Incontinence and Pelvic Pain are Treatable Conditions
By Christine Feely, MPT
Muscular problems in the pelvic
floor can cause symptoms ranging from involuntary loss of urine (urinary
incontinence) to chronic pelvic pain. Millions suffer from pelvic floor
disorders, yet, for many, the symptoms go unidentified and untreated. Although
discussing symptoms associated with pelvic floor dysfunction is difficult for
some, it is important to realize that pelvic floor pain and dysfunction are not
normal and can successfully be treated.
What is the pelvic floor?
The pelvic floor is made of muscles
and tissues that form a “sling” from the pubic bone to the tailbone. They
support abdominal and pelvic organs and help to control bladder, bowel, and
What are the symptoms of pelvic
Symptoms of pelvic pain, urinary
frequency or urgency, painful intercourse, sensation of pelvic pressure or
heaviness, painful defecation, tailbone pain, and low back pain can occur when
the muscles of the pelvic floor are too tight. Weakness in these muscles can
contribute to urinary or bowel incontinence, bladder or rectal prolapse, and low back pain.
What causes pelvic floor
Sometimes the cause of pelvic floor
dysfunction is unknown; however, some common causes include:
poor posture with weak core muscles
or complicated vaginal delivery
or pelvic surgery such as a hysterectomy or prostectomy
(fall on a tailbone, auto accident)
organ disease (endometriosis, irritable bowel, interstitial cystitis, prostatitis)
How are pelvic floor problems
Treatment of pelvic floor problems
begins with a visit to the doctor for a thorough physical history, examination,
and diagnosis. If the underlying cause is related to muscular dysfunction in or
around your pelvic floor, referral to a physical therapist who
specializes in evaluation and treatment of the pelvic floor can be the next
What does physical therapy
Your physical therapist will take a
thorough history of your current condition and evaluate the structure and
function of the pelvic floor region. An internal exam may be necessary to fully
evaluate the muscles of the pelvic floor. The therapist may also use a
biofeedback device to assess muscle activity. Following the evaluation, your
therapist will discuss treatment options with you.
Treatment may include a number of
therapeutic approaches to strengthen weak muscles and to release muscle
tension. Physical therapists often use a technique called manual therapy to help improve muscle mobility, realign pelvic
bones and the spine, and relieve tension in the muscles that attach to the
pelvis. Neuromuscular re-education,
which often uses biofeedback, helps muscles of the pelvic floor learn to fire
with proper force and timing. Ultrasound and
electric stimulation can help with
pain relief. Strengthening exercises
for the muscles of the pelvic floor, trunk and legs improve strength, endurance
and may alleviate symptoms. Your therapist will also teach you self-treatment
techniques, ways to manage symptoms and give you a home exercise program.
Where can I find someone who
specializes in this?
The American Physical Therapy
Association has recognized women’s health and pelvic floor treatment as areas
of specialty within the practice of physical therapy. Practitioners can be
found throughout the region. If you feel you have pelvic floor dysfunction,
talk to your doctor to see if physical therapy is right for you.
Christine Feely has been in practice for nine years, holds a master’s
degree in physical therapy, and is on staff at Cayuga Medical Center’s
Department of Physical Therapy and Sports Medicine located at Island Health and
Fitness. She specializes in pelvic floor dysfunction, women’s health, and hand
therapy, and can be reached at (607) 252-3500.