What is pelvic floor rehabilitation?
Often referred to as pelvic floor physiotherapy, pelvic floor rehabilitation is becoming more established as a first-line of treatment against incontinence and pelvic pain. The pelvic floor muscles must be able to contract to maintain continence and relax to allow for urination, bowel movements, and in women, sexual intercourse. Pelvic floor dysfunction can be caused by:
- Weak pelvic floor muscles: this can contribute to stress incontinence, urge incontinence, and pelvic organ prolapse. Though it is a common occurrence, incontinence is NOT a normal part of aging.
- Tight pelvic floor muscles: this can contribute to urinary and fecal urgency, urge incontinence, chronic pelvic pain, dyspareunia, vaginismus, vulvodynia, pudendal neuralgia, and interstitial cystitis.
The Cochrane Collaboration 2010 concluded that physiotherapists with specialized training in pelvic floor rehabilitation (using internal examination to teach the exercises) should be the first line of defence, before surgical consultation, for stress, urge, and mixed incontinence in women. Pelvic floor dysfunction is diagnosed by specially trained doctors and physiotherapists by using internal and external “hands-on” or manual techniques to evaluate the function of the pelvic floor muscles. They will also assess the ability to contract and relax these muscles. Posture and muscles of the lower back, hips, and sacroiliac joints will be assessed as well since these joints can affect your pelvic floor muscles. Approaches may include behavioral strategies, manual therapies, therapeutic exercise, education, and functional re-training.
When is pelvic floor rehabilitation indicated?
The pelvic floor muscles may be involved and should be assessed in women with concerns of incontinence (stress, urge, or mixed) or voiding dysfunction, pelvic pain (e.g., lumbar, SI joint, vulvodynia, vaginismus), prolapse, sexual dysfunction (e.g., pain with intercourse). Pelvic floor rehabilitation may also be used preventatively in the postpartum period for prevention of the above concerns.
How are the pelvic floor muscles assessed?
The pelvic floor muscles will be examined through visual inspection and internal manual exam techniques to assess tender points as well as the patient’s ability to contract, relax, and bear down.
Dr. Michelle Payne, ND is accepting new patients for this therapy.
