We’ve got a riddle for you – what acts as net to hold in your organs and innards, yet is rarely discussed?
*Drumroll Please* That’s right – your pelvic floor!
If the title of this article hadn’t already given it away, the answer to this riddle may have come as a surprise. Many people are not aware of their pelvic floor, or the extent of issues that can come when it is damaged or injured.
Without many conversations around this area of the body, it’s not common knowledge that pelvic floor physical therapy can be life-changing, let alone an option in the first place.
When you experience a big injury or things feel out of whack in your body, your medical providers will oftentimes refer you to a physical therapist. Physical therapy gives practical ways for people to rehabilitate from chronic pain, discomfort, or injuries, while naturally bringing more flexibility and movement into these areas – especially the pelvic floor.
Who Provides Pelvic Floor PT?
Much like a physical therapist provides physical therapy, a pelvic floor physical therapist provides pelvic floor physical therapy – naturally.
While exact certifications might differ between locations, the training stays somewhat consistent. Most pelvic floor specialists start as physical therapists, however, some go the occupational therapy route. Both routes require at least a master’s degree, and oftentimes a doctorate. These new professionals then go on with specialized classes and internships that focus on developing their skills and understanding of the pelvic floor.
It is possible for providers from other backgrounds such as registered nurses, physician’s assistants, chiropractors, midwives, and medical doctors to become a pelvic floor therapist, however, this is a different scope of practice than physical therapy.
What Does a Pelvic Floor PT Do?
Have you ever had a baby, or are planning on it someday?
Do you ever have issues holding in your pee?
Do you deal with frequent constipation?
Is sex consistently painful for you?
If you answered yes to any of these questions, then pelvic floor physical therapy may be for you.
Although conversation around the pelvic floor has grown in recent years, it often doesn’t get much recognition beyond the old “do your kegels” adage. This isn’t enough for many people.
When there are dysfunctions in the pelvic floor, people can experience pain and weakness, which can lead to all the issues listed above, and more.
More and more people are aware of the benefits of PV PT in the postpartum period, as a means to repair any injury from birth and pregnancy, especially if it has led to subsequent issues like pelvic organ prolapse, painful sex, and incontinence.
What many people don’t realize is that PV PT can also be used as preventative care! Seeing a PV PT during pregnancy gives birthing people the chance to prepare for labor and help prevent injury.
Pelvic floor PT is not just for postpartum and pregnancy. A pelvic floor PT can help give people relief who experience chronic constipation, as well as urinary and fecal incontinence.
People experience pain during sex for a variety of reasons from a birth injury, to endometriosis, to vaginismus. Seeing a pelvic floor specialist can help make sex not just tolerable – but enjoyable and pleasurable.
Pelvic floor dysfunction can also lead to pain in the low back, hip, pelvic, groin, and abdomen, and is something a PT can help address and heal.
Other people who may benefit from pelvic floor PT those who have had surgery, certain illnesses, chronic pelvic pain, or prostate issues.
What Happens in a Session?
Seeing a pelvic floor PT, typically requires an internal examination of the rectum and/or vagina, in order to assess the strength and flexibility of the pelvic floor muscles. This is important to keep in mind, as it can be triggering or uncomfortable but is part of the diagnostic process.
After a comprehensive diagnostic exam, your provider will pull from a variety of tools to help create an individualized treatment plan. They will most likely utilize exercises that stretch and strengthen the pelvic floor and surrounding areas, doing some in office, and also giving you homework to do on your own.
Biofeedback can be helpful in relaxing and strengthening the pelvic floor muscles. Other tools like heat, ice, electrical stimulation, and vaginal dilators may all be used as part of your treatment plan.
Pelvic floor PT is typically ongoing for at least a few sessions, while your provider educates you on how to manage and prevent further issues going forward.
An occupational therapist uses many similar modalities, but they tend to take a more holistic approach and also work with clients around diet, functional movement, and other areas of their lives that may impact their pelvic floor health.
How Do I Find a Pelvic Floor PT?
If you are in the U.S. and are curious about finding pelvic floor physical therapy, you can go to The American Physical Therapy website, and check out their directory to find a provider near you.
Natasha (she/they) is a full spectrum doula, reproductive health content creator, and sexual wellness consultant. Her work focuses on deconstructing the shame, stigma, and barriers people carry around birth, sex, and beyond, to help people navigate through their lives with more pleasure, softness, and sensuality. You can connect with Natasha on IG @spectrumoflovedoula.