As with orthopaedic physical therapy, pelvic floor rehabilitation starts with examination to understand what different factors may be contributing to your dysfunction.
An intial pelvic floor therapy exam will typically involve the following elements:
-A thorough intake of your health history.
Your pelvic floor therapist may ask you questions regarding your bowel and bladder habits, sexual function, and pelvic pain. Any prior abdominal or pelvic surgeries will be discussed, as well as any falls, accidents, or traumas involving the area. For those with female anatomy, this may include asking about any gynecological issues such as endometriosis, pain with menstruation, previous pregnancies, labors, and deliveries.
The external examination is typically done fully dressed and may resemble other orthopaedic physical exams, your therapist will assess your full body movement, strength, and flexibility in order to take the whole system into account.
Internal exams are performed intra-vaginally or intra-rectally, depending on the condition being treated. Your therapist will discuss with you what type of exam is recommended and what you’re comfortable with. The internal exam will help your pelvic floor therapist determine factors such as pelvic floor muscle strength, coordination, and whether your pelvic floor muscles are hypertonic (too active) or hypotonic (underactive).
After getting a complete picture from the examination, your pelvic floor therapist will discuss their findings and share your plan of care with you.
After your initial examination, follow-up visits will focus on treating the issues that were identified. Treatment will depend on what your condition is and what your therapist finds upon examination. Pelvic floor rehabilitation may include:
- Internal and external manual release of restricted muscles
- Pelvic floor muscle strength training with or without biofeedback
- Pelvic floor muscle relaxation training
- Bladder and bowel behavioral retraining strategies
- Dilator training for increasing penetration tolerance
- Core and gluteal training
- Body mechanics training
For more information regarding the pelvic floor conditions we treat, check out this page.