Physical Therapy for Pelvic Floor Disorders
Orthopedic physical therapists at University of Wisconsin Hospital and Clinics in Madison, Wisconsin, have advanced training and expertise in working with patients who have pelvic floor disorders.
What is the pelvic floor?
The pelvic floor is a bowl-shaped part of the body consisting of muscles and other non-muscular soft tissues located in the lower pelvis. It supports the abdominal organs, facilitates urinary and bowel continence and aids in sexual satisfaction.
Physical Therapy and the Pelvic Floor
Through the normal movement and stresses associated with daily living, the pelvic floor can weaken and become lax. It is also an area that can carry increased tension and stress. When the pelvic floor weakens or carries undue stress, individuals may experience urinary or bowel urgency, incontinence, constipation and pelvic pain or pain with intercourse. Physical therapy can often break into those dysfunctional cycles with education, behavior modification, modalities and exercises to facilitate normal coordination of pelvic floor muscles.
An initial evaluation usually includes an extensive history interview, examination of the spine and lower extremities, biofeedback assessment of the pelvic floor muscles and abdominal muscles, an internal pelvic floor assessment, education and initiation of a home program of exercises.
Pelvic Floor Conditions
- Urgency: Urinary and/or bowel urgency is a strong need to void that may result in incontinence (loss of urine or bowel) if a bathroom is not located in a timely manner. Urgency is usually caused by increased muscle tone/tension in the pelvic floor.
- Urge incontinence: Urinary and/or bowel urge incontinence is the loss of bowel and/or urine due to inability to control urgency. Urge incontinence is usually caused by increased muscle tone/tension and weakness in the pelvic floor muscles.
- Stress incontinence: Urinary and/or bowel stress incontinence is the loss of urine and/or bowel with activities that increase pressure in the abdominal cavity such as coughing, sneezing, laughing, running or jumping. Stress incontinence can be caused by weakness of the pelvic floor muscles and lack of coordination of the pelvic floor muscles and the abdominal muscles.
- Mixed incontinence: A combination of urge and stress incontinence.
- Constipation: A decreased ability to move bowel. This can be caused by increased muscle tone/tension; lack of coordination of the pelvic floor and abdominal muscles; poor abdominal strength.
- Pelvic pain: May present as pain while sitting, pain with sexual intercourse, pain in the genital regions, abdominal region, tailbone or buttocks regions. Pain can present as pressure, thickness or stinging. Pelvic pain is often caused by increased muscle tone/tension/spasm in the pelvic floor.