Pelvic Floor

What is the pelvic floor?

A group of muscles create the pelvic floor by extending from the pubic bone to the tailbone. These muscles help support the pelvic organs, maintain continence of the urine and stool, and maintain sexual function, among other things. In addition, many people who suffer from chronic back and hip pain may have an unresolved pelvic floor related dysfunction. Pelvic floor physical therapists aim to improve the function of the pelvic floor muscles through a comprehensive evaluation of the musculoskeletal system, posture, and movement.

Common diagnoses seen by a pelvic floor therapist

  • Anismus
  • Constipation
  • Diastasis Recti
  • Dyspareunia
  • Incontinence (Fecal, Mixed, Stress, Urinary)
  • Levator Ani Syndrome
  • Painful Episiotomy
  • Pelvic Organ Prolapse
  • Post Hysterectomy
  • Post-Prostatectomy Incontinence
  • Pregnancy-related Musculoskeletal Disorders
  • Pre/Post Pelvic Organ Prolapse Repair
  • Sacroiliac Joint Dysfunction
  • Vaginismus
  • Vulvodynia

However, it is important to recognize that almost everyone who has one or more of the above diagnoses, may suffer from other orthopedic and functional complications. Therefore, an experienced physical therapist in the field of orthopedic and pelvic floor is more qualified in providing care for these individuals.

What is biofeedback?

Certain equipment can be used to improve health and function by controlling certain bodily processes that normally happen involuntarily.  This information is used to modify or change abnormal responses to more normal patterns.  For the pelvic floor, increasing or decreasing muscle tone is the goal. Biofeedback along with a personalized exercise program has been shown to help greatly with different diagnoses such as fecal/urinary incontinence, constipation, pelvic pain and general conditions of core and pelvic floor disorders. However, the results vary from person to person.

 

Common biofeedback equipment

sEMG is a neuromuscular education tool that therapists can utilize to assess if the pelvic floor muscles are working correctly. It is a painless process that uses special external or internal sensors to measure the muscle activity by visual and sound graphs. This feedback helps both the therapist and the patient understand if there are any muscle tension, weakness or incoordination that need to be addressed.
Real-time ultrasound provided the traditional ultrasound images to assess the different layers of muscles while the patient actively contract and relax those muscles. It is also used to assess muscle activation when compared to the other side of the body. Real-time ultrasound can help to restore normal muscle function by giving immediate visual feedback.