How Does Pelvic Floor Physical Therapy Work?

Pelvic floor therapy begins with history taking, which includes past surgical and medical history, medications, and sexual, gynecologic, or obstetric history. A thorough orthopedic examination is performed, with close attention to the lumbar spine and hips, gait and posture. 

The assessment usually includes evaluation of both internal and external muscles, with patients often asked to stand, walk and sit to enable the therapist to detect any existing posture or joint issues affecting the pelvic floor muscles.

The evaluation helps via to determine whether the therapy is appropriate and guides the creation of an appropriate care plan. And usually, the type of therapy recommended depends on the symptoms experienced. 

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For example, relaxing and lengthening muscle exercises may be necessary to relieve some symptoms while in other cases strengthening exercises are appropriate.

So the eventual treatment plan may include:

  • Stretching or strengthening exercises of the legs, trunk, or pelvic muscles.
  • Relaxation exercises for shortened pelvic muscles.
  • Education in self-management and prevention.
  • Coordination exercises.
  • Biofeedback for either relaxation or strengthening of pelvic muscles.
  • Modalities such as ice, heat, or electrical stimulation.

Through a tailored treatment plan, the physical therapist manipulates pelvic floor muscles to restore their strength and function. For example, shortened and contracted muscles are stretched to relax in order to relieve pelvic floor pain associated with excessive tightening and cramping. 

Likewise, appropriate techniques are used to strengthen muscles, alleviate contractions associated with overactive bladder, and keep the bladder, rectum, and uterus in their positions. Ultimately, the therapy helps to ease pain and associated symptoms, and restore normal functioning.