Pelvic Health

Dr. Andrea C Wooldridge White, PT, DPT, FPHC, cert. HGP-I

What is the Pelvic Floor?

The “basement of your core” comprises the layers of muscle, fascia and ligaments anchored on and crossing between the bones of the pelvis. These tissues serve to hold up the pelvic organs, allow or prevent passage of urine or feces out of the body, and assist in regulating the pressure in the abdomen. The pelvic floor coordinates with the Transverse abdominus of the belly, the Multifidi along the spine and the diaphragm to create stability within the body during functional activities.

To perform all required tasks, the pelvic floor muscles must have adequate strength, power, endurance, flexibility, and ability to fully relax. Motor control, or the brain’s ability to appropriately isolate and activate/deactivate target muscles, occurs consciously and unconsciously for postural control, body movements, and even breathing.

Who would benefit from Pelvic Health Physical Therapy?

Although commonly referred to as “Women’s Health”, everyone with a pelvis could benefit from Pelvic Health PT.People of all genders and ages, including children, are successfully treated for urine leakage, fecal leakage/streaking, constipation or difficulty passing bowel movements, pelvic pain, abdominal pain, neuralgia also known as sensation changes in the pelvic floor and/or genitalia, scar tissue from injury or surgery, and recurring or chronic back or hip pain.

Common ailments specifically seen in men benefitting from Pelvic Health PT include erectile dysfunction, post-traumatic pain and dysfunction often seen following vehicular accidents or military-related injuries, BPH related pelvic floor dysfunction, and post prostatectomy treatment to restore sensation and function.

Children with complaints of bed-wetting, constipation, urine or fecal leakage when playing or exercising, pelvic/abdominal/back pain, and incomplete voiding of urine also benefitfromPelvicHealthPT.

Women are also seeing the health benefits of receivingtreatmenttominimizerisksduring pregnancy, delivery and postpartum recovery, addressingsexualhealthcomplaintssuchas pain, changes in sensation or dryness, tissue mobility,painandmotorcontroldeficitsrelated to endometriosis, abdominal surgery, or other trauma to tissues, and pelvic girdle instability such as SI Joint pain with or without pain into thethighs/legs.

What do Pelvic Health Physical Therapy Assessments look like?

The initial assessment has multiple components that will be performed over 1-3 visits. Due to the extensive amount of education and training Therapists provide patients during sessions, dividing the examination into portions concurrent with treatment allows patients a better opportunity to absorb and apply newly acquired knowledge.

Along with the interview to obtain the patient’s historyofsymptoms,PelvicHealthPhysical Therapists use a variety of methods to assess thequalityoftheinvolvedtissuesandthebrainbody connection in order to determine the most efficient treatment pathway to restore function and eliminate pain. Examination techniques may include such things as palpation or directly touching the involved and surrounding tissues to assess pliability, tenderness, length:tension ratios, symmetry, and quality of muscle contractions, EMG performance testing commonly referred to as Biofeedback, functional movement assessment, muscle strength testing, and postural assessment.

Not all tests and assessments are needed or even appropriate for all patients.Therapists provide education and instruction throughout testing and treatment to maximize understanding and patient comfort, which sometimes requires aspects of examinations be deferred to later sessions or entirely.

How do I seek help?

Obtaining a Physical Therapy referral from your Medical Doctor, Nurse Practitioner, Dentist or Chiropractor is the first step. Just like a prescription for medication, the referral is yours to use at the Physical Therapy clinic of your choice. Pelvic Health Physical Therapy is a specialty that is not offered at all Physical Therapy clinics, so be sure to check that the clinic offers full Pelvic Health services prior to making your appointment.