Nerves, organs, and joints can lose their natural mobility over time and cause a whole host of symptoms from pain, to loss of range of motion, and poor functioning of the bodily symptoms. Skilled and specialized therapists can use a variety of active techniques (patient assisted) and passive techniques to free up restrictions in these tissues and organs and improve overall function.
“I would recommend that people call the facility and maybe schedule the first appointment and see how you feel about it. I also think patient support groups tend to have closed Facebook groups and they can recommend people in certain geographical areas. I know people call [our practice] a lot and we try and get them paired up with somebody we trust in their area,” Prendergast says.
Stop sucking in your gut. Sucking in your gut does not create core strength and can actually increase downward pressure on your pelvic floor. This creates a strain on the connective tissue in your abdomen by displacing your abdominal viscera. Many people hold in their bellies without knowing it. If you do this, try to consciously relax your belly while sitting, lying down, or in a cat/cow position on your hands and knees while taking deep, relaxing breaths. And pretend you are a dog or cat with your tail out—not tucked under you. Do this several times per day.
Once we determine the cause of our patient’s pelvic floor dysfunction, we design a plan tailored to the patient’s needs. At Beyond Basics, we have a diverse crew of physical therapists who bring their own training and background into each treatment. What is really beautiful about that, is that all teach and help each other grow as practitioners. It will be difficult to go over every single type of treatment in one blog post, but we will review some of the main staples of pelvic floor rehab.
Surface electrodes (self-adhesive pads placed on your skin) can test your pelvic muscle control. This might be an option if you don’t want an internal exam. The electrodes are placed on the perineum (the area between the vagina and rectum in women, and between the testicles and rectum in men) or on the sacrum (the triangular bone at the base of your spine). This test is not painful.
Exercise. There are a number of exercises you can do at home or at the gym to help strengthen your pelvic floor. Some of the best exercises include bridge pose, wall squats, jumping jacks, and dead bug crunch. For instructions on how to do these exercises, ask a knowledgeable trainer. You can also search online for video instructions. I also recommend that you Google Katy Bowman, who has many good resources for pelvic floor exercises.
But while “vaginal massage” is a general, nonspecific term, it may be used to treat the musculoskeletal system of the pelvic floor, notes Dr. Huang. Sometimes this may be internally through the vagina or anus, though the target isn’t the vagina itself, but rather the muscles. “Some muscles, like hip rotator and pelvic floor muscles, are better accessed internally,” she says. (Imbalances in other muscles like those found in the abdominal wall or hip girdle are best treated from the outside.)
Some pelvic floor physical therapists may have the opportunity of getting a lot of time to speak one-on-one with a patient to determine possible causes of his or her symptoms, educate the patient and to guide them to other practitioners who may optimize their physical therapy results if necessary. We truly can find out so much by just listening to what our patients have to say. A fall, or infection can be significant as well as a patient’s feelings and knowledge about their current condition.
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.