Pelvic Floor Therapy: A Newer Option for Women and Men
Therapy Can Relieve Pain, Bladder Issues and Sexual Dysfunction
If you’ve ever had pelvic pain, bladder trouble or some sort of sexual function issues, chances are good it’s connected to problems with the muscles in your pelvic floor. However, pelvic floor dysfunction (PDF) is often misdiagnosed or untreated. It refers to a wide range of problems that occur when the muscles of the pelvic floor are not functioning properly and are often too tight or too weak.
Pelvic Floor Muscle Therapy is an emerging area of treatment that can help men and women with chronic pain, frequent urination, incontinence or painful intercourse. Rachel Williams, a physical therapist based at OSF HealthCare Saint Anthony’s Health Center in Alton, received additional training and certification for the specialized therapy that is currently not part of standard curriculum.
Williams said the therapy begins with a one-hour evaluation and development of a treatment plan to either strengthen or relax pelvic floor muscles. In some cases, patients can benefit from internal muscle manipulation but only if a patient is comfortable pursuing that kind of treatment.
“Sometimes if somebody is not comfortable with that internal treatment, we can just do stretching and relaxation techniques but there’s also a way of doing internal manipulation to those muscles and some kind of abdominal myofascial release (gentle sustained pressure on connective tissue) to kind of release some of the restrictions,” according to Williams.
When a patient we’ll call Susan for privacy reasons was fighting for her life with stage 4 colon cancer in 2014, she didn’t worry about anything else but beating cancer. Neither did her doctors. Susan had only a six percent chance of surviving but she beat the odds. However the treatment, was challenging and included surgery to remove her rectum. It took its toll on her emotionally and physically.
Specifically, Susan feared losing her marriage when her medical issues made sex with her husband so painful, they were not intimate for four years. She was thrilled to be referred to a physical therapist in Alton, rather than having to travel to Saint Louis. She describes Williams as, “just so easy to talk with.” Susan said, “She gave me stretching exercises at first.” She added that Williams was so positive and encouraging about the therapy. “It changed my life.”
Susan was afraid her only solution was surgery. “I never knew what you could accomplish with this therapy. I was truly blessed.” She gushed, “After losing other things, it’s wonderful to get this part of my life back.”
Men Benefit from Pelvic Floor Therapy
Fifteen percent of adult men worldwide suffer from pelvic pain and it’s often because of prostate issues or irritable bowel syndrome. As part of her approach Williams looks at other factors that can be contributing to the pain or issues related to pelvic floor dysfunction.
“We look at soaps. We look at diet. We look at lifestyle. We look at behavior; stress. Stress is huge.” Williams explained, “When you’re stressed, your muscles spasm. Your pelvic floor is a muscle and the next thing you know, you’re going to the bathroom all the time.”
Williams says even smoking can contribute to pelvic pain, bladder and sexual function issues. She advises having a frank conversation with your primary care doctor or specialist.
“People forget that your bladder is a muscle so it can be trained just like any muscle in your body. So, there is a lot of education on bladder health; what is normal. People think, ’Oh I just get up and go to the bathroom three times throughout the night, isn’t that normal?’ No. that’s not really normal,” according to Williams.
Although pelvic physical therapy may sound a little unusual and invasive, it can be effective.
If you’ve been suffering from unexplained chronic pelvic pain, incontinence, frequent urination, painful intercourse, or back, hip or sacroiliac joint (SI) pain that has not improved with time or traditional treatment, Williams suggests specifically asking if pelvic floor physical therapy could be a helpful option. It can be prescribed separately or along with other treatments or medications.
“I’m glad to speak to the physician and they are pleasantly surprised with the patients’ success,” Williams offered.
Pelvic floor physical therapy is covered by most insurance, although coverage may vary.
- Biofeedback - a process that allows an individual to monitor the ability to contract or relax a muscle
- Exercises for the pelvic floor muscles that support the bladder (i.e. Kegels)
- Trigger point and myofascial release techniques
- Diet modifications
- Lifestyle changes
- Physiological quieting techniques