Have you ever experienced discomfort or pain in your pelvic area? You’re not alone. Many people, especially women who have given birth, struggle with pelvic floor issues such as urinary incontinence or painful sex.
The good news is that there’s a solution: internal pelvic floor physical therapy. This specialized type of physical therapy targets the muscles, ligaments, and tissues in the pelvic region to alleviate pain, improve bladder control, and enhance sexual function.
“Internal pelvic floor physical therapy can be life-changing for those who suffer from pelvic floor dysfunction.”
During an internal pelvic floor physical therapy session, a trained therapist will help you perform exercises designed to strengthen and relax your pelvic muscles. The therapist may also use massage techniques to release tension in the pelvic area.
If you’re struggling with pelvic floor issues, it’s important to know that help is available. By exploring the benefits of internal pelvic floor physical therapy, you could experience improved quality of life and greater confidence in your daily activities.
Understanding the Pelvic Floor and Its Importance
What is the Pelvic Floor?
The pelvic floor muscles are a group of muscles that stretch like a sling from the pubic bone in front to the tailbone at the back. The muscles attach to the walls of the pelvis, surrounding the bladder, rectum, and uterus (in women). These muscles support these organs and help control their function.
According to Physical Therapist Vivian Eisenstadt, “The muscles of the pelvic floor act as a hammock, supporting the bladder and bowel and helping us maintain continence.” This makes the pelvic floor muscles essential for activities such as urination, defecation, intercourse, and childbirth.
The Importance of a Strong Pelvic Floor
A strong pelvic floor reduces the risk of urinary incontinence, fecal incontinence, and loss of sexual function. It also aids in labor and delivery during pregnancy.
In fact, weak pelvic floor muscles can lead to problems including urine leakage when coughing, sneezing, or lifting heavy weights; urge incontinence, where you have a sudden, intense urge to pass urine followed by involuntary loss of urine; and prolapse, which happens when an organ like the bladder drops into the vaginal space due to weak pelvic muscles.
Physical therapy for internal pelvic floor aims to strengthen the pelvic floor muscles to prevent these problems. This form of physical therapy can be useful both before and after giving birth, as well as for those who experience chronic pain in the pelvic region. Working with a trained physical therapist can help patients gain better control of their pelvic muscles, relieving pain and improving day-to-day life.
Helen Chen, MD, obstetrician-gynecologist and Urogynecologist says “It’s important to treat pelvic floor problems as they arise since a fair number of women who have urinary leakage or prolapse end up needing more invasive surgery down the line. Studies have also shown that treating prolapse can improve sexual function.”
- Urinary Incontinence: Approximately 25% of American adult women, mostly over age 40, experience urinary incontinence.
- Fecal Incontinence: Approximately 5-8% of adults in the US suffer from fecal incontinence.
These statistics demonstrate why it’s essential for those who are experiencing any symptoms related to their pelvic floor muscles to seek treatment promptly.
“Strengthening your pelvic floor will help keep you active and independent throughout your life,” says Chantal Donnelly, MD, obstetrics and gynecology specialist with Stamford Women’s Health in Connecticut. “It can help reduce leaks when you cough or sneeze and make sex less painful while improving sensation. Pelvic floor therapy is often recommended after childbirth, but I tell my patients to start working on the exercises beforehand to prevent problems.”
What Is Internal Pelvic Floor Physical Therapy?
Pelvic floor physical therapy is a specialized area of physical therapy that focuses on the muscles, ligaments, nerves and connective tissue that make up the pelvic floor. It helps patients manage conditions such as incontinence, pain during intercourse, prolapse, and other functional or structural issues.
The internal version of this therapy involves treatment techniques applied within the vaginal canal to help improve muscle function, relieve tension, reduce pain, and resolve any underlying biomechanical issues that may be contributing to the patient’s symptoms.
Assessment and Evaluation
The first step in internal pelvic floor physical therapy is an assessment by a qualified therapist who specializes in this area. They will take a detailed medical history and perform a physical examination, including an evaluation of the pelvic floor muscles’ strength, tone, flexibility, and coordination.
This process also includes assessing the bladder, urethra, bowel, and rectum to identify any relevant factors that could impact the patient’s treatment plan. The therapist may also use biofeedback technology to further evaluate and enhance the effectiveness of each therapy session.
