Pelvic Floor PT or Women’s Health Physical Therapy
Do you suffer from urinary incontinence? Urinary incontinence, while common and often embarrassing, is NOT normal. You may benefit from Women’s’ Health Physical Therapy. Women’s Health Physical Therapy also known as Pelvic Floor Rehab or Pelvic Floor PT is a specialized area of physical therapy aimed at restoration of urinary and/or bowel function in women.
Many women suffer from incontinence, however in most cases, urinary incontinence can be improved with specialized physical therapy techniques including education, bladder health, biofeedback, manual therapy, and specialized exercises aimed at restoring normal function to the pelvic floor.
Frequently Asked Questions About Women’s Health
What is the pelvic floor?
The pelvic floor is a group of muscles that forms the base of the abdominal cavity which acts as a sling between the bones of the pelvis. These muscles form the base of what is commonly referred to as the core. The pelvic floor is a group of three separate muscles that contract and relax to allow voiding (bowel or bladder) as well as provide support to the pelvic organs (bowel, bladder, uterus). These muscles also provide support during pregnancy and relax during vaginal deliveries to allow a baby to progress through the birth canal. The urethra, anus, and vagina all pass through the pelvic floor muscles which allows the muscles to contract in order to aid in keeping these passages closed.
Are there different types of incontinence? And, if so, what are they?
Pelvic floor dysfunction can result in several different types of incontinence including urinary and bowel incontinence. To answer this question, we are going to focus on urinary incontinence. The following are different types of urinary incontinence:
- Stress Incontinence: the most common type of incontinence which involves leaking with exercise, coughing, sneezing, laughing, or lifting something heavy. Pelvic floor rehab can definitely be beneficial.
- Urge Incontinence: a sudden intense urge to urinate followed by an involuntary loss of control. May include frequent urination even throughout the night.
- Overflow Incontinence: frequent or constant dribbling due to a bladder that doesn’t empty completely
- Functional Incontinence: A mental or physical impairment keeps you from making it to the toilet in time.
- Mixed Incontinence: experiencing more than one type of incontinence; for example a combination of stress and urge incontinence.
What type of problems occur with the pelvic floor?
Pelvic floor muscles are just like other muscles in our body. They can become too tight or too weak. If these muscles become too tight, it is called hypertonic pelvic floor. With hypertonic pelvic floor, you may experience difficulty with voiding urine or feces completely which can be distressing. Occasionally these muscles may become so tight that sexual intercourse is difficult or painful. When the pelvic floor muscles become weak, you may experience loss of urinary or bowel control resulting in incontinence. Incontinence can range from complete loss of urine to “just a little leakage” with coughing or sneezing.
What can cause my pelvic floor muscles to become weak?
The pelvic floor can become weak in women for many reasons. Some of the most common reasons for pelvic floor muscle weakness include:
- Pregnancy and Childbirth: For many women, pelvic floor weakness starts during pregnancy and continues after birth. Pelvic floor weakness is especially prominent in women who have had multiple pregnancies, especially with larger babies. Assisted births may also result in pelvic floor weakness.
- Menopause: Women may also experience weakening of pelvic floor muscles. Reduced estrogen may result in pelvic floor weakness, as well as generalized muscle weakness.
- Age: Unfortunately, pelvic floor muscles tend to get weaker as we age. The good news is that pelvic floor physical therapy exercises can help at any age.
- Straining: Ongoing or repetitive strain may lead to pelvic floor muscle weakness. Straining may also result in prolapse. Prolapse occurs when the pelvic floor can no longer support the bladder and it descends into the vagina. Good toileting habits can reduce strain and help with incontinence. Your pelvic floor physical therapist can help you learn good toileting habits to help reduce the risk of prolapse.
- Coughing: Women who have a chronic cough are at increased risk of prolapse and urinary incontinence due to chronic, repetitive strain on the pelvic floor muscles resulting in weakness.
