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A closer look at pelvic floor physical therapy and the specialized care we provide to patients in Charleston and South Carolina.
How We Help:
What exactly do we do?
Pelvic Floor PT: What You Really Want to Know
- Extensive education about the pelvic floor, what is going on with your body and how you can be successful with pelvic floor physical therapy or if other treatments or providers are needed.
- Manual therapy techniques for tension, trigger points, stiffness, scar tissue and pain of muscles, joints, ligaments and nerves.
- Skilled techniques for internal and external pelvic floor muscles, dry needling, cupping, joint mobility and soft tissue manipulation.
- Nervous system regulation through education, manual therapy and lifestyle changes to enhance sleep and improve resiliency to stressful triggers.
- Coordination training for proper pelvic floor movement with functional activities
- Exercise prescription for strengthening & mobility
- Pain management techniques for persistent and cyclical pain
- Bladder and bowel re-training and scheduling
- Education, assistance and prescription for internal devices such as dilators, trigger point wands & weights.
- Pelvic organ prolapse assessments and pessary fittings
- Education and preparation for garments, support belts and more for pre/postpartum and pre/post operative care
The internal exam is the most common question and concern regarding pelvic floor PT. The goal of the "internal exam" is to assess the levator ani musculature, along with a few other muscles that live deep in the pelvis and can cause things like: painful bowel movements, tailbone pain, deep hip pain, dyspareunia (painful intercourse), bladder pain, genital pain and more. The muscles are assessed via the vagina or rectum with one finger. Our exams are unlike medical exams for OBGYN, prostate or rectal exams. We are assessing the muscle, fascia and tissue of the pelvic floor with a goal of confirming dysfunction that is causing your symptoms. We may also recommend treatment through internal manual therapy techniques if we find these muscles are the problem. An important note is that although we may highly recommend an internal exam, it is optional and never a reason to be afraid to come to pelvic floor PT!
What is an "internal exam/treatment"?
Absolutely not!
Fun Fact: "Kegel" is named after Dr. Arnold Kegel, an OBGYN who discovered that the pelvic floor muscles could contract voluntarily and help with urinary incontinence... in 1948.
We have evolved significantly since then with research about how the pelvic floor actually functions, how tissue quality can affect the pelvic floor, how the spine/hip/abdomen contribute to the pelvic floor, how the nervous system affects the pelvic floor, and more.
While some people do need strengthening, we know the pelvic floor does not work in isolation - kegels are not enough. We also know that the majority of people with pelvic floor dysfunction have overactive pelvic floor muscles and need strategies other than strengthening.
Isn't pelvic floor PT just Kegels?
This is why our first visit is so important!
We ask a lot of questions. We get very specific.
The more we know, the more we can make an educated hypothesis on what we believe is going on and how to tailor our assessments. The clearer we are on what to assess, the more efficient and beneficial your first visit is. We provide extensive education, especially if we recommend an internal exam at your first visit. In addition to the pelvic floor, we may also look at your spine, your hips, your abdomen, and your specific movement patterns. Every assessment we perform has a goal of giving you the best possible answer to why is this happening? What is going on? Is my pelvic floor the problem, and why?
From there, we can start our treatment prescription. No one receives a generic exercise handout. Every treatment is tailored to what we find at visit one, and tailored to your progress at subsequent visits.
How Do You Determine What I Need?
That does not necessarily mean that pelvic floor PT didn't work for you. It may mean that you haven't found the right approach yet.
For example - if you have chronically tight and painful muscles and only received hands on work, you may need to dig deeper into your nervous system, bladder/bowel strategies and looking outside of the pelvis for weaknesses causing the pelvic floor to be overactive.
Or the opposite scenario - you've only tried exercises for leakage, tailbone pain, etc. without an internal exam - you may be missing a huge piece to your treatment - sometimes it's tightness or referred pain that needs a whole body approach.
Don't give up just yet!
What if I already tried pelvic floor PT?
That is okay! We are here to help you uncover that answer.
If you are struggling to resolve leaks and stubborn pain - you don't need to figure it out on your own. Sometimes pelvic floor PT is the answer. And sometimes, we are part of your journey to finally get your questions answered and symptoms resolved for good.
