Do You Need Pelvic Floor Physiotherapy?

You’ve probably never heard of Pelvic Floor Physiotherapy before, and it’s a shame: It is an extremely useful treatment option for many complex conditions. The pelvic floor covers the pelvic area like a hammock and supports the pelvic organs (uterus, bladder, and rectum). It also helps with urination and anal continence and plays a role in core strengthening and orgasm. People of all genders have a pelvic floor.

To help me learn more about Pelvic Floor Physical Therapy , I spoke with Heather Jeffcote, a physical therapist and owner of Femina Physical Therapy in Los Angeles, and author of Pain-Free Sex: A Self-Healing Guide to the Sex Life You Deserve . Here’s what you need to know about pelvic therapy and how it can help you.

How Pelvic Floor Physiotherapy Works

Many things can weaken the pelvic floor, including pregnancy, childbirth, and aging, which leads to pelvic pain as well as bladder, bowel, and sexual dysfunction.

The first step in Pelvic Floor Physiotherapy is taking a history of the client, setting goals and providing information on how the pelvic floor works. This is followed by a manual inspection. Physiotherapists then use a combination of manual therapy, pelvic floor exercises, biofeedback, and / or vaginal dilators. Patients are regularly visited and given exercises to do at home.

You can find therapists by searching the American Physical Therapy Association and the International Pelvic Pain Society . Many PTs, including Dr. Jeffcote, also offer telemedicine appointments if you prefer to start this way or cannot find PTs in your area.

What Pelvic Floor Physiotherapy Can Treat

Pelvic floor physical therapy can be effective in treating a wide range of conditions, including:

• Painful sex
• Pain with insertion of a tampon or obstetrics / gynecology
• Vulvar pain
• Itching of the vulva
• Urgency and frequency of urination
• Recurrent UTIs
• Urinary incontinence
• Bowel incontinence
• Pain in the pelvis and / or lower abdomen

Dr. Jeffcote says: “I like to tell doctors that if they have looked for the cause of someone’s pain between the ribs and hips / pelvis and have been medically resolved, they should be referred to a qualified health care professional.”

Pelvic floor FT can also be used to prepare transgender patients for gender reassignment surgery and to facilitate postoperative healing.

Pelvic Floor Physiotherapy and Sexual Pain

Researchers at Indiana University’s Center for Sexual Health Promotion recently found that 30% of women experienced pain during their last intercourse. Although sexual pain is widespread, it often takes a woman a very long time to diagnose the condition of sexual pain. I have heard horror stories from clients who have been told by doctors that their pain is “all in their head” or that they need to “just have a glass of wine.” I’ve heard doctors recommend an alcohol shot or anti-anxiety medication right before sex. Dr. Jeffcote has heard the same stories and says that most conventional doctors are ill-equipped to deal with sexual pain, although in reality there is almost always a physical cause.

If you try to talk to your doctor about your sexual pain and come across an annoying response like “just relax,” it is much better to find a pelvic floor physical therapist in your area. A good physicist will work with you to uncover the root of your pain and discomfort and develop a targeted game plan for relief. I have worked with many clients with sexual pain and they all praised pelvic floor exercise.

Maintaining the shape of the pelvic floor

Even if you’ve never heard of pelvic floor physiotherapy before, you’ve probably heard of the most popular exercise in the field: the kegel. There have been many articles on Kegel (also known as PC exercise) over the past few years, and there are also a ton of Kegel machines on the market designed to help you get your Kegel muscles in top shape. Kegel exercises can have great benefits, including stronger orgasms and more control over urination. But Dr. Jeffcoat advises a little caution. She shared that about half of all women do Kegel incorrectly, and about 25% do it in a way that can worsen their other symptoms. She doesn’t like vaginal weights or exercise machines because, she says, they can make the irregular shape worse.

Dr. Jeffcoat says that if you are currently experiencing sexual pain, urge to urinate or frequent urination, bladder pain, urinary incontinence, constipation, rectal pain, or any pelvic pain, avoid kegels and refer to therapist.

If you don’t have bowel or bladder symptoms, Dr. Jeffcoat recommends combining longer delays with shorter pulses. To find your PC muscles, turn off urination before the bladder is empty. You must use exactly the muscles that you need to use for this. For longer delays, gently squeeze the PC muscles for 3-5 seconds, then gradually relax. For shorter pulses, contract your PC muscles and then immediately relax them. If you want to make sure you are doing your Kegel exercises correctly, or if you want a personalized play plan, be sure to see a physical therapist.

If you are confused about pelvic floor exercise

Yes, your PC will directly drive your muscles through the walls of your vagina or anus. But Dr. Jeffcoat has assured me that a good Pelvic Floor Physical Therapist is passionate about his job and helps his clients feel comfortable. Pelvic floor problems are very common and healthcare professionals want to help remove the stigma surrounding seeking help. Dr. Jeffcote’s standard initial visit is 90 minutes, much of which is spent talking and helping you feel more comfortable. You also have the option to defer your physical examination to a later session.

It is also helpful to think about the positive effects of pelvic floor physiotherapy. I asked Dr. Jeffcote about some of her favorite patient success stories, and she told me how she saw patients end their marriage for the first time in her life. One incident occurred after 19 years of marriage. She also wrote: “I have had so many women who can get pregnant without fertility treatment because they can have sex without pain. I’ve seen women gain a new sense of empowerment, reaching a goal they never thought would ever happen. ” There can also be something incredibly convincing that you know the pain is not “in your head.” Bottom line: Pelvic floor physiotherapy can be life-changing.