Pelvic Floor Therapy: When to Go & What to Expect

With SMH Outpatient Rehab Pelvic Floor Therapist Shayna Shefrin, DPT

Does any of this sound familiar?

• I’m going through 4 pads a day because I pee my pants every time I sneeze.
• It feels like my bladder is falling down and I’m peeing every 30 minutes.
• It hurts to have sex and I’ve tried lubricant but it’s not helping.
• I have this pain in my hips and lower abdomen that keeps coming back.
• I had a prostatectomy and now I have to wear adult diapers every day.

Chronic pelvic pain, incontinence, overactive bladder and/or sexual dysfunction due to problems with the muscles of the pelvic floor are not uncommon and can affect both men and women.

And these are all reasons to consider Pelvic Floor Physical Therapy, or PFPT.

What is Pelvic Floor Rehab?

Like all physical therapy, pelvic floor physical therapy involves working with and strengthening the body’s musculoskeletal system in order to improve function and relieve discomfort.

PFPT focuses on the muscles that relate to and help support bowel, bladder and sexual function. When these muscles weaken or are damaged, it can result in chronic pain, urinary leakage, fecal incontinence, pain during sex and even pelvic organ prolapse.

PFPT works to strengthen and rehabilitate these muscles, so that symptoms resolve. It can be practiced on its own, or incorporated into a larger treatment plan.

Your First Evaluation

The evaluation begins with a conversation, during which there will be a thorough rundown of both your current symptoms and your medical history. Topics such as diet and lifestyle will also be covered here.

“All of this information helps to develop an appropriate and individualized plan of care,” says Shefrin. “Pelvic floor physical therapy isn’t a ‘one size fits all’ approach.”

There will also be an anatomy lesson, during which the pelvic floor physical therapist explains how the muscles of the pelvic floor work and where they are located. 

“I use a 3-D model of a pelvis so patients can get an idea of what muscles will be assessed,” says Shefrin. “Since these pelvic floor muscles are impossible to see and hard to feel, it helps to have a visual of what we will be working with.”

When the physical exam begins, your strength, range of motion, posture and balance will then be evaluated. Each of these can inform the physical therapist as to possible avenues of symptom resolution.

But what makes pelvic floor physical therapy different from other forms of physical therapy is that some of the muscles are best accessed through an internal pelvic exam. This exam assesses muscle function and strength of muscle contractions, looking for any noticeable weakening, tightening or dysfunction. To conduct the exam, the physical therapist will insert one or two gloved fingers into the vagina and/or rectum to examine the muscles.

“But an internal pelvic exam will only be conducted if the patient has given consent and is comfortable with the process,” says Shefrin. “If it is beyond their comfort level, it is not necessary.” 

For women, the examination is done without stirrups or a speculum, but rather lying down with the knees bent. For men, the exam is typically done lying on the left side. 

Is Pelvic Floor Therapy Right For You?

Following your physical examination, the physical therapist will take those findings, as well as any pertinent information from the medical history and reported symptoms, and determine if PFPT is right for you.

To learn more about rehabilitation services at Sarasota Memorial Hospital, as well as available locations for outpatient rehab, click here.

More Resources

To learn more about pelvic floor physical therapy, follow the links below:

Relief For New & Pregnant Moms

Written by Sarasota Memorial copywriter Philip Lederer, MA, who crafts a variety of external communications for the healthcare system. SMH’s in-house wordsmith, Lederer earned his Master’s degree in Public Administration and Political Philosophy from Morehead State University, Ky, and dreams of electric sheep.