During the internal exam, your physical therapist will place a gloved finger into your vagina or rectum to assess the tone, strength, and irritability of your pelvic floor muscles and tissues. Internal exams and internal treatment are invaluable tools that are taught to pelvic floor physical therapists. It can tell us if there are trigger points (painful spots, with a referral pattern or local); muscle/tissue shortening; nerve irritation and/or bony malalignment that could be causing your pain directly or inhibiting the full function of your pelvic floor muscles. We can also determine if your pelvic floor has good coordination during the exam. A pelvic floor without good coordination, may not open and close appropriately for activities such as going to the bathroom, supporting our pelvis and trunk, sexual activity, and keeping us continent.
Thank you Dr. Northrup for sharing great information about pelvic floor dysfunction. I am a physical therapist and board-certified women’s clinical specialist. I’ve been practicing pelvic physical therapy since 1999. Over the years I have realized that we as women to not have basic information to take care of our bodies and never discuss the ‘secret’ pelvic area. I have such a passion for bringing this information forward that I wrote a book Pelvic Zone Coach, Every Wonan’s Guide To Pelvic Health and Sexual Vitality (available on Amazon).
Practice yoga or Pilates. My Pilates teacher has had countless clients over the years who have healed their urinary incontinence in a few months after starting classical Pilates. And, many pelvic floor physical therapists use Pilates reformers as part of their practices. Both Pilates and yoga can help strengthen your core, which helps improve pelvic floor strength. Pilates targets the deep core and helps you develop both strength and flexibility. You can try a Pilates mat class or seek out an instructor who is well-versed in using the equipment. In yoga class you can practice your root lock, or mula bandha, to target your pelvic floor.
Joint mobilization is a common and favorite tool of most orthopedic physical therapists. We love it so much because it can have so many different benefits depending on the type of technique used. Maitland describes types of joint mobilization on a scale between 1 and 5. Grade 1 and 2 mobilizations are applied to a joint to help to lessen pain and spasm. These types of mobilizations are typically used when a patient is in a lot of pain and to help break the pain cycle. On a non-painful joint, grade 3, 4, and 5 (grade 5 requires post graduate training) mobilizations can be used to help restore full range of motion. By restoring full range of motion within a restricted joint, it is possible to lessen the burden on that and surrounding joints, thereby alleviating pain and improving function.