When most people think of pelvic health physical therapy, they think about kegels, internal work, and dilators. While this can be a component of pelvic care, it is not the only piece! There is so much more that goes into a pelvic health physical therapy session.
Internal Pelvic Floor Assessments & Treatments
An internal pelvic floor muscle exam allows us to directly assess the pelvic floor muscles. Are the muscles tight, weak, or both? Can you fully contract and, just as importantly, fully relax? Is there tenderness or a trigger point that’s part of your symptoms? From there, we might work on coordinating your pelvic floor to contract, relax, and lengthen, work on areas that are tense, or bring in dilators / wands when they’re the right tool for you. But it’s one piece of a much bigger picture. It’s not the whole treatment plan, and it’s always optional.
Pressure Management & Breath Work
Your breath plays a large role in how your pelvic floor muscles operate, and this is largely due to the movement of your diaphragm and how we can manage pressure within our abdominal cavity. When you inhale, your pelvic floor lengthens; when you exhale, your pelvic floor lifts. Learning to time your breath with lifting, running, or getting up off the floor can change how your pelvic floor handles load.
Core Strength & Control
Your abdominal muscles act as the front wall of your abdominal cavity. If these muscles are not as strong as they could be, especially if Diastasis Recti (abdominal separation) is present, this can impact how you manage pressure within your abdominal cavity. Strengthening your core is important for so many reasons, but it can actually also even take the load off of your pelvic floor.
Check out this blog post for more information on what “core strength” really means.
Hip Strength & Flexibility
Some of your deep hip muscles share real estate with your pelvic floor. When your hips are weak or stiff, your pelvic floor often picks up the slack. We will often do a lot of hip mobility and strengthening exercises to help improve pelvic floor dysfunction.
Check out this blog post for more information on how the hips are connected to your pelvic floor.
Spinal Flexibility & Strength
Your middle back plays a big role in how your trunk, core, and pelvic floor function. We often see stiffness in the thoracic spine and ribcage. If your ribcage can’t expand, your breath has nowhere to go but down, putting extra pressure on your pelvic floor. This is especially common after pregnancy, when the ribs flare to make room for baby. We work on opening up your thoracic spine and helping your ribs move in all directions, so your diaphragm and pelvic floor can do their job together.
Functional Movement Training
Squatting down to lift your baby out of the car seat. Carrying groceries up the stairs. Getting back to lifting, running, or your favorite pilates class. We practice the things you actually do, so your progress shows up in your real life, not just in the clinic.
Pelvic PT is More Than Just Internal Work
Pelvic health physical therapy is so much more than just internal pelvic work. While this can often be a component of care, we at BEYOND PT believe that it should not be the only component in someone’s plan of care. If you’re interested to learn more about what pelvic PT could look like for you, let’s chat.
Sources:
PMID: 34366727
PMID: 36237644
Disclaimer: The exercises demonstrated in this post are intended for general educational purposes only and do not constitute medical advice. Always consult with a licensed physical therapist or healthcare provider before starting any new exercise program, especially if you are recovering from an injury or have specific medical concerns.