Most of us are familiar with the idea (and the benefits) of undergoing physical therapy after experiencing trauma to a particular part of our body (perhaps a major surgery, injury, etc.). However, we don’t often think about it pelvic floor physical therapy to help the critical deep core muscles of our pelvic floor recover from the stresses of pregnancy and childbirth.
To help you understand what pelvic floor physical therapy is, and why it’s so important for everyone with vaginal anatomy — especially those who are pregnant or have had children at any point — we go to the pelvic floor physical therapist, Ashley Rawlins, PT, DPT of Origin Physical Therapy, a leading provider of pelvic floor and whole-body physical therapy nationwide with a special focus on pregnancy, postpartum and sexual health.
Let’s start with the basics.
What exactly is the “Pelvic Floor”?
At the very bottom of your pelvis is a bowl-shaped group of muscles and tissues that together make up what’s called your pelvic floor. These include the muscles that anchor your pubic bone and tailbone, and wrap around the vagina, urethral, and anal openings. The pelvic floor also includes the skin, nerves, and blood supply that help the muscles survive.
What is the Role of the Pelvic Floor Muscles?
Your pelvic floor muscles are responsible for several things, including interacting with your diaphragm to help you breathe; contracting and relaxing to help you control your bowel, bladder, and sexual functions; and even works to provide stability and circulation to your pelvis. Like all the muscles in your body, the pelvic floor muscles need to be strong, flexible, and coordinated to function effectively.
Most of these functions seem to happen automatically every day, which is what can make the pelvic floor so mysterious. However, when the muscles become unused and weak, or too much work and tight, or they lose coordination from years of suboptimal habits, you may begin to notice symptoms of pelvic floor dysfunction.
What is Pelvic Floor Dysfunction?
Pelvic floor dysfunction (PFD) describes a group of symptoms that occur when the pelvic floor muscles are not working properly. Common life events such as pregnancy, childbirth, trauma, and menopause can increase the chance of these muscles developing dysfunction. Symptoms commonly associated with PFD include:
- Bowel or bladder leakage of any amount, including difficulties with passing gas, urine leakage or stool leakage
- Pelvic heaviness or a feeling that your penis is leaking or falling off
- Sexual dysfunction, or other sexual dysfunction
- Pain anywhere in the pelvis or low back
- Difficulties starting your urine flow, or emptying your bladder completely
- Difficulties holding your bladder due to a sudden, strong urge to urinate
- Constipation, or feeling like you can’t empty your bowels completely
The PFD is Common but not Normal
If you’re thinking that many of the above symptoms seem common (especially to those with children), you’re right. In fact, here’s what the research shows us:
- Every year, 40 million women experience pelvic floor issues which are often easily prevented or treated with pelvic PT (Nygaard et al., 2008)
- 1 in 3 women have bladder leakage. This is noticeable within the first three months after having a baby, but the chances increase again as we age and move into menopause (Grodstein, 2003).
- 50% of women experience lower back pain during pregnancy. Having pain in pregnancy increases the chance of long-term postpartum pain (Katonis et al., 2011).
- More than 1 in 4 women have it painful intercourse (Flynn et al., 2017). It is more common in the first year after having a baby two-thirds of women reporting postpartum sexual dysfunction (Khajehei et al., 2015)
- Up to 70% of women will experience changes in bladder and sexual functionincluding increased bladder leakage, and pain during sex (Moral et al., 2018).
These numbers are just the tip of the iceberg when it comes to pelvic floor symptoms. Pelvic floor dysfunction is common, but let’s make one thing clear:
Just because it’s common, doesn’t mean it’s NORMAL.
None of the above symptoms normal. These are signs of core dysregulation, and will certainly affect a person’s core strength and quality of life. The good news is that when it comes to pelvic floor dysfunction, Pelvic physical therapy is evidence-basedvery effective treatment option for any of these symptoms (Wallace, Miller, & Mishra, 2019).
What is Pelvic Floor Physical Therapy?
Pelvic floor physical therapy (PT) is a specialized area of physical therapy that focuses on improving and restoring the pelvic floor. A pelvic floor PT will spend time getting all the details about your symptoms (no TMI), work to fully understand your relevant health history, and evaluate your pelvic floor muscles. After conducting a thorough examination, and by determining how your health history and muscle function interact with your symptoms, your PT will work with you to determine the most effective physical therapy program for you.
We understand that it can be scary to think about seeing a pelvic floor PT, especially if it’s a part of your body that’s difficult to discuss — or if you’ve brought your symptoms to a healthcare provider in the past, only to be dismissed or downplayed. Seeing a pelvic floor PT will be very different, and many more positive experiences.
Book a FREE 10 Minute Consultation
If you think you could benefit from pelvic floor PT, book a FREE 10 minute intro call with the experts at Origin Physical Therapy. Origin offers virtual and in-person PT sessions, covered by insurance and supported by proprietary exercise programs, educational content, and community experiences. Get started with this free introductory call to see how it can benefit you.
Post a Contributor
Dr. Ashley Rawlins, PT, DPT is a doctor of physical therapy and Clinical Learning & Development Lead at Source of Physical Therapy. He has advanced certification in the treatment of Pelvic Health and Obstetric Health (CAPP-Pelvic, CAPP-OB). He specializes in the treatment of pelvic floor muscle dysfunctions including pelvic pain, sexual dysfunction, pregnancy related pain, postpartum recovery, and bowel and bladder dysfunction. She is a practicing clinician, educator, and author in the field of women’s health physiotherapy. She has taught women’s health physical therapy courses to physical therapy students in Dallas, provided education to groups throughout the community, as well as assisted in teaching continuing education courses to physical therapists and others. another health care professional. Her most important job is being a wife and mother to her silly, active little boy and sassy, precious daughter.
Sources
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Grodstein F, Fretts R, Lifford K, Resnick N, Curhan G. Association of age, race, and obstetric history with urinary symptoms among women in the Nurses’ Health Study. Am J Obstet Gynecol. 2003 Aug;189(2):428-34. doi: 10.1067/s0002-9378(03)00361-2. PMID: 14520212.
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