Nonsurgical Treatments

Weak Pelvic Floor Muscles? How Physical Therapy Can Help

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By Henry Ford Health System Staff

For both men and women, your pelvic floor muscles are responsible for many bodily functions. They help you use the bathroom properly, engage sexually, birth children and even stabilize your spine, back and abdomen.

When your pelvic floor muscles weaken, it can often lead to pain or health issues related to your body’s natural functions. Sometimes, instead of weakening, these muscles become tight or immobile – also affecting your daily life. These muscles can be affected by:

  • Pregnancy and childbirth for women
  • Straining on the toilet
  • Surgery or cancer treatments
  • Heavy lifting
  • High-impact exercise
  • Age

Fortunately, relief through pelvic floor physical therapy is a solution for many. “People think that pain or issues they have caused by the weakening of pelvic muscles is something they have to live with,” says Aparna Rajagopal, a physical therapist at Henry Ford Health System. “Our goal is to identify what triggers a patient’s condition and provide recommendations for relief.”

There are many pelvic health issues that Rajagopal sees physical therapy patients for, including:

  • Pelvic pain (acute and chronic) in both men and women
  • Pain associated with endometriosis
  • Pregnancy-related pelvic or back conditions
  • Post-partum scaring, incontinence or pain
  • Pain during sexual intercourse
  • Abdominal separation
  • Pelvic organ prolapse
  • Chronic back or SI joint pain
  • Erectile dysfunction
  • Post-prostatectomy issues
  • Tailbone injuries
  • Constipation
  • Urinary or fecal incontinence

What to Expect from Your Pelvic Floor Physical Therapy Appointment

“Pelvic floor physical therapy is so much more than just Kegels,” says Rajagopal. “The purpose of this therapy is to stretch, strengthen and mobilize muscles and tissues of different parts of the body – not just the pelvic floor.”

Here’s a breakdown of what to expect at your first appointment:

  1. Posture assessment. The way you stand affects muscle position. Muscles held in the wrong position can become shortened and tight – causing pain or spasms.
  2. Range of motion assessment. This evaluation is used to identify areas where the muscles are strained or more tense than normal. Sometimes incorrect use of muscles groups (caused by straining during a workout or while going to the bathroom) can weaken pelvic floor muscles.
  3. Breathing analysis. “Most people only breath from their chest and not their diaphragm,” says Rajagopal. “The pelvic floor is naturally worked out by deep breathing.” Breathing in short, rapid breaths can lead to a tense and weakened pelvic floor and lower back pain.
  4. Pelvic muscle examination. To identify the trigger points of pelvic pain or tense pelvic floor muscles, an internal and external exam is conducted.

After initial assessments, your physical therapist will make recommendations for ways to relieve any pain and strengthen or stretch your pelvic floor.

“We provide recommendations for better posture, breathing and even different positions for going to the bathroom effectively,” says Rajagopal. “Many patients find relief of their issues when they increase abdominal pressure in different ways.”

Typically, patients start by coming in for therapy for one hour a week for three weeks. From there, the frequency of appointments is reduced to give patients more time to practice their recommendations. Reassessments will be done every few weeks following the first four weeks.

Like any type of physical therapy, pelvic floor physical therapy takes time and practice to be effective – and patients can reap the benefits when they stick with it. In fact, Rajagopal finds that most patients report relief of symptoms after three months of therapy – often of symptoms that they expected to live with for the rest of their lives.

Talk to your primary care doctor to see if pelvic floor physical therapy is an option for you. Your doctor may ask that you see your urologist or gynecologist before recommending physical therapy.

To learn more about pelvic floor therapy, visit henryford.com or call (586) 285-3884.

Aparna Rajagopal sees patients at Henry Ford Rehabilitation and Sports Medicine – Fraser.