Treatment Techniques
Once the therapist has evaluated the patient and identified areas for improvement, they will develop an individualized treatment plan tailored to their specific needs. Treatment techniques can vary based on the individual, but some common approaches in internal pelvic floor physical therapy include:
- Manual pressure release: The therapist applies direct manual pressure to trigger points or tight spots within the pelvic floor muscles to relieve pain and relax them.
- Biofeedback: This is a technique used to help teach the patient how to properly contract and relax the muscles while monitoring it through electrodes placed externally near the pelvic floor muscles.
- Stretching and Therapeutic Exercises: Customized stretching exercises based on each individual’s condition are used to increase flexibility, strength and endurance within the pelvic floor area. These exercises can also include positional changes like squatting or lunges under the supervision of a therapist.
- Soft tissue mobilization: This technique is done through gentle massage inside the vaginal canal with specially designed tools to relieve adhesions, break up scar tissue, and reduce muscle tension which improves blood flow while enhancing healing capability.
Home Exercise Program
A pelvic floor physical therapy program typically incorporates home exercise programs that aim to reinforce treatment progress made in the therapist’s office.
The therapist will work with the patient to customize an at-home exercise plan tailored to their specific needs and goals. The focus is always on providing realistic and practical exercises that they can easily incorporate into their daily routine.
“Pelvic floor PT should be viewed as regular self-care, like brushing your teeth, for anyone who has undergone pregnancy, labor/delivery, abdominal, hip, back or pelvic surgery.” – Amy Stein, DPT
This therapy represents one part of integrative rehab approach towards managing pelvic pain issues. It involves a close working relationship between both the therapist and the patient. With consistency and dedication, patients can expect to see significant improvements in their pelvic floor function by using these methods. Contact a pelvic floor specialist to discuss any concerns you may have regarding internal pelvic floor physical therapy and its potential benefits.
Conditions That Can Benefit from Internal Pelvic Floor Physical Therapy
Urinary Incontinence
One of the most common conditions that can benefit from internal pelvic floor physical therapy is urinary incontinence. This condition affects millions of people, and it’s more prevalent among women than men.
The symptoms of urinary incontinence vary from person to person, but the most common symptom is leakage of urine when coughing or sneezing, laughing or lifting heavy objects. Other causes may be associated with a strong urge to urinate before losing control of the bladder or frequent urges to go even without having much urine.
A recent study published by the National Library of Medicine found that pelvic floor muscle training (PFMT) was effective for treating urinary incontinence in both men and women. The study suggested that PFMT should be recommended as a first-line treatment for all types of urinary incontinence because it has few side effects and generally considered safe.
“Pelvic floor muscle training is an evidence-based intervention for urinary incontinence.” -National Insitute for Health and Care Excellence
Pelvic Pain
Pelvic pain refers to any discomfort felt in the area between lower abdomen and thighs. It could result from various underlying ailments like endometriosis, vaginismus, interstitial cystitis, chronic prostatitis, and irritable bowel syndrome(IBS).
Internal pelvic floor physical therapy techniques such as trigger point release, massage, stretching, and relaxation exercises have been proven helpful in relieving pelvic pain. A Meta-analysis carried out on the efficiency of biofeedback-assisted pelvic floor therapy showed improved outcomes in reducing vulvar pain, sexual dysfunction, and bladder function.
Mind-body treatments, including meditation and yoga stretches, in addition with physical therapy may help relieve pain symptoms for some people. These relaxation techniques focus on reducing tension in the pelvic muscles through proper breathing exercises.
“Physical therapists can play an essential role in identifying and treating muscle-related pain syndromes, including those of the pelvic floor.” – American Physical Therapy Association
Sexual Dysfunction
Pelvic Floor dysfunction affects up to 20% of women worldwide and has a significant impact on individual’s sexual health and overall quality of life.
The causes of sexual dysfunction associated with the pelvic floor are diverse but can involve muscular imbalances or weakness within the deep core muscles located in the pelvis area. This reduced tissue elasticity, leading to painful vaginal penetration and discomfort during intercourse
A study published in Journal Clinical Obstetrics & Gynecology underscored that “treatment of pelvic floor disorders should be approached comprehensively, addressing multiple domains of function, include quality-of-life measures.”
Luckily, various Internal Pelvic Floor Physical Therapy procedures like Kegels and Biofeedback have been proved effective at countering such conditions.
