Pelvic Floor Therapy Expectations and Treatment Modalities


It has been established that pelvic floor therapy is one key to treating pain, weakness, and dysfunction of the pelvic floor muscles. Blood flow to connective and muscle tissue is allowed when the pelvic floor muscles are functioning efficiently. The pelvic floor muscles also help improve mobility through increased blood flow.

Pelvic floor therapy seeks to restore higher mobility levels and healthy function of the pelvic floor muscles. Well-functioning pelvic floor muscles will lead to an efficient blood flow to connective tissues and muscles thereby improving mobility.

Another goal of pelvic floor therapy is to reinstate a higher level of mobility, healthy functioning, and movement. Pelvic floor therapy clinics will try to work on the identified muscle trigger point and tight or relaxed connective tissues that have been determined to be the cause of pain or discomfort.

For decades, the medical practice has regarded pelvic floor physical therapy effective in improving pelvic floor dysfunction symptoms, and it is a non-invasive procedure at that. Physical therapists at a pelvic floor therapy clinic use a variety of painless and non-surgical treatments to retrain the pelvic floor muscles. This in turn helps control bladder and bowel control, and sexual function. When patients learn to strengthen and relax pelvic floor muscles, pelvic floor muscles not only improve in terms of function but the pain or discomfort experienced by patients is often reduced.

During pelvic floor therapy sessions, physical therapists teach patients exercises to stabilize and strengthen the core. The core is the major muscle that holds the trunk, including the pelvic floor, abdomen, back, and diaphragm, and keeps it stable. Stabilizing the core in pelvic floor therapy sessions is also involved in re-training and giving strength back to the pelvic floor muscles.

The pelvic floor therapy practitioners will determine overly tight muscles and will teach patients exercises to stretch them to improve mobility and coordination. They will also teach patients several things including postural exercise, diaphragmatic breathing, and relaxation techniques. These practices improve symptoms and the overall health and well-being of the patient.

The actual treatment approach that a pelvic floor therapy clinic recommends to a patient varies depending on the symptoms they experience. For some patients, they will have to teach how to relax and lengthen the pelvic floor muscles while in others the opposite of strengthening the pelvic floor muscles is advisable.

Most pelvic floor therapy clinic therapists will work with patients on behavioral modifications. Behavioral modifications to help pelvic floor muscle functions include dietary and lifestyle modifications that will help relieve the experienced symptoms and improve the patient’s overall quality of life.

What to Expect in the Early Phase of Pelvic Floor Therapy

It can be understandable why pelvic floor dysfunction matters can be highly personal. Patients of pelvic floor therapy clinics often feel nervous, even fearful of what to experience and expect. Pelvic floor therapy clinics should reassure their patients that their staff is compassionate, highly-trained professionals. An extensive experience working for a pelvic floor therapy clinic and with pelvic conditions can give patients more assurance of the services they are getting. Therapists of a pelvic floor therapy clinic should also take their time to answer questions and explain each procedure thoroughly.

During the first few appointments, the pelvic floor therapy practitioner should perform a comprehensive assessment to craft the most fitting treatment plan for the patient’s case or situation.

As mentioned, pelvic floor therapy seeks to restore movement and mobility, and decrease the pain experienced. It follows therefore that during the examinations, the pelvic floor therapy practitioner should assess the posture, strength, flexibility (of the spine, hip, and abdominal area), and breathing patterns to point out contributing factors.

The primary goal of the earlier visits to a pelvic floor therapy clinic is for them to identify the probable causes of the patient’s pelvic floor dysfunction. The more the information provided or gathered about the patient’s symptoms, the quicker the physical therapists can determine the issue. Patients are also free and encouraged to do their assessment and findings (perhaps bring notes) about their symptoms. These observations may include what worsens or relieves the pain. These are important data that the physical therapist may gladly welcome.

Patients should expect that the pelvic floor therapy practitioners will ask them to move around during their first few visits to assess certain functions. Patients should remember to dress comfortably during this process. The best pelvic floor therapy clinics encourage patients to ask questions and provide feedback throughout the procedures and during every visit. During this examination phase, the practitioner will ask patients to stand, walk and sit so that potential issues in posture or joints can be pointed out and how it affects the pelvic floor muscles. Pelvic floor therapy clinics should also evaluate whether the bone or muscle problems (in the lower back, hips, sacrum, buttocks, or thighs) are placing undue stress on the pelvic floor muscles, and are causing pain or dysfunction.

The physical therapist should also perform a physical examination. In some instances, physical examinations during pelvic floor therapy sessions include an internal exam. Make sure pelvic floor therapy practitioners have received specialized training on doing the internal exam for pelvic floor muscle dysfunctions. This procedure may be understandably uncomfortable, thus conducting each step slowly and deliberately helps alleviate these apprehensions. When this assessment method is necessary and done, it offers valuable information in identifying strength-related issues and muscle groups that are causing the problem.

Trained pelvic floor therapists should proceed carefully slow and should be able to explain what to expect during each step of the examination. Patients should also be encouraged to ask questions and are allowed to ask for a pause at any time during the performance of the exam.

Initial assessments of a pelvic floor therapy clinic may include the following:

  • A thorough review of medical history
  • A detailed evaluation of symptoms
  • Evaluation of areas that are dysfunctional, tight, or painful
  • Complete physical examination reports

Common Treatment Modalities Utilized by a Pelvic Floor Therapy Clinic

Pelvic floor therapy to treat pelvic floor dysfunctions include both external and internal physical therapies. Patients are often nervous or even reluctant at the prospect of internal therapy, thus most pelvic floor therapy clinics wait until they are ready for it.

For external manual therapies, however, there is a variety of them including a tool that can be incorporated with ease into the treatment plan. An example of this is the manual therapy physical therapists perform to stabilize the pelvis and increase the mobility of the skin, muscles, and fascia. This manual therapy is usually done before using other treatment modalities.

  • External Manual Therapies

    • Trigger point release – a manual therapy used to relieve chronic pain
    • Visceral mobilization – a gentle release technique to restore normal movement to internal organs
    • Connective or scar tissue release – aims to break up scar tissues that may have caused the stiffness, pain, or desensitization
    • Skin rolling
    • Joint mobilization – improves ROM (range of motion) of joints
  • Pelvic Floor Therapy Tools, Exercises, and Techniques

    • Biofeedback – painless procedure that uses special sensors to monitor pelvic floor muscles
    • Kegel exercises
    • Weighted vaginal cones
    • Electrical stimulation therapy – painless, electrical impulses are sent through electrodes placed in specific areas
    • Therapeutic ultrasound
    • Relaxation techniques
    • Meditations