Pelvic floor physical therapy is a specialty that is now becoming more known as our health care providers are exploring more conservative options for treatment of pelvic pain and dysfunction. As a physical therapy provider, I see dysfunction across the spectrum, ranging from mild incontinence to debilitating pain which prevents people from getting out of bed. Pelvic floor physical therapy is a treatment provided by physical therapists aimed to strengthen the muscles that support our internal organs, function to assist in bowel/bladder voiding, and is important for overall sexual health and satisfaction.

If you are wondering if this is a service you might need, here are a few reasons why you might want to ask your MD to refer you to a pelvic floor specialist:

1. “I pee when I sneeze.” According to the National Association for Incontinence, of the 25 million adult Americans suffering from some form of urinary incontinence, 75-80% of those are women. Whether you laughed too hard with your best friend, jumped too high on the trampoline, or simply got up from your chair too quickly, urinary leakage is something many Americans deal with (but don’t have to).

2. “I have to go to the bathroom a lot… I always know where the exits are in case I have to go in a hurry.” The “norm” for urination is 6 – 7 times in a 24-hour period or once every 2 hours. Many people find themselves having intense urges to go, despite only having maybe a “drizzle” when they actually go. Often this can be a byproduct of pelvic floor muscle dysfunction since many people have a hard time “relaxing” those muscles in order to go to the bathroom. Think about your urethra as a garden hose and the pelvic floor muscles as a nozzle of that hose, if your muscles are “tight” or are not lengthened properly, urine will not have the opportunity to escape out of the hose. This may also be due to signals to your brain that are “overactive” which cause you to experience urgency even though your bladder isn’t full. A pelvic floor physical therapist can also discuss options for you regarding adjusting your bladder schedule, water intake, and discuss ways to sit on the toilet which will help you take pressure off so you have an easier time going (this goes for constipation too!).

3. “I just can’t enjoy sex, it’s so painful.” If you are having difficulty with sexual intimacy due to increased pain or even difficulty with tampon insertion, you are not alone. Many women suffer with the same issue, which can lead to difficulty enjoying intimacy with their partner or even tolerating gynecological medical examinations involving a speculum. Often a pelvic floor therapist will give you the proper instruction and feedback to lengthen pelvic floor muscles and may even provide manual therapy to treat any muscle trigger points that may be associated with muscular pain. Your therapist will discuss treatment options that are right for you given your medical history and other factors involved with your care.