Q: Why would I need physical therapy for the pelvis?

The pelvic floor is made up of multiple muscles and supporting tendons. They act like a hammock or trampoline to support a number of vital organs: the bladder and urethra, uterus and vagina, and rectum and anus, to name a few. It's a very unique area of the body, involving organs that play a role in varied and important functions: urination, defecation, sex, and childbirth.

Many things can disrupt the proper function of the pelvic floor; childbirth, natural aging, and menopause are common. Surgery can have an immediate effect. Sexual trauma may result in damage, and so can actions as simple as lifting or coughing. Symptoms of the pelvic floor not behaving properly might be urinary incontinence (involuntary loss of urine), painful sex, or constipation or difficulty moving bowels. Pelvic organ prolapse can cause or exacerbate some of those symptoms; that's when one or more of the organs resting on the pelvic floor sag into one another.

A discussion with your provider about your symptoms, accompanied by a good pelvic exam, can help in determining whether pelvic physical therapy is likely to help your condition. To get the best outcome it is best to find someone who specializes in this area of the body. A great pelvic physical therapist can work magic!

A common reason for referring to physical therapy is urinary incontinence. As part of treatment, physical therapists use electrical muscle stimulation, employing devices that stimulate the muscles of the pelvic floor to teach them to properly contract and relax. Several of these devices recently became available for home use. In addition to increasing continence, Intensity also treats orgasmic dysfunction (difficulty achieving orgasm). It works in two ways: providing electrical stimulation to the pelvic muscles (you increase the stimulation as the muscles get stronger) and offering a very intense vibration that improves the ability to orgasm. Orgasm is, after all, a series of very intense muscle contractions; as the muscles grow stronger, you improve orgasm. So far my patients have given Intensity two thumbs up! Other, lower-tech options to improve pelvic floor muscle function are vaginal weights and barbells.