What is pelvic floor therapy?

Pelvic floor issues can occur among both men and women, but non-invasive strengthening therapy is available for people experiencing these issues. A Baylor College of Medicine urologist explains the importance of pelvic floor therapy to support critical functions.

The pelvic floor is a network of muscles and ligaments that bathe the pelvis, which is a bowl-shaped structure. The pelvis is bordered by the hip bone and pubic symphysis and supports internal organs such as the intestines in addition to the uterus and vagina in women, prostate for men, bladder and rectum. In addition to providing structural support for the abdominal and pelvic organs, the connective network of muscles and ligaments in the pelvic floor play a critical role in how we urinate, pass bowel movements and support sexual function, as well as childbirth and delivery.

Pelvic floor therapy helps to treat any injuries or disorders that disrupt the function of the pelvic floor, according to Dr. Rotimi Nettey, assistant professor in the Scott Department of Urology at Baylor. Urinary and fecal incontinence, constipation, pelvic organ prolapse or sexual dysfunction are examples of conditions that can be treated with pelvic floor therapy.

Everyone can benefit from pelvic floor therapy. Men may see a pelvic floor therapist if they suffer from sexual dysfunction, pelvic pain or premature ejaculation, or if they experience incontinence after prostate surgery. For a significant proportion of women, injury to the pelvic floor occurs after pregnancy and vaginal delivery. While many women are encouraged to see a pelvic floor therapist during pregnancy, pelvic floor therapy can be beneficial in the postpartum period and well beyond. Women who experience incontinence, pelvic organ prolapse, defecation issues, pain with intercourse or sexual dysfunction may also benefit from pelvic floor therapy.

"Like physical therapy is helpful for a knee or shoulder injury, pelvic floor therapy works the muscles in the pelvic floor to rehabilitate those muscles from injury or destruction," Nettey said.

Pregnancy is the single most common injury to the pelvic floor because the uterus can directly compress various muscles and nerve groups. The muscles get strained from being constantly taxed as they are relied upon for more support. The process of vaginal delivery induces trauma to the pelvic floor ligaments and muscles, causing lacerations or tears to those structures. Pelvic floor therapy helps regain control and rehabilitate these muscle groups. After childbirth, women might experience changes in control of bladder function and bowel movements. Therapy can help to regain control in terms of incontinence and less obstructive defecation.

Pelvic floor therapists use a variety of techniques including relaxation and down training exercises, which can be useful for patients with overactive bladder or those with a tense, high tone pelvic floor; myofascial release for patients with pelvic floor pain or biofeedback therapy.

"Pelvic floor therapy helps empower patients because they can do it on their own once they see a therapist who can extend those lessons they learn in therapy," Nettey said. "It's beneficial and harmless to patients and is pretty non-invasive compared to other therapies offered. Patients who are interested in learning more about pelvic floor therapy should consult their urologist or gynecologist."