“Kegel exercises can improve your sex life and help with bladder control” -National Institute of Diabetes and Digestive Kidney Diseases
Pelvic Organ Prolapse
Pelvic organ prolapse (POP) is caused when one of the organs in the female reproductive system drops below its normal location. More specifically, POP occurs when the tissues supporting the uterus, bladder, vagina, rectum become weakened over time, causing these organs to drop downward from their original place.
Typically, this condition might cause a backache, constipation issues, feeling uncomfortable during intercourse, or stress urinary incontinence. In severe cases, surgical interventions might be required, while milder situations can best be managed with Internal Pelvic Floor Physical Therapy.
A study evaluating the effectiveness of PFMT suggested that regular exercises could strengthen pelvic floor muscles, which can lead to a reduction in prolapse symptoms. “Pelvic muscle strengthening is effective for reducing POP symptoms” – Cochrane Library
Pelvic physical therapy administered by qualified professionals has been proven to alleviate chronic conditionallens such as urinary incontinence, vulvodynia, and painful sex.
“Physical therapy may, therefore, benefit patients who present with different types of pelvic abnormalities.” – International Journal of Women’s Health
What to Expect During an Internal Pelvic Floor Physical Therapy Session
Initial Consultation:
Prior to beginning internal pelvic floor physical therapy, you will meet with a licensed physical therapist who specializes in pelvic floor care. This first appointment is generally called the initial consultation or evaluation.
The primary goal of this visit is to provide your physical therapist with information about your health history and current symptoms. Your therapist may ask questions relating to bowel movements, urination, sexual function, pain levels, and any medications you are taking.
You can also expect to discuss concerns regarding your bladder control, pain during sex, and urinary leakage or incontinence. This meeting helps establish realistic goals for what you would like to accomplish during future sessions, as well as answering any questions you might have regarding the process of the internal examination.
Assessment and Evaluation:
Your next step towards internal pelvic floor physical therapy is the actual assessment and evaluation. These appointments involve internal exams of your pelvic floor muscles by a trained and licensed physical therapist.
During these sessions, the therapist will look for areas of weakness, tension, tenderness, or discomfort within the muscles of the pelvic floor. This exam provides valuable information about the source of your symptoms, which then allows the physical therapist to create a personalized treatment plan that targets those areas which require attention.
You should know that treatment plans vary from person to person depending on their specific needs. A customized program specifically tailored to address individual symptoms increases the chance of success while making it more likely patients achieve results quicker than they might with generic treatments such as Kegels alone.
The length of each session varies based on how long it takes for the therapist to determine the necessary steps for improvement. Often times multiple visits are required so be prepared to invest time in yourself and your health.
When it’s not possible to address all of the issues that came up in one session, a plan will be made for follow up appointments. It’s critical you stay committed to the prescribed treatment program to ensure maximum progress is achieved as the results can sometimes happen fast while other times they take more effort and time.
“Internal physical therapy benefits both men and women suffering from conditions such as sexual dysfunction or incontinence.” -Fiona McMahon, DPT
The Benefits of Internal Pelvic Floor Physical Therapy for Your Overall Health and Well-being
Many people are not aware that a weak pelvic floor can lead to various problems. The pelvic floor muscles support the organs in the lower abdomen and regulate urinary, bowel, and sexual functions. Therefore, the weakening of these muscles can cause bladder and bowel issues, pelvic pain, and sexual dysfunction.
Internal pelvic floor physical therapy is an effective method to strengthen these crucial muscles. This therapy involves the use of equipment such as biofeedback machines or internal sensors to train the patient’s pelvic floor muscles. It is a non-surgical treatment option that could provide long-term benefits. Here are some advantages of internal pelvic floor physical therapy:
Improved Bladder and Bowel Control
A weakened pelvic floor can lead to urinary and fecal incontinence, which can disrupt daily life activities. According to the American Urogynecologic Society, about 25% of young women and up to 50% of older women experience urinary incontinence at some point in their lives. For men, prostate surgery and aging also contribute to bladder control issues. However, internal pelvis floor physical therapy could improve bladder and bowel control by strengthening the muscles responsible for controlling urinary and anal sphincters.
In a study published on the National Institute of Health’s website (NIH), researchers found that internal pelvic floor muscle training significantly improved symptoms of urge urinary incontinence among middle-aged women. Another NIH study revealed that this therapy also helped chronic constipation patients evacuate stool more easily and with greater frequency.
