For pelvic floor issues, strength may only be part of the solution
If you find yourself leaking a bit of urine when you laugh, straining to have bowel movements, or unable to tolerate sexual intercourse or a gynecology exam, you might benefit from seeing a physical therapist.
These are signs of pelvic floor issues. Pelvic floor disorders are common, affecting more than half of all women at some point in their lives. They can cause urinary incontinence, pain, pressure, a heavy feeling known as prolapse, and sexual problems. The pelvic floor supports the bladder, uterus, and rectum. It also provides a base for the pelvis and spine.
Incontinence and pain with intercourse might not be the most comfortable topics to discuss, but physical therapists who specialize in pelvic floor health have these conversations every day and welcome a discussion with you. They are available to help you navigate information you may have heard in the media and find a solution that will work for you.
Programs and exercise tips online can be helpful tools; however, they are not personalized to your specific needs, and may not be instructed by trained experts in the area. They can also be expensive and difficult to do correctly without feedback.
“Having an assessment with a therapist can help ensure that what you're doing at home is the right thing for the condition or issue we believe you are experiencing and not just what you can see or hear on YouTube,” said Eric Preslaski, PT, system director of rehabilitation at M Health Fairview.
When you work with a licensed physical therapist, they can offer feedback to make sure you’re doing the exercise correctly and that it will help you. That way you aren’t spending time and money on something that might not benefit you.
Kegels aren’t the only answer to pelvic floor issues.
Kegels are an exercise that involves tightening and releasing the pelvic floor muscles. Those are the muscles that support the organs in your pelvis, like your bladder, vagina, and bowel. They are, for example, the muscles you’d use to stop the flow of urine. But doing dozens of Kegels each day might not solve your problem.
“The message out there is that you need to do Kegels and strengthen,” said Tan Scheraldi, PT, a physical therapist. “But it’s not just about power and strength. It’s about coordination and awareness. You also need to be able to fully relax that muscle for peeing and pooping.”
If your muscles are tight, you might have an incomplete bowel movement or some leakage. Often people think that means they need to strengthen, but sometimes it’s the opposite, Scheraldi said. Stress is a contributing factor. If your shoulders are tight, your pelvic floor might be as well. So relaxation is important.
Consider seeing a pelvic floor physical therapist – or mentioning your concerns to your primary care or women’s health provider. Going to the bathroom more than a dozen times a day to urinate or leaking a few drops of urine when laughing or sneezing is common, particularly after having a baby or going through hormonal changes like perimenopause. But it can also be prevented. Pelvic therapists are trained to understand pelvic issues that can happen through the lifespan. So if it’s bothersome, it might be worth getting checked out before it becomes a bigger issue.
The assessment usually starts with the therapist asking about your goals. Some women want to be able to sit through a baseball game or theater event without having to get up to use the bathroom. Others want to avoid irritation from constantly using pads or participate in activities like sports and running. Pelvic floor physical therapy can help with sexual health concerns, including decreased arousal, pain, and even difficulty with tampon insertion.
M Health Fairview offers pelvic health at 24 locations.
Physical therapists are trained to provide pelvic floor healthcare at 24 of our locations across the Twin Cities metro area. Pelvic floor care can help people of all genders with bowel, bladder, and sexual health issues.
