Although the symptoms may be difficult to discuss, seeking treatment for pelvic floor issues can make all the difference. “Whether it’s bladder or bowel incontinence, frequent urination, or pain in the region, there’s a good chance it’s your pelvic floor,” according to SSM Health’s Breanna Edenborough, PT, DPT, PRPC. “And any type of pelvic floor dysfunction is not normal.”
Even so, the concept of pelvic floor therapy may be difficult for some to grasp. “I find most of the time, patients come in not knowing what to expect,” Edenborough said. As a certified pelvic rehabilitation practitioner, she is a specialist in diagnosing and treating issues in women and men. And putting patients at ease is part of that job.
What is the pelvic floor?
“There are three layers of muscles that create the pelvic bowl,” said Edenborough. “And each of the three layers has a unique purpose: arousal, urination, or bowel function.” Together, those muscles and the connective tissues support the pelvic organs, control the release of urine and feces, stabilize the core, support sexual function, and more. In short, they play an important role in our everyday lives and health.
Getting started with pelvic therapy
Edenborough reports that most patients are referred when a specific problem is identified. Referrals typically come from a primary care physician, OBGYN, urologist, or urogynecologist. “Pregnancy, post-partem issues, prolapse, and prostate surgery (in men) are among the most common causes of pelvic floor issues.” And these can lead to a wide range of symptoms that are treatable, even in their early stages. She noted, “If you can address the problem early – prior to menopause – it reduces severity as we age.”
What to expect on your first visit
According to Edenborough, preparing for your initial visit is very simple. Just wear comfortable clothing and be prepared to answer questions. The visit takes place in a private treatment room. “You’ll be asked to complete an intake form about all three processes – arousal, urinary, bowel – and we’ll go into detail about each layer.
“If the patient is comfortable, we’ll complete an internal exam, similar to a gynecological exam but without equipment. It helps give us a better understanding of what’s going on. But we can make an educated guess about needs if the patient prefers to avoid an internal exam.”
Next, the physical therapist develops a treatment plan based on the patient’s specific needs. “If the pelvic floor is weak, we’ll work to strengthen it. If the floor is too tight – which can cause leakage – we’ll focus on breathing and stretching.” Common techniques include:
- Guided exercise with tactile feedback – light touch and feedback helps the patient identify and engage the correct muscles.
- Manual therapy – specialized, hands-on techniques use pressure and manipulation to address pain, muscle tension, and function.
- Neuromuscular reeducation – a technique to retrain the brain to improve muscle coordination.
At the end of the visit, you’ll receive a handout to continue treatment at home and schedule a follow-up appointment.
Treatment timeframes and outcomes
“Most of the time symptoms respond – and most care plans last between eight and 12 weeks,” she said. Edenborough also noted that “symptom and severity go hand in hand. Once symptoms improve, visits will go to every other week, and so forth.”
However, she indicates that pain from tightness or history of trauma (surgery, radiation scar tissue, etc.) may take more time to resolve – up to 18 weeks. “And while problems like leakage will almost always resolve, the patient will need to continue exercises at home to maintain the gains.”
Learn more about pelvic health at SSM Health and find a specialist near you.