Reduced Pelvic Pain
Pain in the pelvic region can be unbearable for both men and women and sometimes leads to frustration, depression, and reduced quality of life. Some common causes include childbirth, pelvic injury, surgeries, infections, or nerve damage. The pain often escalates due to muscle tension and spasms in the pelvic floor muscles.
Internal pelvic floor physical therapy is an effective strategy for reducing chronic pelvic pain. A case series study at Loyola University Medical Center found that patients who underwent this form of therapy experienced a significant decrease in their pelvic pain levels after only six sessions. Another article published in Clinical Obstetrics and Gynecology emphasized that internal physical therapy could be used alone or with other treatments as a non-invasive alternative for pelvic pain management.
Enhanced Sexual Functioning
A weak pelvic floor can affect both sexes’ sexual health, causing issues like erectile dysfunction and painful sex. In women, weak pelvic floor muscles could lead to difficulties reaching orgasm, reduced vaginal sensations, and involuntary urine leakage during intercourse.
Internal pelvic floor physical therapy has been shown to help reduce these symptoms while also enhancing overall sexual function. According to a meta-analysis review by Cochrane Database Systematic Reviews, pelvic floor muscle training improved women’s sexual function measures, including increased arousal, lubrication, and enhanced orgasm intensity. Similarly, another research study showed that men experiencing post-radical prostatectomy impotence restored normal erectile function through this kind of therapy.
“Internal physiotherapy techniques are effective in treating various conditions that cause lower urinary tract symptoms (LUTS), including male and female voiding dysfunctions, urinary incontinence, and pelvic pain syndromes.” -Lin-Yang Chi et al., Asian Journal of Urology
Internal pelvic floor physical therapy is a non-invasive and effective method to deal with pelvic floor problems. With personalized care plans designed to suit individual needs, pelvic floor physical therapists can help restore optimal pelvic floor muscle functioning, reducing discomfort and improving quality-of-life.
Frequently Asked Questions
What are the benefits of internal pelvic floor physical therapy?
Internal pelvic floor physical therapy can improve pelvic muscle strength, flexibility, and coordination. This therapy can relieve symptoms of urinary incontinence, fecal incontinence, pelvic pain, and sexual dysfunction. It can also aid in postpartum recovery and prevent future pelvic floor problems. Additionally, it can help individuals avoid the need for surgery or medication.
How does internal pelvic floor physical therapy work?
Internal pelvic floor physical therapy involves the use of techniques such as biofeedback, manual therapy, and exercises to improve the strength and coordination of pelvic floor muscles. A trained therapist will use a gloved finger to assess and treat the pelvic floor muscles from inside the vagina or rectum. This therapy can also involve external exercises to supplement internal treatment.
Is internal pelvic floor physical therapy painful?
Internal pelvic floor physical therapy may cause mild discomfort or pressure during treatment, but it should not be painful. The therapist will work with the patient to ensure they are comfortable throughout the session. However, if an individual experiences pain or discomfort during treatment, they should inform their therapist immediately.
What conditions can internal pelvic floor physical therapy help with?
Internal pelvic floor physical therapy can help with a variety of conditions, including urinary incontinence, fecal incontinence, pelvic pain, sexual dysfunction, and pelvic organ prolapse. It can also aid in postpartum recovery and prevent future pelvic floor problems. Individuals with these conditions should consult with their healthcare provider to determine if internal pelvic floor physical therapy is right for them.
What should I expect during an internal pelvic floor physical therapy session?
During an internal pelvic floor physical therapy session, a trained therapist will insert a gloved finger into the patient’s vagina or rectum to assess and treat the pelvic floor muscles. The therapist may also use techniques such as biofeedback and external exercises to supplement internal treatment. The session may last 30-60 minutes, and the therapist will work with the patient to ensure they are comfortable throughout the session.
Who is a good candidate for internal pelvic floor physical therapy?
Individuals with pelvic floor dysfunction, such as urinary incontinence, fecal incontinence, pelvic pain, sexual dysfunction, and pelvic organ prolapse, may be good candidates for internal pelvic floor physical therapy. This therapy can also aid in postpartum recovery and prevent future pelvic floor problems. Individuals should consult with their healthcare provider to determine if internal pelvic floor physical therapy is right for them.