| Lauren Peterson
What is Pelvic Floor Physical Therapy? By Dr. Peterson
I am Dr. Lauren Peterson, and I am a Pelvic Floor Physical Therapist in Oklahoma City. Many pelvic floor physical therapists think of themselves as “Women’s Health Physical Therapist” and while I treat mostly
women, I have plenty of men who come to me for pelvic floor dysfunction. I realize that while I want to stand on the top of mountains and scream about the importance of pelvic floor physical therapy, it might fall on some deaf ears. In fact, I often have to explain what I do to my close family and friends. So, I wanted to share what pelvic floor physical therapy is and how it could help you.
Before I get into “What is Pelvic Floor Physical Therapy?” Let me introduce myself. I have been using women’s health physical therapy to treat a variety of pelvic health conditions over the last 4 years. It all
started because I was having issues with stress incontinence (more on SI later), and I wanted a cure. I didn’t want to take medication, and wearing a pad for the next 60 years didn’t seem like a reasonable solution. I was living in rural NW Iowa at the time and with no other pelvic floor physical therapists
around, I ended up being my own first patient. Since that time I have successfully treated hundreds of women, and men, for their pelvic dysfunction and helped restore their quality of life.
To understand pelvic floor physical therapy, I want to highlight physical therapy generally. PTs consider themselves the musculoskeletal experts. We are experts in optimizing movement and anatomical functioning, which means that when you have an ache or pain, or when you are not moving at your best a physical therapist is the first person you should be talking to. Pelvic floor physical therapy in this regard is no different than traditional orthopedic physical therapy, we treat musculoskeletal dysfunction. Just like an orthopedic physical therapist might specialize in working with injuries of the leg, spine, or arm, a pelvic floor physical therapist specializes in keeping your pelvic floor healthy.
Your pelvic floor muscles are those at the base of your core. For a woman, they include the muscles that stretch from the front (pubic bone) to the back (tail bone) of your pelvis, including the muscles surrounding the urethra, vagina, and anus. While you may not have given a lot of thought to these muscles, they are extremely important in several daily bodily functions including: keeping your
abdominal organs inside your body, bowel and bladder control, and sexual functioning. If your pelvic floor is healthy, you should have no issues with any of these, but if your pelvic floor isn’t as healthy as it should be, a variety of problems arise. These problems are the ones that as a pelvic floor physical
therapist, I treat in Oklahoma City.
The problems fall generally into three categories: incontinence, prolapse, and sexual dysfunction. When is comes to pelvic floor physical therapy, the most common problem is with incontinence. With approximately 1 in 3 women suffering from incontinence that is no surprise, but there are different
types of incontinence. The most common I see is stress incontinence, which is what got me into pelvic floor physical therapy in the first place. Stress incontinence is sometimes called “exercise induced incontinence” because it commonly occurs when the woman is active (such as during running, jumping,
or dancing), but it also commonly occurs when you sneeze, cough and laugh. Other types of incontinence include urge incontinence (or “overactive bladder”) and bowel incontinence.
High-tone or hypertonic pelvic floor muscles affect 16% of women and are associated with pelvic floor myofascial pain, dyspareunia, vaginismus, and vulvodynia . Pelvic floor myofascial pain Pelvic floor myofascial pain disorder is characterized by short, tight, tender pelvic floor muscles with myofascial trigger points causing local and referred pain. Symptoms include chronic vaginal discomfort and dyspareunia . PFPT is considered the firstline therapy of myofascial pain and spasm . Tu et al. performed a 2005 systematic review of two RCTs and 27 observational case series to evaluate the use of manual techniques to alleviate musculoskeletal pelvic pain. Although there was wide variation in PFPT techniques and study size, the authors concluded that 59–80% of women reported improvement in pelvic pain . Oyama et al. performed a nonrandomized study of 21 women with muscle responsiveness to pain, less pelvic floor muscle tone, improved vaginal flexibility, and improved pelvic floor muscle capacity .
66. Mathias SD, Kuppermann M, Liberman RF, et al. Chronic pelvic pain: prevalence, health-related quality of life, and economic correlates. Obstet Gynecol 1996; 87:321–327. 67. Tu FF, As-Sanie S, Steege JF. Musculoskeletal causes of chronic pelvic pain: a systematic review of existing therapies: Part I. Obstet Gynecol Surv 2005; 60:474–483. 68. Reiter RC. Evidence-based management of chronic pelvic pain. Clin Obstet Gynecol 1998; 41:422–435. 69. Tu FF, As-Sanie S, Steege JF. Musculoskeletal causes of chronic pelvic pain: a systematic review of existing therapies: Part II. Obstet Gynecol Surv 2005; 60:474–483. 79. Gentilcore-Saulnier E, McLean L, Goldfinger C, et al. Pelvic floor muscle assessment outcomes in women with and without provoked vestibulodynia and the impact of a physical therapy program. J Sex Med 2010; 7:1003–1022.
Prolapse occurs when the internal organs begin to leave the abdominal cavity through the vagina or rectum. Prolapse can be a painful condition for some women, but it is an uncomfortable condition for all women. A strong, healthy pelvic floor can prevent your internal organs from dropping out of your vagina.
The most common sexual dysfunction I see is pelvic pain. More often than not this pelvic pain occurs during intercourse in a condition called “dyspareunia,” which is pain with insertion into the vagina. Most women think they are the only ones going through this; however, it affects more women than you think, women are just afraid to talk about it. Pelvic pain can be isolating and a strain on your romantic relationships, but treatment options exist. If your provider is unsure, seek a second opinion, don’t live in pain.
The thing about pelvic floor dysfunction that many people get wrong, including some Ob/GYNs, is believing that the pelvic floor is always unhealthy because it is too lax, or the muscles are not strong enough. While that is true for some patients, for many others the pelvic floor is actually too tight, which can present very similarly. In the case of pelvic floor tightness, you have to learn to relax first before any strengthening can happen. If you balled your fist, you couldn’t tighten it any further. If your pelvic floor is already tightened, trying to contract further will not be helpful. Your pelvic floor physical therapist wants you to perform at your optimum. We want to know what you are missing out on. Are you missing family time because you have to find a bathroom all the time? What is your dysfunction preventing you from doing? Maybe you can’t take your favorite dance or aerobics class, maybe when you bend over to pick up your little once you leak. Or maybe for you optimal functioning of your pelvic floor means the ability to be intimate with your partner.
What is optimal functioning for you?
Pelvic floor physical therapy will teach you to properly coordinate your breathing and pelvic floor muscle contractions, which will allow you to properly release tension in your pelvic floor while also allowing you to get the most from a pelvic floor muscle contraction when the time comes. Your pelvic floor physical
therapist wants to make sure you can perform at your best, and for her that starts at your foundation.
If you are in the OKC area and would like a pelvic floor physical therapy evaluation appt with Lauren, visit her website here: fyzical.com/oklahoma-city
Dilator therapy helps improve pelvic health and female sexuality. They are used to help a wide variety of female health concerns. Speak to your doctor today about how dilator therapy can help you.
Do you need to order vaginal dilators so you can start your pelvic floor therapy process? Made in the USA. Visit www.vuvatech.com
VuVa Dilator Company Helpful Links:
Tara Langdale Schmidt is the inventor of the VuVa Dilator Company. She has pelvic floor dysfunction herself and wanted to create a dilator set that is made in America that women can trust. VuVatech has been in business since 2014 and has helped over 50,000 women all over the globe. She patented the Neodymium Vaginal Dilator, that is clinically proven to help with blood flow and nerve pain.