Pelvic Health physical therapy is a specialized field within PT that involves additional training. We are able to help many men and women who are suffering from incontinence (leaking urine or feces) or various types of pelvic pain. I talk with women all the time who have no idea that the leaking they are experiencing during exercise, coughing, laughing and sneezing is not something they have to live with the rest of their lives nor is it "just part of aging or having children." Leaking urine is a common problem and not something to be ashamed of, however it is not to be considered "normal". A Women's Health/Pelvic Health physical therapist can help and these conditions can often be improved or eliminated!
Pelvic Health physical therapists learn all about the anatomy, assessment and treatment of the pelvic floor muscles and their involvement in incontinence, pelvic pain and orthopedic conditions. I will leave it for another post to explain more about the function of the pelvic floor and how these muscles team up with other important core muscles. Many people aren't aware of that there even are muscles "down there". In fact, the pelvic floor muscles encompass the entire area from pubic bone to tailbone and outer hip bone to outer hip bone and have an integral relationship with maintaining continence (keeping you leak free!), sexual function, supporting the pelvic organs, and contributing to dynamic stability and efficient movement of the trunk.
There are several types of incontinence. Stress incontinence involves leaking during activities that create a downward pressure into your pelvis, such as jumping, running laughing and coughing. Urge incontinence involves an involuntary loss of urine along with a sudden strong need to urinate. This can sometimes (but not always) go along with an overactive bladder during which a person has a sense of urgency and needs to urinate more than 8 times in 24 hours on a consistent basis. It is not uncommon to have "mixed incontinence" which involves both stress and urge incontinence. Though most women know about Kegel exercises, and may try using them to improve their incontinence, it is often not enough. Studies show that between 30-50% of women doing kegels are doing them incorrectly. In addition, kegels do not work in isolation and need to be trained with other muscles of the body. Many people also need to learn to let go of their pelvic floor musculature, lengthening and relaxing the muscles before they can adequately strengthen them. Conditions such as overactive bladder and urge incontinence can be made worse when women do excessive kegels without first learning to lengthen and relax the muscles. A pelvic health physical therapist is trained to assess these conditions and come up with an individualized treatment plan that may include a bladder retraining program, types of biofeedback, manual therapy, specific exercises that may be isolated to the pelvic floor + other muscles of the core, integrated breathing work, and more. Later in rehab, new musculoskeletal or breathing strategies may be combined with other movements and into your fitness routine or home activities.
Pelvic pain is another condition that pelvic health PTs are trained to assess and treat. There are many examples of pelvic pain. A few examples include: tailbone pain, dysmenorrhea (painful menstruation), vulvodynia, vaginismus and painful sex, interstitial cystitis/painful bladder syndrome, pelvic girdle pain, pelvic organ prolapse and piriformis or buttock pain. Pelvic Health PT is not just for women! Men also suffer with pelvic pain and are often diagnosed with "Chronic Nonbacterial Prostatitis", which usually doesn't involve the prostate at all but rather painful pelvic floor muscles. They may experience pain in the testicles, penis, buttocks, rectum, perineum or lower abdomen that is related to pelvic floor overactivity and tender points. Post prostate surgery, many men experience urinary incontinence and physical therapy is often part of the rehab process. In addition, we are starting to learn that low back pain and pelvic floor muscle overactivity, weakness and tenderness are often associated. Urinary incontinence and low back pain in women also often go hand in hand.
If any of these problems sound a little too familiar, don't hesitate to call and make an appointment with a pelvic health/pelvic floor physical therapist! You can look for a specialist through Herman & Wallace directory or the APTA Section on Women's Health, found through this link.
Stacy is a physical therapist specializing in pelvic health/pelvic floor physical therapy and chronic pain in Germantown and West Bend, WI. Schedule an appointment at Health in Balance PT beginning week of July 23.