If you’re experiencing pelvic floor dysfunction, it can be intimidating not knowing what to expect from physical therapy treatments and examinations. I’ve compiled this article to explain the disorder, its conditions, how physical therapy can help, and what to expect in an examination and treatments.
What is pelvic floor dysfunction?
Pelvic floor dysfunction is abnormal functioning of the pelvic floor. The following
conditions may occur as a result of pelvic floor dysfunction:
- Urinary incontinence (stress, urge, and mixed incontinence)
- Pelvic organ prolapse
- Sensory and emptying abnormalities of the lower urinary tract
- Sexual dysfunction
- Chronic pain syndromes
How prevalent are these conditions?
Of the pelvic floor conditions noted above, urinary incontinence is the most prevalent. According to the Agency for Healthcare Research and Quality (AHRQ), 13 million Americans are incontinent. Urinary incontinence is two to three times more common in women than men. High risk groups for developing urinary incontinence include pregnant or menopausal women, women with vaginal prolapse, men treated for prostate disease, patients with rectal prolapse, and frail elderly and nursing home residents.
What is the physical therapist’s role in the examination of
pelvic floor dysfunction?
Physical therapists have training in the anatomy, physiology, and the function of the
neuromuscular and fascial support structures of the lumbopelvic region. They
assess the core support muscles for motor control, strength, and endurance as
well as assess the coordination of muscles for different activities and positions. The physical therapy evaluation may also include postural assessment, manual
muscle testing, internal muscle and fascial palpation, EMG testing and
assessment of scar- and soft-tissue restrictions, gait, and movement patterns.
Results of the patient examination guide the identification of
an individualized treatment plan to improve pelvic floor function. Treatment
strategies may address increasing patient knowledge of bladder re-training
techniques, decreasing postural asymmetries, reducing pain, normalizing tone,
increasing strength, reducing myofascial restrictions,and improving
neuromuscular coordination. These treatments address functional goals such as
improved continence, decreased painful voiding syndromes, and decreased pain with
daily activities including sitting, walking, prolonged standing, and sexual function.
What kind of physical therapist services are available for patients with
pelvic floor dysfunction?
Therapeutic strategies for pelvic floor dysfunction have evolved beyond the
traditional Kegel exercises for incontinence. Physical therapists customize
treatment plans and select treatments based on the examination and evaluation.
Pelvic floor muscle rehabilitation employs a variety of strategies to improve the
capacity of the muscles through neuromuscular re-education. This rehabilitation
includes but is not limited to:
- Trigger point release
- Electrical stimulation for pain relief/control
- Myofascial release
- Soft tissue lengthening
- Dry needling
- Soft tissue manipulation
- Deep tissue manipulation
- Joint mobilizations
If you’re experiencing pelvic floor dysfunction, please schedule an appointment at one of our physical therapy clinics and let our experts help you to achieve your health goals.
While there are many different factors that impact health, fitness, and recovery, stretching is one important component that is often forgotten. As a competitive gymnast for over 10 years, I have learned certain factors that can have a dramatic effect on performance, pain, and overall functional mobility – and the importance of stretching can never be over-emphasized. No matter who you are, or what types of activities you perform in everyday life, stretching your body is worthwhile.
Some common benefits of stretching include:
- Increased range of motion
- Decreased risk of structural deformities that are preventable but result from restricted movement
- Less muscle weakness due to shortened tissue or muscular imbalance
- Decreased risk of musculoskeletal injuries
- Reduced muscle soreness
Ultimately, all of these benefits of stretching lead to a decreased risk for falls and an increase in functional mobility.
There are many different ways a person can stretch, and the decision on how to stretch should be made based on the goals, abilities, and skills of the person stretching. Two commonly used methods include dynamic stretching and static stretching. Before deciding between the two, it is important to understand the qualities of muscle fibers and the effects of each type of stretching.
Elasticity and plasticity are both important qualities of muscle fibers. Elasticity is the ability of tissue components to stretch past their normal length, and then quickly return to their pre-stretched length. This happens when you perform tasks such as throwing a ball, jumping, brushing your hair, or reaching into the top cabinet in the kitchen. Dynamic stretches, which involve rhythmic movements, are generally most useful for improving elasticity. Plasticity is the ability of the tissue components to adapt over time and become longer than their original, pre-stretched length in a more permanent manner. Static stretches, which require holding a stretch for a prolonged period of time, are more useful for this.
Static stretching is often important for those who are sitting for extended periods of time, such as at a desk job. Dynamic stretching is usually designed with a specific activity in mind and is often accepted as an appropriate warm-up routine for many athletic activities or sports. While both types of stretching have their individual purposes, the most successful stretching program will involve both. If you think you would benefit from a stretching program that is tailored to your specific goals, abilities, and skills, please feel free to contact your local Foothills Sports Medicine AZ physical therapy clinic for more information!
There are some instances in which stretching would not be beneficial to your body – for example, if you have recent fractures, strains, or sprains, severe osteoporosis, sharp pain with lengthening of tissues or joint movement, hematoma, hypermobility, or situations in which the shortened tissues provide necessary stability. However, for the majority of people, stretching is helpful. (If you’re not sure if stretching would benefit you, a physical therapist can help determine which stretches your body needs.)