with your health professional first

FAQs about pelvic floor physio:

A few facts about pelvic floor physio: you don’t need a referral to see a physiotherapist, the first appointment lasts around 30 – 45 minutes, and women on their period can still attend their physio appointment.

Why do pelvic floor therapists say not to pee in the shower?

Nikolina Ilic gives us this answer by calling on the expertise of Dr. Alicia Jeffrey-Thomas, PT, DPT, PRPC, who warns “peeing in the shower is an extremely bad habit for your pelvic floor.” It trains your body to want to urinate whenever you hear running water. The other issue is that women aren’t designed to pee standing up. Instead of relaxing your muscles as you should when you urinate, women’s bodies contract when they pee standing up. If you’re not having pelvic floor issues now but are part of this practice, it could lead to issues such as urinary incontinence, later on in life.

Do they touch you in pelvic floor therapy?

Whether you want to be touched during a pelvic floor therapy session is completely up to you. As with anything else, a person has the right to say no to something they are not comfortable with or prepared for. That being said, as stated earlier, pelvic floor physiotherapists are able to better assess your pelvic floor by completing an internal exam. This will be done at your pace, however, so you are the deciding factor if it happens on the first visit, the second, or numerous ones later.

pelvic floor physio exam
A pelvic floor physiotherapist focuses on the pelvic floor muscles; they assess your body, determining whether those muscles need strengthening or relaxing.

How often should you go to pelvic floor physio?

This answer is a difficult one because just like your treatment plan, how often you see the pelvic floor physiotherapist depends on you. Scheduling four appointments, one per week, is a good place to start. From there, the physiotherapist will determine what your body needs and how much time will be spent in their care.

Is pelvic floor physio really worth it?

Yes, pelvic floor physiotherapy is worth it. The pelvic floor plays an extremely important role in both men’s and women’s health. Taking the time to figure out what your body needs so that it is not in pain or disrupting your everyday life is worth the time, money, and work spent on physiotherapy.

Summary

Seeing a physiotherapist can be daunting, just like any trip to the clinic or hospital; we’d all like to believe our bodies will just right themselves if we give them enough time. This lie we tell ourselves is outdated and dangerous. If you’re experiencing pain in your pelvis, or any of the other issues discussed above, seek medical advice from your doctor, and don’t stop searching until your questions are answered instead of disregarded. Caring for our bodies is the best thing we can do for ourselves and our loved ones, to ensure the quality of life.

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