Pelvic Floor Physical Therapy
“It’s hard to describe it.” “I’m embarrassed to talk about it.” “Who can I talk to about this?” Sadly, some topics in health care are still taboo in conversation, and as a result, people neglect seeking the help they need. Among these topics for both women and men is pelvic pain, sexual dysfunction and incontinence. If left unaddressed these issues can lead to increased anxiety, mental and emotional issues, and an overall decreased quality of life. Have you or a loved one ever expressed these feelings?
Many people know the term Physical Therapy (PT) and how PT can be used to treat injuries such as a painful shoulder, arthritis in the knees, or pain in the hips. However, few people have heard of pelvic floor physical therapy, and may be confused when their doctor recommends it for treatment.
What is the “Pelvic Floor Physical Therapy”?
Pelvic floor physical therapy involves treating the muscles, joints, connective tissue and nerves in the pelvic area. These structures have three important bodily functions. First, they prevent people from leaking urine or stool. Second, they act like a hammock and keep the organs ascended in the abdomen, preventing them from moving downward and coming out of the vaginal or rectal opening. This is termed a pelvic organ prolapse. Thirdly, the muscles and tissue in this area need to be healthy and free of pain in order to fully enjoy sexual intercourse, experience sexual arousal, tolerate a gynecological or rectal exam, tolerate the insertion of a tampon, or any other vaginal penetration. When the muscles inside the pelvis become weak or tight they lead to issues such as urinary or fecal incontinence, pelvic organ prolapse, painful sex, pelvic pain, abdominal pain, lower back pain, chronic constipation, or the inability to completely expel urine. Pelvic floor therapy is also common after delivering a baby to address issues related to birth trauma.
Pelvic floor physical therapy is a specialized practice which most physical therapists do not know how to practice. It is a post graduate specialty in the field of physical therapy which requires additional training in order to treat patients.
Common Types of Symptoms
There are two major symptoms of Pelvic Floor dysfunction.
Incontinence occurs when the pelvic floor muscles are weak, and there are three different classifications of it. Stress Incontinence refers to the involuntary loss of urine or stool on exertion, such as when sneezing, coughing, laughing or lifting objects. Urge Incontinence involves leaking urine when rushing to get to the bathroom. Mixed Incontinence refers to someone who has both stress and urge incontinence. Many individuals with incontinence hesitate leaving their homes due to fear of leaking urine or stool and creating an embarrassing situation. Additionally, incontinence is the number one reason why people are admitted into nursing homes. Often, family members are not able to cope with an older family member who is leaking urine or bowel on a regular basis.
Many people believe that incontinence is a natural progression of aging, however this is not true. As long as someone is mentally astute, they can train the muscles in the pelvic area to stop leaking. Anecdotally, young teenage volleyball players who leak when jumping as well as 90 year-old men who leak when they sneeze or cough are both candidates for successful pelvic floor physical therapy.
Expelling urine fully is critical to ensure the kidneys and bladder do not harvest bacteria. Pelvic floor (PT) identifies this issue and works to strengthen these muscles, thereby helping to prevent urinary tract infections (UTIs), bladder infections, or worse, kidney infections.
Sexual Pain and Dysfunction
For women, painful vaginal penetration is common and it occurs when the pelvic floor muscles are tight, in spasm, or have trigger points which make intercourse uncomfortable. This is often a sensitive and emotional topic for women. A pain cycle often develops. If someone has a painful sexual encounter, they will tense their pelvic floor muscles the next time they try sexual intercourse due to fear of pain, and the pain and tightness in their pelvic floor will worsen. Many women also face additional stress in these situations when wanting to get pregnant and starting a family with their partner. For men, erectile dysfunction may be related to weak or tight pelvic floor muscles. Many people suffer from pain for many years prior to seeking treatment which leads to relationship stress with their spouses or partners.
A Hidden and Taboo Topic
Why is this treatment not discussed more readily? Dysfunctions of the pelvic floor can be sensitive and emotional topics for patients to discuss with spouses, family members, and friends. Most people are uncomfortable acknowledging they may need this type of treatment, and cultural stigmas only make worse the possibility of seeking treatment. Unfortunately, many people believe that their dysfunction is unique to them, which can lead to loneliness and feelings of isolation. However, on average there are over 10 million people in the United States with pelvic pain and over 13 million Americans who suffer from incontinence. Men and women both experience these symptoms. Everyone needs to understand that they don’t have to live with these issues. Pelvic floor therapy takes time, commitment and patience for results, and the remedies are not easily sold in a commercial or bought with a pill. This therapy has been validated in numerous research studies to be a proven and highly effective treatment for pelvic pain, postpartum pain, sexual dysfunction and incontinence in males and females.
Take Ownership of Your Health
Rinku Singh is a certified pelvic floor specialist with the American Physical Therapy Association and a board certified women’s clinical specialist with the American Physical Therapy Association with 20 years of professional experience. It is her passion to work with patients facing pelvic floor dysfunction, knowing therapeutic methods are available to transform people’s lives. She has witnessed how pelvic floor dysfunction can impact one’s self confidence and can lead to relationship stress and social isolation. Pelvic floor dysfunction is very common within the Indian community. She practices in Farmington Hills, Michigan providing safe, private, one-on-one sessions to help people achieve their health goals, creating a culture of bodily dignity for achieving better health outcomes.
By Rinku Singh
MPT, WCS at Lifespan Therapy and Wellness