Pelvic Floor Physical Therapy

    When treating pelvic pain we focus on creating balance and harmony among the joints, muscles, and nerves. Whenever possible, we use non-pharmacologic and noninvasive interventions that expose patients to less risk than invasive measures or drug therapies. One of the most important of these treatment options is physical therapy.

    Indication Physical Therapy is Needed

    Pelvic joints include the pubic symphysis, sacroiliac joints, and hip joints. Pelvic floor dysfunction can occur when these joints are not working in harmony often causing tight and weak nearby muscles and nerves. Impairments of the sacroiliac joint, low back, coccyx and/or hip joint can contribute to pain and loss of function.  The result is often a short term or chronic pain state leading to physical therapy.

    Preparation for Physical Therapy

    Be prepared to provide a history of your pain; when the discomfort began, the cause, and treatment history.   Be sure to provide as much information as possible so your therapist can help pinpoint the issue and help with your recovery process.   Your therapist will also likely offer an external and/or internal examination.

    Pelvic Floor Dysfunction and Physical Therapy

    To effectively evaluate and treat pelvic floor dysfunction, our practice works with several prominent physical therapists in the community. These experts have advanced, specialized training that is essential to successfully resolve pelvic floor problems.

    Pelvic floor physical therapy plays a key role in calming and desensitizing the central nervous system, and as such, it is considered the gold standard treatment. Therapists evaluate and treat dysfunction of the pelvic floor muscles using a range of techniques and modalities:

    • Myofascial release – This technique applies sustained pressure to reduce restrictions on the connective tisphysical therapy for complex regional pain syndromesue called “fascia” that surrounds, separates, and connects muscles, organs and other soft body structures. It can relieve pain, improve range of motion, relax muscles, and ease neurological dysfunction.
    • Deep tissue massage – Using firm pressure and slow strokes to reach the deepest layers of muscle and fascia, this type of massage can break up scar tissue and physically undo muscle “knots” and painful, rigid tissue.
    • Postural re-education – Therapists evaluate overall posture as well as body position when standing, walking, and sitting. They will assess whether body posture and movements are contributing to pelvic pain.
    • Education for bowel and bladder issues – Many people don’t realize that the position we take when voiding our bladder or our bowel can have important impacts on our pelvic health. Training provided by a therapist often has unexpected benefits.
    • Body empowerment training – Advanced physical therapy techniques can not only help heal the pelvic region, but they can also improve the way we feel about our bodies as a whole.
    • Other physical therapy modalities that can aid pelvic health include – The internal and external mobilization of joints and soft tissue; sensory, motor and sympathetic and parasympathetic nerve re-training; muscle relaxation techniques; and a variety of strengthening exercises.

    Pelvic Floor Physical Therapy Aftercare

    Depending on your therapist’s prognosis you might leave with some exercises to do at home, medications, or some tips on lifestyle changes that will help you recover. Your therapist should also have an idea of what your recovery path will look like and if you start with exercises you may feel mild soreness for 12-24 hours and you should use ice and heat accordingly.

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    Meet Pelvic Rehabilitation Medicine

    At Pelvic Rehabilitation Medicine, we treat whole human beings, not symptoms. In the body, everything is connected; and the pelvic region is the vital center of the body’s connected functioning. Our physicians take an innovative approach, combining traditional medicine with holistic modalities and restorative and regenerative medicine. We treat both male and female patients who experience core muscle and nerve problems; chronic pelvic pain; and pelvic floor muscle dysfunction. Learn More »

    Relevant Publications/Citations

    Shrikhande A, Ahmed T, Shrikhande G, Hill C. A Novel, Non-Opiod Based Treatment Approach to Men with Urologic Chronic Pelvic Pain Syndrome (UCPPS) Using Ultrasound Guided Nerve Hydrodissection and Pelvic Floor Musculature Trigger Point Injections. The International Continence Society. 2018 Aug. Link to Article.

    Charity Hill, MD sits as a committee member of the Medical Education Committee for the International Pelvic Pain Society. Link to Medical Committee.

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