Pelvic Floor Therapy

Many people (men and women of all ages) do not seek treatment for pelvic conditions such as pelvic pain, overactive bladder and urinary incontinence, because they are embarrassed or feel that it is a normal part of the aging process.

Heather Forrest OTR/L with Carolina Prime Physical Therapy is an occupational therapist specializing in pelvic floor therapy and women’s health. She will work with your patients to develop an individualized treatment plan to address specific concerns.

What is Pelvic Floor?

The pelvic floor is a group of muscles that lie at the bottom of your pelvis and surround your genitalia. These muscles work to support your abdominal contents (specifically the rectum, bladder, and uterus), allow for urination and defecation, prevent leakage of urine or stool when not desired, and help sexual processes including pleasure responses and reproductive functioning. These muscles also help to stabilize the pelvis, working with your abdominal muscles, back muscles, and diaphragm to make up your core.

For proper functioning of the pelvic floor, it is important to have:

  • Strength:
    • To stabilize the pelvis and prevent hip/low back/pelvic pain
    • To prevent leakage of urine or stool with increases in abdominal pressure like with sneezing, coughing, squatting, or jumping
  • Endurance:
    • To maintain proper spine posture and stabilize the pelvis over longer periods of time and with longer physical activities
  • Flexibility:
    • To relax and stretch for bearing down when trying to urinate, defecate, or during childbirth
    • To promote pelvic mobility for dynamic activities like walking, running, stair climbing
  • Motor control:
    • To allow you full control of when you urinate, defecate, and pass gas
    • To prevent painful conditions of the hip/low back/pelvis

Pelvic floor therapy can address a variety of pelvic conditions and dysfunctions such as:

  • Urinary incontinence (stressed, urge, mixed)
  • Overactive Bladder
  • Urinary frequency (day and/or night)
  • Pelvic organ prolapse
  • Interstitial Cystitis
  • Painful intercourse/dyspareunia
  • Vaginismus
  • Pelvic Pain
  • Fecal incontinence
  • Constipation
  • Dyssnergia
  • Coccydynia

Prenatal and postpartum conditions include

  • Pelvic pain
  • Low back pain
  • Sacroiliac joint dysfunction or pain
  • Pubic symphysis dysfunction or pain
  • Diastasis recti
  • Sciatica
  • Scar tissue management from episiotomy
  • Perineal tearing or cesarean

How can a pelvic floor physical therapist help?

On initial evaluation, a pelvic floor physical therapist will first sit down with you to discuss the full extent of what you’re seeking PT for. We often have a lot of questions about your bladder, bowel, and sexual health. Then, we will perform a physical evaluation that includes watching you walk, squat, bend over, breathe – all to observe for any muscle imbalances, mobility deficits, or postural dysfunction. We might also assess your hip and core strength. Then, we will evaluate the strength, endurance, flexibility, and motor control of the pelvic floor muscles. This will typically involve internal palpation of these muscles via the vaginal or rectal canals. We will then come up with a treatment program together based on your goals.
At CPPT we understand the sensitive nature of the pelvic region. We will educate you on what is happening, what we’ll be doing, and what to expect in your plan of care. We are here to help you reach your goals!

Treatment options for pelvic conditions may include:

  • Strengthening of pelvic floor muscles
  • Strengthening of core muscles
  • Down-training / muscle relaxation
  • Use of biofeedback tool to assess pelvic floor muscles and retrain
  • Electrical Stimulation to re-train and strengthening weak muscles
  • Manual therapy techniques to release restrictions in pelvic floor and associated muscles
  • Personalized program to facilitate a healthy and active lifestyle/pregnancy
  • Diet adjustments to facilitate “gut health” and nutritional support
  • Positioning education for toileting, pain reduction and pressure relief
  • Bowel and bladder retraining
  • Management and modification for pelvic organ prolapse
  • Habit/trigger identification and retraining
  • Urgency suppression strategies
  • Pain management techniques
  • Proper body mechanics for lifting, exercise and other activities of interests.
  • Decrease in nighttime voiding
  • Support belts/taping techniques for prenatal and postpartum

It is my goal to empower individuals through education and increasing one’s awareness of the body and nutrition.  My hope is to help women regain control and confidence in their body and unleash their potential.

Other Frequently Asked Questions

Does everyone have a pelvic floor?

Yes! All people, regardless of gender, have pelvises and therefore have pelvic floor muscles.

Should pregnant or postpartum women have pelvic floor physical therapy?

Absolutely! Whether you’ve delivered vaginally or through a Cesarean section, being pregnant for 40 weeks puts a lot of pressure on the pelvic floor, which could lead to tension, weakness, and motor control impairments. If you are currently pregnant, that is often the best time to see a pelvic floor physical therapist. You, then, have the opportunity to not only learn how to use your pelvic floor as your body changes and grows, but also how to effectively use your pelvic floor during labor and delivery. This can help reduce the risk of tearing and post-partum related issues like incontinence and pain. Having a baby is beautiful and joyous, but physically demanding! A pelvic floor physical therapist can help you prepare for the changes and rehabilitate your body so you can be at your best for your baby!