Pelvic floor rehabilitation is a specialized subset of orthopaedic physical therapy designed to treat a range of issues. Our pelvic floor therapists have undergone additional post-doctorate training to be able to perform pelvic floor examination and treatment.

Typical Conditions Treated in Pelvic Floor Therapy:

Bladder Dysfunction

• Urinary urge incontinence – increased frequency of urges and urination, with potential leaking
• Stress urinary incontinence – leaking with activities that increase intra-abdominal pressure, such as laughing, coughing, sneezing, jumping
• Interstitial Cystitis – chronic pain and pressure in the bladder, also known as bladder pain syndrome (BPS)

Pelvic Dysfunction

• Pelvic pain – pain in the groin and pelvis
• Pain with intercourse (dyspareunia)
• Pain with orgasm or difficulty with orgasm (anorgasmia)
• Clitoral pain
• Perineal pain or anal/rectal pain
• Hip pain/labral dysfunction/impingement
• Chronic pelvic pain
• Pudendal neuralgia – pelvic nerve pain
• Vulvodynia/Vulvar Vestibulitis – pain around the vulva or vaginal opening
• Vaginismus – muscle spasm of the pelvic floor muscles
• Tailbone pain – pain in the tailbone with movement or sitting
• Pelvic organ prolapse
• Endometriosis
• Dysmenorrheaa (painful periods)
• Coccydynia (tailbone pain)
• Pubic Symphysis Pain and Dysfunction
• Chronic Prostatitis/Benign prostate hyperplasia (male patients)
• Testicular pain (male patients)
• Pain or discomfort with ejaculation
• Erectile Dysfunction
• SI Joint pain
• Interstitial Cystitis/Bladder pain syndrome

Bowel Dysfunction

• Fecal incontinence – increased fecal urges or difficulty controlling bowel movements
• Constipation – decreased frequency of bowel movements and hard stool
• Irritable Bowel Syndrome – chronic disorder of the large intestine with bowel changes and discomfort

Post Surgical

• Cesarean Section
• Hysterectomy
• Prostatectomy
• Episiotomy
• Any abdominal or pelvic operation
• Gender Confirmation Surgery
• Endometriosis Surgery

What does pelvic floor therapy involve?

Examination:

As with orthopaedic physical therapy, pelvic floor rehabilitation starts with examination. An intial exam typically involves both an external exam and internal examination, depending on the needs of the client. 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. In addition to pelvic-specific examinations, your therapist will also assess full body movement, strength, and flexibility in order to take the whole system into account.

Treatment:

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