Pelvic Floor Therapy: How Pain, Leaking, & Discomfort Can Be Treated

Thanks to our partners at Apex Physical Therapy & Wellness for sponsoring this article!

“Pelvic what? What is Pelvic Floor Therapy?”

If you are asking yourself this question, you aren’t alone!

Pelvic floor awareness has increased with the help of social media platforms like Instagram and Tik Tok. Within the last six months, I’ve had patients seek pelvic floor therapy due to a Tik Tok video, a podcast they heard, and several patients request advice on postpartum core training thanks to some internet searching they did

So, we know there’s just so much information out there, but where do you start when you have concerns about your pelvic floor?  

Pelvic floor conditions usually fall into one of two categories—hypertonicity (over-active muscles) or hypotonicity (under-active muscles).  BOTH of these conditions are usually associated with weak muscles and BOTH of these conditions can lead to urinary incontinence. However, treatment differs for both! The difference between these two conditions has contributed to consumer confusion over the question of “to kegel or not to kegel.”pelvic floor therapy fargo

And the answer is….it depends! 

While sharing knowledge online is helpful in bringing awareness to pelvic floor issues,  it leads women to self-diagnose or self-treat without having input from a professional (in other words, a certified Women’s Health Physical Therapist!). Without the proper assessment and evaluation from a skilled physical therapist, one can get led down a frustrating road – working harder and harder, yet not seeing results. 

A pelvic health physical therapist is skilled in the evaluation and assessment of the pelvic floor. Part of that assessment process is to determine which of these categories (hypertonicity or hypotonicity) their patient may fall into. We do this by examining the muscles and tissues and checking on multiple things.

Firstly, we have the patient attempt a pelvic floor contraction (also known as a kegel) and assess for strength, endurance, and the ability to relax and/or bear down (think of trying to pass gas or have a bowel movement!). With a professional assessment plus patient feedback, physical therapists can determine where we need to focus our treatment. 

Common Pelvic Floor Symptoms or Complaints

Hypertonicity (Over Active Muscles)

  • Low back, pelvic, or hip pain
  • Urinary retention, urge, and/or incontinence (leaking)
  • Pain during intercourse
  • Constipation
  • Lower abdominal pain

Hypotonicity (Under Active Muscles)

  • Stress incontinence (leaking after laughing, sneezing, jumping, etc.) 
  • Fecal incontinence
  • Feelings of a pressure or bulge at vagina and/or rectum
  • Weakness
  • Instability

For someone with an overactive pelvic floor, it will likely not be beneficial to start treatment with kegels. The pelvic floor is already shortened, tight, and not relaxing. Kegels could in fact exacerbate pain levels and lead to further dysfunction. It is more important to calm or relax the pelvic floor—which can be tricky.

Finding the why behind the over-activity will help guide the treatment. Do you have a lot of stress or anxiety? Do you have a history of abuse or trauma? What was your labor and delivery like? Unfortunately, it’s not always a straight road to healing. Each patient is unique, with their own personal and medical history. Therefore, each treatment plan is individualized to meet their specific needs.  

While watching a video or Tik Tok can help us discover issues like pelvic floor muscles, it cannot replace a personalized plan of care from a physical therapist. This is not to say that all the information on the internet is wrong! I follow a lot of these platforms and enjoy seeing tips and tricks from other therapists and professionals. There is actually a lot of GOOD information out there!

apex physical therapy

So, the key is the ability to decipher the good from the bad, along with determining what is best for you. That is where a pelvic floor therapy can help!

The physical therapists at Apex Physical Therapy & Wellness are specially trained to help you! Visit them on their Website, Facebook page, or Instagram to find out more or schedule an appointment.

About the Author

pelvic floor therapy

Danielle Anderson PT, DPT, WCS is a graduate from Florida International University Physical Therapy Program.

Danielle has experience treating a variety of orthopedic and sports injuries, with a special interest in female athletics. She is one of three women’s health physical therapists at Apex Physical Therapy & Wellness, treating conditions such as incontinence and pelvic pain. Danielle has additional training in post breast cancer rehabilitation, including the treatment of axillary web syndrome, upper quarter soft tissue dysfunction, and postural and scapular dysfunction.

Danielle and her husband, Nick enjoy spending time with family, either at the lake in Minnesota or with her family in Florida. She also volunteers with Girls on The Run for two seasons each year. In her spare time she enjoys reading, running, playing softball, and being outdoors (in the summer!).

Dani treats patients at the Apex Physical Therapy West Fargo location. She can be reached at [email protected].

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