- Heavy Lifting or High Impact Exercise: Repetitive heavy lifting, especially with poor technique, can add increased strain to the pelvic floor muscles resulting in urinary incontinence. High impact exercise (jumping, plyometrics, etc) may also add increased stress to the pelvic floor. Women who participate in these activities may be at increased risk of urinary incontinence however these activities can be completed safely with proper training.
- BMI: Having a higher body mass index (a measure of body fat based on height and weight that applies to adult men and women) can increase your risk of urinary incontinence. Weight loss and pelvic floor strengthening may help.
- Medical History: Women who have had pelvic or abdominal surgeries are at increased risk for pelvic floor weakness. Procedures and surgeries including hysterectomy, oorphorectomy, and others may increase your risk for incontinence. Radiation treatment for cancer may also increase your risk.
How can Pelvic Floor PT help with incontinence?
Just like the other muscles in our body, the pelvic floor muscles are very responsive to strengthening, neuromuscular re-education, and manual therapy. A women’s health specialist or Pelvic Floor PT can provide education to you regarding good urinary health habits, good toileting habits, exercises to help strengthen your pelvic floor, avoiding bladder irritants and more.
For hypertonic muscles, a women’s health therapist can help teach you how to relax your pelvic floor muscles, voiding techniques to ensure you void completely, and other techniques to help your pelvic floor relax and work toward continence.
Isn’t leaking a little when I laugh or cough normal?
No. Many women think that a “just a little leakage” is completely normal because we so often hear our mothers, grandmothers, aunts, and other women talking about it. Sometimes as women, we even joke about it. However leaking, even “just a little”, is considered urinary incontinence, which is a medical condition that should be addressed. The good news is that most forms of incontinence can be treated successfully with pelvic floor therapy, which is physical therapy performed by a women’s health therapist. If you are curious if pelvic floor therapy could help you, call us today to schedule an appointment with Kailey.
Do I really need to see a pelvic floor therapist? Can’t all PTs treat incontinence?
While most PTs can and often do treat incontinence, a pelvic floor therapist has further training above and beyond the normal physical therapist. This training is specific for Pelvic Floor PT and often includes: incontinence, pelvic floor function, and specialized treatment options that aren’t typically performed by orthopedic or sports physical therapists.
Advanced treatment options include biofeedback, manual therapy, and specialized exercises that should be integrated in a specialized and individualized manner in order to teach the pelvic floor to contract and relax in an effort to restore normal pelvic floor function.
For your best chance of experiencing a successful pelvic floor rehab, we recommend getting an evaluation and starting treatment as soon as possible so that Dr. Kailey Edgar PT, DPT at Optimal Sports Physical Therapy can guide you in your recovery.
In addition to pelvic floor physical therapy, are there other things I can do to help my incontinence?
Absolutely. Patient education is a large part of treating incontinence. Each woman is unique in her symptoms and pain, so after a complete evaluation, Kailey can help provide you with the necessary education to be able to help you modify your lifestyle, nutrition, hydration, and more. Learning bladder training techniques as well as healthy bowel and bladder tips can often help incontinence. Call today to get all of your questions answered and begin your work toward a healthy pelvic floor.
What should I do if I think pelvic floor rehab might help me?
The best course of action is to get a physical therapy referral to see a pelvic floor PT. Some insurance companies allow direct access to physical therapy (you can call customer service number on the back of your card to find out if your plan allows direct access). If your insurance plan allows direct access, call us to schedule your Pelvic Floor PT session today.
However many insurance companies still require a referral from a medical provider in order to utilize your therapy benefits. If you are interested in finding out more about your insurance coverage and if a referral is required, our office manager, Leslie, can help you find out. Call us today.
Where can I learn more about Pelvic Floor PT?
Check out our Women’s Health Blog post and the following resources for more information on Pelvic Floor PT.
Here are some reliable links to help you learn more about incontinence, pelvic floor therapy, and healthy bladder habits.