Prioritizing pelvic health is something that can benefit any woman at any stage of life. From enhancing core strength to addressing common issues like urinary incontinence and pelvic organ prolapse, maintaining a healthy pelvic floor is crucial for your overall well-being.

While pelvic health often garners attention during pregnancy and postpartum recovery, pelvic floor therapy offers benefits for many other conditions affecting women of all ages.

What Is the Pelvic Floor?

The pelvic floor is a group of muscles and connective tissues that span the bottom of your pelvis, forming a supportive sling for your pelvic organs, including the bladder, uterus, and rectum. These muscles stretch like a hammock from the pubic bone at the front to the tailbone at the back and from one sitting bone to the other.

Functions of the Pelvic Floor:

Support: Provides support for pelvic organs.
Control: Assists in controlling bladder and bowel functions.
Stability: Contributes to core stability.
Sexual Function: Plays a role in sexual arousal and orgasm.

Common Pelvic Floor Disorders

A strong pelvic floor contributes to overall health and well-being. Weakness or dysfunction in these muscles can lead to issues such as urinary incontinence, pelvic organ prolapse, and decreased sexual satisfaction. Factors like childbirth, aging, surgery, and high-impact sports can all affect pelvic floor strength.

Common pelvic floor disorders include:

Urinary Incontinence

This condition involves the involuntary leakage of urine. It can affect anyone, not just postpartum women.

Causes:

• Aging: As we age, the muscles and tissues around the bladder and urethra can weaken, leading to incontinence.
• Obesity: Excess weight increases pressure on the bladder and pelvic floor muscles, contributing to incontinence.
• Certain Surgeries: Surgeries like hysterectomy or prostatectomy can sometimes lead to urinary incontinence due to changes in the pelvic structure and nerve damage.

Types:

• Stress Incontinence: Leakage occurs during physical activities such as coughing, sneezing, or lifting heavy objects.
• Urge Incontinence: A sudden, intense urge to urinate followed by involuntary leakage.
• Mixed Incontinence: A combination of stress and urge incontinence.

Pelvic Organ Prolapse

This condition occurs when pelvic organs, such as the bladder, uterus, or rectum, drop from their normal position, protruding into the vaginal canal.

Causes:

• Childbirth: Vaginal delivery can stretch and weaken pelvic floor muscles and tissues.
• Aging: The natural decline in estrogen and muscle tone can contribute to prolapse.
• Chronic Strain: Persistent coughing, heavy lifting, or chronic constipation can exert excessive pressure on the pelvic floor.

Symptoms: Discomfort, a sensation of heaviness or pulling in the pelvis, and functional issues like difficulty with urination or bowel movements.

Chronic Pelvic Pain

Persistent pain in the pelvic region lasting six months or longer, often with no clear cause.

Conditions:

• Interstitial Cystitis: A chronic bladder condition causing bladder pressure, bladder pain, and sometimes pelvic pain.
• Endometriosis: A painful disorder where tissue similar to the lining inside the uterus grows outside the uterus, causing pelvic pain.
• Prostatitis: Inflammation of the prostate gland, which can cause pain in the pelvic area, particularly in men.

Symptoms: Persistent pain that can be sharp, cramping, or a dull ache, often affecting daily activities and quality of life.

Sexual Dysfunction

Problems that prevent individuals from experiencing satisfaction during sexual activity.

Issues:

• Painful Intercourse (Dyspareunia): Pain during sexual intercourse, often linked to pelvic floor dysfunction or other medical conditions.
• Vaginismus: Involuntary contraction of vaginal muscles, making penetration painful or impossible.

Bowel Disorders

Issues affecting bowel control and function.

Conditions:

• Fecal Incontinence: Involuntary loss of stool due to weakened pelvic floor muscles or nerve damage.
• Constipation: Difficulty in emptying the bowels, often associated with a lack of muscle coordination or strength in the pelvic floor.

How Pelvic Rehabilitation Therapy Can Help

Pelvic therapy is a specialized form of physical therapy aimed at treating a variety of conditions related to the pelvic floor. Pelvic therapy focuses on the muscles, ligaments, and connective tissues in the pelvic region.

Here’s what to expect from pelvic floor therapy:

Initial consultation – Your therapist will begin by taking a detailed medical history, including any symptoms, previous surgeries, childbirth experiences, and lifestyle factors that may affect your pelvic health.

You'll discuss your specific symptoms, such as pain, incontinence, or sexual dysfunction, and how these issues impact your daily life.

A thorough physical examination will also be performed and include an assessment of your posture, alignment, and movement patterns. The therapist may also perform an internal pelvic exam to evaluate the strength, tone, and coordination of your pelvic floor muscles.

Individualized treatment plan – Based on the evaluation, the therapist will develop a customized plan that may include exercises, stretches, manual therapy techniques, biofeedback therapy, or electrical stimulation.

It's important to note that pelvic floor therapy is a personalized approach, and the number of sessions required may vary depending on the individual's condition and progress.

Education – Your therapist will also educate you on proper body mechanics, lifestyle modifications, and self-care strategies to maintain pelvic floor health. This can include guidance on maintaining a healthy weight to reduce pressure on the pelvic floor, advice on modifying physical activities to avoid exacerbating pelvic floor issues, and recommendations on dietary changes to manage symptoms, such as increasing fiber intake to prevent constipation.

Exercises — Kegel exercises are commonly prescribed to strengthen the pelvic floor muscles. You'll learn how to properly perform Kegel exercises and your therapist will ensure you’re engaging the correct muscles.

Sometimes, biofeedback devices are used to help you visualize your pelvic floor muscle activity, aiding in better control and awareness. Your therapist may also show you exercises that integrate pelvic floor muscle activation into everyday movements, such as squats or lunges, to enhance muscle coordination and function.

Below is an example of what an exercise plan may look like for you:

Kegel Exercises:

• Identify your pelvic floor muscles by stopping the flow of urine midstream.
• Squeeze and lift these muscles, hold for a count of 5-10 seconds, then relax for the same amount of time.
• Repeat 10-15 times, three times a day.
• Ensure you’re not tightening your abdomen, buttocks, or thighs while performing Kegels.

Bridge Pose:

• Lie on your back with your knees bent and feet flat on the floor, hip-width apart.
• Lift your hips toward the ceiling while squeezing your pelvic floor muscles.
• Hold for a few seconds, then lower your hips back to the floor.
• Repeat 10-15 times.

Squats:

• Stand with your feet shoulder-width apart.
• Lower your body as if you are going to sit in a chair, ensuring your knees don’t extend past your toes.
• As you rise, engage your pelvic floor muscles.
• Repeat 10-15 times.

Pelvic Tilts:

• Lie on your back with your knees bent and feet flat on the floor.
• Flatten your back against the floor by tightening your abdominal muscles and tilting your pelvis up slightly.
• Hold for a few seconds, then relax.
• Repeat 10-15 times.

The Takeaway

Taking charge of your pelvic health is essential for women at all stages of life. By understanding the function of your pelvic floor, incorporating targeted exercises into your routine, and addressing any issues proactively, you can maintain a strong, healthy pelvic floor.

Texas Health aims to normalize care for pelvic floor conditions by providing one-on-one treatment in a caring and compassionate setting to address sensitive issues and restore pelvic health. To learn more, visit TexasHealth.org/RehabilitationServices.