WHAT IS THE PELVIC FLOOR, HOW IS IT ADDRESSED IN PHYSICAL THERAPY, AND WHY YOU SHOULD CARE?

Posted on Posted in All Posts, Let's Get Technical, Reproductive Health, Take Control of Your Health
 

Hello Thrivers,

I’m writing today to clarify what it means to get “pelvic floor PT.”  It has come to my attention that people believe this is a service that applies only to postpartum persons seeking to stop urinary leakage.  And while that is certainly a reason to come to physical therapy, it is only a narrow facet of how PT can address pelvic floor dysfunction.  So, the intent of this missive is to offer clarity on what qualifies as pelvic floor dysfunction and when to seek care from your physical therapist.

First, “pelvic floor PT” is a flawed term.  Physical therapists are movement scientists trained to care for a body in motion.  We use our collection of skills to address dysfunctions in motor control, range of motion, strength, etc. with the intent to enhance function and improve our patient’s participation in society.  The pelvic floor is a group of muscles that, like every other muscle, contributes to our ability to function and participate in our chosen activities.  It is not divorced or separate from the rest of the body…we are not disembodied floating pelvises.  However, a physical therapist does have to train for enhanced examination and treatment skills to treat the pelvic floor.  Therefore, when you go to “pelvic floor PT,” you are really just seeing a physical therapist who has a collection of skills that allows them to integrate into the whole the assessment and treatment of the tissues of the pelvic floor.

pelvic floor physical therapy nyc
Pelvic Floor model by Marie Josee Forget (www.totalpelvichealth.ca)

As pictured, the pelvic floor consists of three layers of musculature.  These muscles do the following:

– Maintain bowel and bladder continence

– Allow for bowel and bladder evacuation

– Enhance sexual appreciation

– Support the organs of the pelvic basin

– Act as part of the postural core support mechanism

Given what we now know of the role of the pelvic floor muscle network, it would make sense that dysfunction could vary widely in presentation and that the avenues for treatment equally as numerous.  Direct dysfunction of these muscles can contribute to loss of bowel/bladder control, constipation, urinary and bowel urgency/frequency, pelvic pain, diminished sexual appreciation or pain with intercourse, pelvic organ prolapse, and lumbo-pelvic-hip control issues.  Additionally, these tissues are influenced by infection, hormonal changes across the lifetime, history of trauma, pain states, pregnancy, nerve injury (both peripheral and central), autoimmune disease, and much more. That is so much more than (but inclusive of) postpartum leaking!!

At Thrive, we care for persons with the following issues related to the pelvic floor:

– Urinary urgency/frequency

– Bowel urgency/frequency

– Bowel or bladder incontinence

– Bladder Pain Syndrome

– Chronic constipation

– Pelvic organ prolapse

Birthing preparation for the pregnant patient

Return to activity participation for the postpartum patient

Diastasis recti management

– Chronic pelvic pain

– Pain with intercourse

– Low back pain

– Hip pain

– Coccyx pain

As you can see, the list is varied and long.  You might also notice that the symptoms listed above might reasonably apply to LOTS OF PEOPLE!  Therefore, the question is less, Who is appropriate for PT with pelvic floor treatment? but rather, Who isn’t?

If you are interested in treatment options for any of the above conditions, please contact the office at info@thrivept.com or submit your insurance information and appointment request through our secure online portal by clicking HERE.

 


Elizabeth D'Annunzio Shah Physical Therapist New York CityElizabeth D’Annunzio Shah, PT, DPT, OCS, MTC works with patients of all ages and abilities including recreational athletes, professional dancers and performing artists. She has a special interest in vestibular and balance disorders, movement theory and creative solutions for both neurologically and musculoskeletally impaired persons. Elizabeth is passionate about exercise as a means to maintain health, manage stress and enjoy life! She practices yoga in the Iyengar tradition, is an avid surfer, and participates in distance running events whenever possible. (more)