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Although many centers are familiar with retraining techniques to improve pelvic floor dysfunction, few have the multidisciplinary expertise to teach patients with constipation how to appropriately coordinate abdominal and pelvic floor muscles during defecation, and how to use bowel management techniques, along with behavior modification, to relieve symptoms. Because pelvic floor dysfunction can be associated with psychological, sexual or physical abuse and other life stressors, psychological counseling is often included in the evaluation process.
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Get therapy. A women’s health physical therapist (WHPT) can diagnose and treat pelvic floor issues. They often perform manual therapy where the therapist gently massages, stretches and releases the spasms and trigger points in the deep tissue of your vagina. This, alone, can sometimes be enough to resolve symptoms of PFD, including urinary incontinence and pelvic pain. Some WHPTs partner with OB/GYNs, urologists, and other specialists. Your first session may include an internal exam to assess your pelvic floor. Then your therapist will create a program that is right for you. Women who have PFD and have practiced Kegels with little or no results typically benefit from seeing a WHPT. You can search the American Physical Therapy Association website for a licensed WHPT.
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.
With her finger inside me, Christensen mentioned that the three superficial pelvic floor muscles on each side were very tight and tensed when she touched them. I was too tight and in pain for her to check the deepest muscle (the obturator internus). Finally, she checked to see if I could do a Kegel or relax the muscles, and I was unable to do either.
