Comprehensive Pelvic Floor

Physical Therapy

What we treat

Pelvic floor physical therapy for men and women includes internal & external evaluations for pelvic floor muscle integrity and how that affects your whole body from an orthopedic viewpoint. Some of the conditions that we treat are:

  • Anorectal pain

  • Coccyx / Tailbone pain

  • Constipation

  • Diastasis recti

  • Fecal incontinence

  • Interstitial cystitis / painful bladder syndrome

  • Low back and hip pain

  • Pelvic pain and pelvic floor dysfunction

  • Prolapse

  • Prostatitis syndrome

  • Pudendal neuralgia

  • Sacroiliac dysfunction

  • Urinary incontinence, frequency, and urgency

What is the Pelvic floor?

The pelvic floor refers to the muscles that support your reproductive and urinary tract, including your bladder, uterus/prostate, and rectum. These muscles attach to your pelvis, tailbone, and sacrum. In addition to providing support, they also help you control bladder and bowel function. When these muscles aren’t working as they should, they can cause pain and other symptoms that interfere with daily functioning.

Physical therapy can help ease pain and associated symptoms, getting you back to normal functioning.

What is Pelvic floor physical therapy?

Pelvic floor physical therapy is a hands-on treatment to help address pain, weakness, and dysfunction in the pelvic floor muscles. This form of therapy may contain pelvic floor muscle reeducation, pain desensitization, bowel and bladder retraining, breath work, postural and gait modifications, and diet and fluid intake assessment. The type of therapy prescribed will depend upon the symptoms you’re experiencing. For example, some symptoms will require relaxing and lengthening of the muscles, while others may require strengthening the muscles.

Pelvic floor physical therapy can be used to treat pelvic floor dysfunction and the symptoms often associated with it. Some symptoms that can be improved with pelvic floor physical therapy are:

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

Unexplained pain

    • Pelvic pain

    • Pain in the genital area

    • Rectal pain

    • Pain during intercourse

    • Chronic low back pain

What to expect at your first appointment

When you start working with a physical therapist to address pelvic floor functioning, there are some things you can expect. At your first appointment, your therapist will do an assessment before deciding which types of therapy will be most effective. That assessment will include an orthopedic evaluation. You may be asked to stand, walk, and sit so the therapist can see whether you may have posture or joint issues that could be affecting the pelvic floor muscles.

Most physical therapy to treat pelvic floor dysfunction and pain is hands-on, which includes both internal and external therapy. Because internal physical therapy may be difficult for some people, therapists are sensitive to the needs of every individual and will not begin with internal physical therapy until you are ready.

Internal techniques may include using a specialized instrument or a finger inside the vagina or rectum to do trigger point therapy.

Depending on your condition, your therapist may also suggest Kegel exercises to strengthen your muscles. She will help train you on the proper way to do Kegels.

The evaluation of the pelvic floor itself usually requires an internal exam. To do this, we will use manual palpation either vaginally or rectally, whichever is appropriate. Manual palpation means that we will use one finger to do the assessment. This is different from a female gynecological exam, which uses instruments, such as a speculum. The purpose of the exam is to assess for muscle strength, excessive tightness, trigger points (small muscle “knots”), painful areas, and muscle coordination. Usually, the internal exam is not painful. If you are coming here because of a pain condition, it’s important during the exam to identify the specific muscles that are causing pain. This will help to create a proper plan of care.

The initial evaluation will first determine whether therapy is appropriate, and if it is, it will determine the appropriate plan of care. Treatment may include:

  • Strengthening or stretching exercises of the trunk, legs, or pelvic muscles

  • Relaxation exercises for shortened pelvic muscles

  • Coordination exercises

  • Education in self-management and prevention

  • Biofeedback for either strengthening or relaxation of the pelvic muscles

  • Modalities like heat, ice, or electrical stimulation.

Treatment will vary depending on the specific problems identified.
Pelvic floor therapy is recommended as a first-line treatment for many disorders of the pelvic region.

Where do services take place?

Services take place at our clinic located at 410 University Parkway, Suite 2200, Aiken, SC.

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