Pelvic floor physical therapy includes an orthopedic assessment of pelvic floor muscle integrity and how it affects your entire body. Some common symptoms are:

• Anorectal discomfort

• Coccyx/tailbone ache

• Constipation

• Recti diastasis

• Erectile dysfunction

• Fecal incontinence

• Bladder incontinence. 

• Interstitial cystitis / painful bladder syndrome

• Low back pain

• Hip pain

• Pelvic pain

• Prolapse

• Prostatitis syndrome

• Pudendal neuralgia

• Sacroiliac dysfunction

The muscles that support your reproductive and urinary tracts, including your bladder, uterus, prostate, and rectum, are referred to as the pelvic floor. These muscles are connected to the pelvis, tailbone, and sacrum. They help you control your bladder and bowel function in addition to providing support. When these muscles don't work right, they can cause pain and other symptoms that make it hard to go about your daily life.

Both men and women can have trouble with their pelvic floor. It happens when the muscles are weak, don't work well, and only contract. If the muscles don't relax as they should, they cause the following.

• Urinary incontinence/urinary incontinence in men.

• Frequent urination.

• Constipation.

• Erectile dysfunction.

• Prostatitis.

• Women experience pain during sex.

No one knows what causes pelvic floor dysfunction, but there are some things that can make it happen. These are some of them:

• Having surgery on the pelvic area.

• Pregnancy.

• Aging.

• Using the pelvic muscles too much.

• Injury or damage to the area around the pelvis.

• Weight problems and obesity.

Physical therapy can help relieve pain and other symptoms so you can get back to normal.

Pelvic floor physical therapy is a hands-on treatment that can help with pelvic floor muscle pain, weakness, and dysfunction. This type of therapy may include pelvic floor muscle reeducation, pain desensitization, bowel and bladder retraining, breath work, changes to posture and gait, and an assessment of the diet and amount of fluids taken in. The type of therapy recommended will be determined by the symptoms you are experiencing. For example, some symptoms require muscles to be relaxed and lengthened, while others may require muscles to be strengthened.

Pelvic floor physical therapy can be used to treat pelvic floor dysfunction as well as the symptoms that often accompany it. Pelvic floor physical therapy can help with the following symptoms:

Urinary problems, such as:

• Urinary incontinence

• Urinary frequency

• Urinary urgency

• Painful urination

• Difficulty stopping or starting urinating

• Difficulty fully emptying the bladder

Bowel problems, such as:

• Fecal incontinence

• Straining or experiencing pain during bowel movements

Chronic pain, such as:

• Pelvic pain

• Perineum pain

• Penile pain

• Rectal pain

• Painful intercourse

• Low back pain

• Hip “popping” or “snapping”

There are some things you can expect when working with a physical therapist to improve pelvic floor function. Your therapist will conduct an assessment at your first appointment before determining which types of therapy will be most effective. An orthopedic evaluation will be part of that evaluation. You may be asked to stand, walk, and sit so that the therapist can determine whether you have any posture or joint problems that are affecting your pelvic floor muscles.

Most physical therapy for pelvic floor pain and dysfunction is done by hand, both inside and outside the body. Because some people find internal physical therapy difficult, therapists are sensitive to the needs of each individual and will not begin internal physical therapy until you are ready.

Your therapist may recommend Kegel exercises to strengthen your muscles, depending on your condition. She will assist you in learning how to do Kegels correctly.

Internal techniques may include using a specialized instrument or a finger to perform trigger point therapy inside the vagina or rectum. An internal exam is usually required to evaluate the pelvic floor.  The exam is designed to look for muscle strength, tightness, trigger points (small muscle "knots"), painful areas, and muscle coordination. The internal exam is usually not painful. If you are here for pain relief, it is critical that the specific muscles causing the pain be identified during the exam. This will aid in the development of an appropriate care plan.

The initial evaluation will determine the appropriate plan of care. Treatment options include:

• Exercises to strengthen or stretch the trunk, legs, or pelvic muscles

• Exercises to relax shortened pelvic muscles

• Exercising coordination

• Self-management and prevention education

• Biofeedback electrical stimulation for either pelvic muscle strengthening or relaxation

Pelvic floor therapy is recommended as a first-line treatment for many pelvic disorders.