Pelvic Health & Physical Therapy

Patient physical therapy session

Pelvic health is not something that many women actively think about regularly. Maintaining fitness, mind, body, and emotions usually take up the priority list when it comes to overall health. About the only time pelvic health is discussed is during the once-a-year annual check-ups with your OB doctor. However, as a woman, your pelvic health should be a priority, especially if you’re experiencing problems in that area.

Pelvic problems, often generally called pelvic disorders, can affect women of all ages regardless of childbearing. However, it’s most often associated with pregnancy and postpartum. Almost one-quarter of U.S. women are affected by pelvic problems. Researchers also think that the number may even be higher considering it’s an uncomfortable topic. Furthermore, pelvic problems can often be misdiagnosed considering the complexities of the area of the body. Such issues include incontinence, pain, and discomfort that are left untreated, undiagnosed, and misdiagnosed. Yet, there is an option that can help with pelvic problems. This option doesn’t rely on medication, surgery, or simply “dealing with it”. Physical therapy is extremely effective in helping women increase their pelvic health and treat pelvic disorders.

Pelvic Disorders Can Start At A Young Age

Unfortunately, most people assume pelvic disorders, such as incontinence and pelvic floor dysfunction, only occur in your older years. However, pelvic problems can start at a young age, says OSR physical therapist Elizabeth Johnston.

“I remember when I was on a dance team in high school and there were several dancers who experienced what I now know to be called stress incontinence,” she said. “It’s the involuntary loss of urine with physical exertion and I didn’t think there was anything that could be done to help them. But there is, and it’s physical therapy.”

Johnston has her doctorate in physical therapy and is currently working on becoming a specialist in pelvic health and physical therapy. When she first started working on her physical therapy education, she had no idea that it could help with pelvic health. It wasn’t until grad school, she commented, that she found out how beneficial it was for treating pelvic problems. It just goes to show how unknown this treatment option is for women who experience these types of problems.

Pelvic Health And Physical Therapy

According to Johnston, physical therapy for the pelvic region focuses on the muscles, ligaments, and bones of the pelvis. It addresses the level of tension of the pelvic floor muscles as well as their strength. If anything looks or moves abnormally that is what is addressed during each session.

“Pelvic health physical therapy is very similar to orthopedic physical therapy. I address dysfunctions of the musculoskeletal system and with pelvic physical therapy,” Johnston says. “I perform a general movement screen of patients. I’ll continue my examination more specifically from there based on what I find. An assessment includes the pelvic floor muscles, their resting level of tension, and strength of contraction. Also, I assess for any muscle tender points in and around the pelvis and/or any mobility restrictions.”

Common Pelvic Problem Complaints

Pelvic physical therapy assessments help in the diagnosing of any pelvic-related complaints. Physical therapists and doctors often hear many complaints and concerns regarding the pelvic area.

  • Leaking urine during such simple movements as sneezing
  • Pelvic pressure
  • Abnormal urine stream
  • Pelvic pain when sitting or moving
  • Tailbone pain when sitting
  • Separation of the abdominal wall with/without a bulge of the abdomen.

Some women go through life with these complaints never fully addressed or treated. Or, they end up in surgery to fix something that could’ve been fixed with physical therapy.

“I think the conditions that I treat as a pelvic health physical therapist can interfere with a person’s quality of life,” Johnston commented. “I don’t think that a lot of people recognize these issues, conditions, and complaints as being related to musculoskeletal dysfunction. Yet, they are and because they are physical therapy can help them.”

The woman who has had three children and leaks urine every time she sneezes or exercises shouldn’t have to just “deal with it”, Johnson says. “Many people think this is normal. It’s a common problem for many women who have had children but it’s not normal and they shouldn’t have to live with it.”

Physical Therapists Help Treat Pelvic Disorders

Just like any other physical or musculoskeletal dysfunction, physical therapists use exercise-based therapy as well as manual therapy.

“After the assessment, I just treat what I find!” Johnston says. “This can include manual therapy techniques, neuromuscular re-education, and instruction in therapeutic exercises. I also will do functional activities training like going from sitting to standing, rolling in bed, navigating stairs, squatting, lifting, etc. If it’s related to the pelvis, we’ll work on it.”

Such therapeutic exercises can include strengthening and stretching the muscles in and around the pelvis. Along with working on the pelvic region, physical therapy should always include educating the patient, says Johnston.

Education Of Pelvic Health

“Another large component of pelvic health physical therapy includes patient education. I educate each patient extensively about the pelvic anatomy, function of the pelvic floor and related muscles, implications of their symptoms on the musculoskeletal system, and the various ways to address these,” she continues. “I frequently also will discuss general lifestyle and habit modifications that help them be successful in recovery if I see fit.”

Education is the biggest way to help a patient maintain a higher quality of life when it comes to pelvic health. However, this can only happen if a physical therapist assesses you right away, suggests Johnston.

“The earlier you can get evaluated by a physical therapist who specializes in pelvic disorders, the better,” she says. “If you think you may have some sort of pelvic floor dysfunction or you’re experiencing problems in that area, go get assessed. We even offer 15-minute free consultations. If you have a question about your pelvic health, then seek out the answer from a specialist. If you’re experiencing problems, speak up! You’re not alone in this and you shouldn’t have to deal with it when there are ways to improve your quality of life and help you manage it.”