Pelvic Floor Physiotherapy: What it is, and Why it’s Important
Awareness is spreading around pelvic floor health and the volume of individuals seeking Pelvic Floor Physiotherapy is growing year over year, but what is this niche service and why is it so important?
What Is Pelvic Floor Physiotherapy?
Pelvic Floor Physiotherapy (PFPT) is a specialized area of Physiotherapy that focuses on issues involving the muscles, ligaments, and connective tissues in the pelvic region. Pelvic Health takes a holistic approach, meaning that the assessment and treatment does not only focus on the pelvic area but involves the whole body as a system that works together.
Pelvic Floor Physiotherapists are Registered Physiotherapists (PTs), many with postgraduate Masters or Doctoral degrees in Physical Therapy, who go on to advance their skills through additional education in Pelvic Health.
Majority of the conditions that are treated through Pelvic Floor Physiotherapy involve the pelvic floor muscles.
The pelvic floor is a group of muscles that form a hammock-like structure at the base of the pelvis. Functions include supporting the pelvic organs (bladder, uterus, and rectum), controlling bowel and bladder continence, core stabilization, sexual health, and pumping lymphatic fluid through the pelvic region (in fact, it is the second biggest lymphatic fluid pump in the body). The pelvic floor muscles play a role in childbirth, as they are situated around the vaginal canal where the baby must pass through. Given the direct involvement of these muscles during the birthing process, care during and after pregnancy is especially important for maintaining the vital functions mentioned above.
What types of conditions do Pelvic Floor Physiotherapists treat?
When the pelvic floor muscles aren’t functioning properly, issues can arise such as:
Pelvic pain: Discomfort or pain in the pelvic region, which may be constant or intermittent.
Urinary problems: Urinary incontinence (involuntary leakage of urine), difficulty emptying the bladder, and/or a frequent urge to urinate including waking up in the night to pee.
Bowel issues: Constipation, straining during bowel movements, fecal incontinence, and/or difficulty controlling gas.
Sexual dysfunction: Pain during intercourse or other sexual activities, involuntary contraction of the pelvic floor muscles that prevents penetration, lack of or decreased sensation during sex, urinary incontinence during sex, and/or frequent post-coital UTIs.
Muscle spasms: Involuntary contractions or spasms of the pelvic floor muscles.
Factors known to contribute to pelvic floor dysfunction include:
Pregnancy and childbirth: The pelvic floor muscles can be stretched or weakened during pregnancy and delivery.
Chronic constipation or straining during bowel movements: This can lead to increased pressure on the pelvic floor.
Obesity: Excess weight can strain the pelvic floor muscles.
Surgery: Certain surgical procedures, especially those in the pelvic area, may impact the function of the pelvic floor.
Trauma or injury to the pelvic area: Accidents or injuries can affect the pelvic floor muscles and surrounding structures.
What happens during a Pelvic Floor Physiotherapy appointment?
During a typical PFPT session, the Physiotherapist will perform a thorough assessment of the pelvic floor muscles and surrounding structures. This may involve internal and external examinations to evaluate muscle tone, strength, flexibility, and coordination. The PT will also assess other areas of the body relevant to the presenting issue (eg. hips, low back, core, neck). Based on the assessment, the PT will develop a treatment plan. Follow up usually involves 6-8 sessions, but can extend to a year or more depending on the issue being treated.
Where do Pelvic Floor Physiotherapists see patients?
Pelvic Floor PTs work in both inpatient and outpatient settings, meaning they can work in hospitals, rehab facilities, as well as private clinics.
How is pelvic floor dysfunction treated?
Pelvic floor dysfunction is often treated using a holistic, whole-body approach, including:
Individualized exercise prescription and training to target involved areas of the body.
Education and Lifestyle Modification: Guidance on managing stress, water intake, posture, breathing, lifting techniques, microbiome and nutritional support, and more to support pelvic health.
Manual Therapy: Hands-on techniques to release tension and improve mobility in the pelvic floor and other areas of the body.
Biofeedback: Using technology to provide visual or auditory feedback to help individuals learn to control and coordinate their pelvic floor muscles.
Behavioral Strategies: Techniques to address habits or behaviors that may contribute to pelvic floor dysfunction, such as voiding habits.
Is Pelvic Floor Physiotherapy only for women?
This is a great misconception! Men can greatly benefit from Pelvic Floor Physiotherapy for conditions such as pelvic pain, bladder pain syndrome (interstitial cystitis), overactive bladder syndrome, nocturia, erectile dysfunction, non-bacterial chronic prostatitis, and post-prostatectomy issues among others. It is important for men to vocalize their symptoms to their healthcare provider and seek the necessary treatment (eg. referral to a Urologist and Pelvic Floor PT) in order to address these conditions that can worsen with time.
Is Pelvic Floor Physiotherapy covered by insurance?
Most insurance companies offer coverage for PFPT, as it a carefully regulated health care profession under the medical sciences. Pelvic Floor Physiotherapy is conservative and non-invasive. It can be a primary form of care, meaning you do not need a prescription from your doctor to see a PT (unless your insurance company requires it). PFPT can complement medical treatments as an essential component of a holistic approach to pelvic health. Individuals experiencing pelvic floor issues who are unsure about treatment options should consult with their healthcare provider to determine if PFPT is appropriate for them.
