Undergoing pelvic floor physical therapy can help strengthen the muscles in your pelvic floor. Those muscles support the organs of the urinary tract, bowel, and reproductive organs. They also help control your bladder and bowel function.
If you’re experiencing symptoms related to bladder or bowel control or sexual function, pelvic floor physical therapy can help. Here’s more about how it works, and when to seek care.
The Pelvic Floor Muscles
All genders have pelvic floor muscles. They sit at the bottom of the pelvis in the lower abdomen and run from your pubic bone to the tailbone. Your pelvic floor muscles form a sling and support the organs above, which include the:
- Bowel and rectum
- Uterus and vagina
When pelvic floor muscles are weak or don’t relax and tighten properly, the organs above them may not work as they should. As a result, pelvic floor dysfunction can cause problems with bowel or bladder incontinence or issues during intercourse.
Pelvic floor disorders can happen for these reasons:
- Pregnancy or childbirth.
- Being overweight.
- Heavy lifting.
- Straining your pelvic muscles by pushing too hard when you go to the bathroom or doing certain exercises.
- A severe injury to the pelvic area, like a car accident.
- Pelvic surgery.
Pregnancy is among the most common reasons for pelvic floor dysfunction. The weight of your growing baby and the strain of childbirth can strain pelvic floor muscles and tissues.
“In its most severe form, pelvic floor disorders can involve incontinence or loss of control of urine, the bowels, or both,” says John Reilly, MD, a UPMC colorectal surgeon at Colon & Rectal Surgeons of Erie. “Women may be too modest or embarrassed to talk about this. It’s a very common problem. They may chalk it up to being the price they pay for having babies. But, for whatever reason, it is really a problem that is not spoken about as often as it should be.”
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Symptoms of Pelvic Floor Dysfunction
Issues with the pelvic floor can occur in women and men of all ages. In women, certain stages of life, such as pregnancy, childbirth, or menopause can cause pelvic weakness. Some people are naturally prone to pelvic weakness, while some have muscles that are too tight and cannot relax. If your muscles do not work together as they should, you can have symptoms like:
- Constipation or straining to have a bowel movement.
- Incontinence (leaking stool or urine).
- Urinating frequently or having pain when you urinate.
- Too tight pelvic floor muscles can lead to pain during vaginal intercourse or erectile dysfunction.
- Pelvic organ prolapse can occur after delivery of a child. This is when the uterus or bladder can drop causing pelvic pressure or heaviness.
- Pelvic floor dysfunction can also lead into back pain.
“Very often, we’ll hear that the patient has diarrhea, but when we ask further, we find when someone goes out to eat dinner, they have to know where the bathroom is because they know they’re going to make a beeline to the bathroom,” says Dr. Reilly. “They’re afraid to go out. They’re afraid to go on vacation. It’s an issue of control.”
None of these symptoms are normal, so if you have them, you should ask your doctor about treatment options.
How Pelvic Floor Physical Therapy Works
If you have problems with your bowel, bladder, or sexual function, it’s important to talk to your doctor. These symptoms can affect your quality of life. If your pelvic floor muscles are to blame, pelvic floor physical therapy can help.
A specialized physical therapist uses various treatments to help you learn to control and strengthen your pelvic floor muscles. The type and number of treatments depend on the diagnosis and severity of your symptoms. Some common pelvic floor physical therapy treatments include:
- Education about how your pelvic muscles and anatomy work. Your therapist can also provide information about how your bathroom habits affect your muscles and symptoms.
- Educating and instructing on performing pelvic floor strengthening exercises, including Kegels correctly. These exercises help strengthen your pelvic floor muscles and reduce bladder or bowel incontinence — and you can do them at home.
- Hands-on therapy to gently manipulate scar tissue, muscles, connective tissue, and nerves. This can help improve blood circulation and soften tense tissues.
- Functional activities to address your positioning, posture, and body mechanics. These might include bowel and bladder retraining or device recommendations.
- Pelvic floor biofeedback to help you “see” and use your pelvic floor muscles correctly. Here, probes placed on your abdomen, along your anal area, or in your vagina monitor your pelvic floor contractions.
- Electrical nerve or muscle stimulation. Your therapist applies electrodes to the outside of your body, which delivers gentle pulses to help strengthen muscles or relax nerves.
Often, a pelvic floor physical therapist works as part of a team with your primary care doctor, gynecologist, and urologist.
When to Get Help
It’s not uncommon to feel uncomfortable or embarrassed talking about incontinence or problems with intercourse. But pelvic floor dysfunction is more common than you might think. Also, it won’t go away on its own and often gets worse over time if it’s not treated.
This type of physical therapy is very effective for treating problems with your pelvic floor muscles and it’s safe to do. If you feel like you have symptoms of pelvic floor dysfunction, don’t wait. Talk to your doctor about it soon so you can prevent uncomfortable symptoms and improve your quality of life.
Editor's Note: This article was originally published on , and was last reviewed on .
Headquartered in Pittsburgh, UPMC is a world-renowned health care provider and insurer. We operate 40 hospitals and 800 doctors’ offices and outpatient centers, with locations throughout Pennsylvania, Maryland, New York, West Virginia, and internationally. We employ 4,900 physicians, and we are leaders in clinical care, groundbreaking research, and treatment breakthroughs. U.S. News & World Report consistently ranks UPMC Presbyterian Shadyside as one of the nation’s best hospitals in many specialties and ranks UPMC Children’s Hospital of Pittsburgh on its Honor Roll of America’s Best Children’s Hospitals. We are dedicated to providing Life Changing Medicine to our communities.