Pelvic Floor Dysfunction: Examination and Treatment

Feb 7, 2018

Bree Wickey

by Bree Wickey
PT, DPT | North Scottsdale Location

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:

  • Exercise
  • Biofeedback
  • 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.

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