What is Pelvic Floor Physical Therapy?

What Exactly Is Pelvic PT?
 
Although I realize the term “Pelvic PT” is not exactly a common term, I’m still surprised when I discover that many healthcare professionals, specifically physicians, have no knowledge that this type of specialty exists.

It all started a few weeks ago when my friend (who happens to be a physician) and I were catching up after not seeing each other for several months.  I shared with her that our clinic had been featured on KCTV 5 News while covering a story about a young couple that struggled with the inability to start a family after 9 years of marriage.  The reason was not “infertility,” but rather “pain with intercourse” due to pelvic floor muscle spasms.  My friend asked, “So what do you do exactly for that type of condition?”  When I explained that we do a thorough pelvic exam to assess the health of the pelvic floor, she was shocked.  “You mean you actually do a vaginal exam?” she asked.  I further explained that yes, in fact, we do a very thorough exam, which includes assessment of the skin, pelvic floor muscle strength/integrity, organ position of the bladder/uterus/rectum and testing of reflexes. 

​In addition to this internal exam, we also assess the alignment of the pelvic bones, spine and hips.  We address any abdominal muscle or fascial tension, which may include releasing tight scars, etc.  Oftentimes, scar tissue from past surgeries can adhere to the connective tissues (fascia) around our pelvic organs and cause dysfunctions, such as:

• Urinary Incontinence
• Fecal Incontinence
• Urgency/Frequency of voiding
• Constipation
• Painful Intercourse (Dysparuenia)
• Abdominal/Pelvic Pain
• Malalignment of the pelvic bones

If a patient has a malalignment of the pubic bones, sacrum or coccyx, the pelvic floor muscles will then be imbalanced (due to their attachments to these bones), which can then lead to either weakness or tension within the pelvic floor.  This type of problem then presents itself as one of the above dysfunctions.

As Pelvic Physical Therapists, our job is to determine the problem, treat it with various manual and therapeutic techniques, and then restore the patient’s function.  That is what we do in a “nutshell”!  No woman should be living with a disabling condition when there are so many conservative treatments that we can provide to improve her quality of life.

Due to changes in the insurance and healthcare world, many women are only seeing their gynecologist or family physician every 3 years for a PAP Smear.  Unfortunately, this test only addresses cervical cancer and does not address all the other pelvic conditions that a woman might be enduring.  We recommend that women should seek out a Pelvic Physical Therapist if they are experiencing conditions such as those listed above, so that they can be thoroughly evaluated and treated before their situation becomes more serious.

Shannon DeSalvo, PT, CAPP