Procedures

For a variety of reasons, women often seek pelvic floor physical therapy after birth as it comes highly recommended for its ability to improve a range of conditions. However, as awareness of its high efficacy in restoring normal functioning grows, many expectant mothers are wondering about the safety and potential benefits of getting this type of therapy during their pregnancy. Here is a look at what expectant mothers should know about pelvic floor therapy.

What Is Pelvic Floor Therapy?

Pelvic floor physical therapy is a type of treatment that follows the principles of physical therapy to safely recondition the pelvic floor muscles. These muscles work together with the corresponding ligaments and connective tissues to support pelvic organs, assist in bowel and bladder control, and contribute to sexual function. Because the tissues in the pelvic area are attached to the tailbone, sacrum and pelvis, they also impact posture and breathing.

Pelvic floor therapy is often recommended for issues such as chronic pelvic pain, pelvic organ prolapse, incontinence, difficulty with urination or bowel movement, endometriosis, and painful intercourse. Although many women’s first experience with pelvic floor therapy may come after giving birth, it is also highly suited to women with nonpregnancy-related issues. In fact, it can help some women avoid the need for surgery to correct pelvic organ prolapse, which is fairly common as women age.

Is Pelvic Floor Therapy Safe During Pregnancy?

Because this therapy involves moving the muscles of the pelvic floor, it is not unusual for women to wonder if it is a good idea during pregnancy as their baby is developing in the area or if the movements involved could put their baby at risk. Although pelvic floor physical therapy is indeed considered safe during pregnancy, patients should advise their therapist that they are pregnant beforehand so they can ensure they are carrying out appropriate exercises in a safe manner.

It is important to remain active throughout your pregnancy to keep up your strength and flexibility. While you should never overexert yourself, many exercises are not only safe but also recommended during pregnancy, and this includes many of the movements in pelvic floor therapy.

Moreover, pelvic floor therapy is under the careful guidance of trained professionals who can ensure you are using the correct form. Your physical therapist can show you safe movements, activities, and exercises that can help you during your pregnancy and give you advice on modifying them as your pregnancy progresses and your pelvic region must support an increasing amount of weight.

How Can Pelvic Floor Therapy Help During Pregnancy?

Pelvic floor therapy is very useful during pregnancy, and many of its greatest benefits are preventive in nature. It is normal to wonder how your body will recover from pregnancy and childbirth, and this therapy can be thought of as providing a helping hand toward a speedier recovery.

Maintaining Proper Posture

For example, pelvic floor therapy helps women learn and maintain the proper posture and techniques for daily living to prevent discomfort and injuries during pregnancy, such as lifting heavy objects safely and entering and exiting vehicles. It can prevent many of the issues women experience following birth, such as prolapse, urinary incontinence, and the abnormal abdominal separation known as diastasis recti.

Improving Sleep

It can also provide women with strategies and positions for getting a better night’s sleep, which will remain important throughout your pregnancy as well as in the first months with a newborn as you adjust to your new reality. Proper sleep plays an outsized role in mental and physical recovery after childbirth.

Strengthening Pelvic Floor Muscles

Perhaps the biggest benefit of this therapy, however, is its ability to strengthen the pelvic floor muscles, which experience great strain during pregnancy and childbirth. This helps your body to cope with the growing weight of your baby safely and comfortably. In addition, muscles that are fit and healthy before birth will heal quicker after birth.

Preventing Incontinence

When your pelvic floor muscles are weakened, you could leak urine when sneezing, coughing, or straining. Known as stress incontinence, this is not uncommon after pregnancy. Many women think it is just one of the side effects of childbirth that they have to get through, but pelvic floor exercises can help you minimize or avoid this inconvenient and sometimes embarrassing problem.

Reducing Pain

With pelvic floor physical therapy, it can also help to alleviate common types of pregnancy pain. For example, it can address and treat postural pain, pelvic pain, lower back pain, and hip pain. It also helps women prepare for labor by learning birthing positions and strategies for breathing and relaxing the pelvic floor.

Discuss Pelvic Floor Therapy With Women’s Healthcare Professionals

Whether you are planning to start a family, are currently pregnant, or have recently given birth, pelvic floor therapy offers an array of preventive and curative benefits. Get in touch with the women’s healthcare professionals at Raleigh Gynecology & Wellness today to find out if it is a viable solution for you.

Bringing a new baby into the world is often a time that is filled with excitement and joy. As you get settled in with your child and adjust to your growing household, however, you might also be dealing with some physical issues related to pregnancy and birth. It is all too easy to ignore problems like stress, incontinence, and pelvic pain or pass them off as a normal part of the process, but many women don’t realize that there is no need to suffer. An array of pregnancy and childbirth-related issues can be corrected with pelvic floor therapy after birth.

Pelvic floor therapy is a type of physical therapy aimed at strengthening the muscles of the pelvic floor. It can help to treat pelvic floor muscle weakness or tightness and the problems these conditions can cause. By returning the pelvic floor muscles to their normal strength and tone, your pelvic organs will gain sufficient support and you can enjoy normal sexual function, urination, and bowel movements.

Here is a look at some of the top reasons all new mothers should consider pelvic floor therapy.

It Can Address a Wide Range of Issues

Your body goes through a lot when you are pregnant and during childbirth, even if you ultimately get a C-section. Pelvic organ prolapse and urinary incontinence are some of the most common negative effects of childbirth, with vaginal delivery in particular linked to a higher chance of postpartum urinary issues and incontinence of flatulence and stool.

Pelvic muscles and tissues often weaken during pregnancy and are placed under considerable strain during childbirth. For vaginal deliveries, there is also the risk of perineal injury such as episiotomies and tears. Some women may even experience nerve damage that affects their pelvic organ support.

Postpartum pelvic floor issues are incredibly common, with many women experiencing severe pelvic floor muscle injuries following a normal pregnancy and delivery as well as urinary incontinence. All of these issues can be addressed with pelvic floor physical therapy after birth.

You Could Experience Ongoing Pain

Some women may experience pain for months and possibly even years after childbirth. This might include pain in the groin, vagina, tailbone, or at the site of an episiotomy, tear, or C-section scar. Pelvic pain can make it unpleasant to sit, walk, or stand, while vulvar pain can make it difficult to tolerate tight clothing and underwear. It is also worth noting that pelvic organ prolapse might not occur until several years after childbirth.

Therefore, it is a good idea to seek pelvic floor therapy after birth not only to treat any current unpleasant effects you are experiencing but as a preventive means of avoiding serious problems in the future.

It Can Help You Be a Better Mother

Although you may struggle to find time away from your new baby to attend therapy sessions, taking care of yourself is one of the best things you can do for your baby. Freeing yourself from the distraction and discomfort of postpartum pain, incontinence and other issues will allow you to focus on your child and be more present with them.

Signs You May Need Pelvic Floor Therapy

If you are experiencing any of the following symptoms after giving birth, get in touch with your gynecologist for help determining whether pelvic floor physical therapy could help.

• Pain in your perineum, which is the area of skin found between the vagina and the anus
• Urinary or bowel incontinence
• Pain or numbness in your pelvis, hips, spine, vulva, neck, tailbone, shoulders, legs, or arms
• Pelvic pressure
• Trouble releasing bowel movements
• Painful urination
• Urinary or bowel incontinence
• Hemorrhoids
• Chronic constipation
• Trouble walking or carrying out your normal activities
• Pain during sex
• Tight or weak muscles
• Difficulty inserting tampons
• Difficulty getting into or out of bed, chairs, or cars

What Is Involved in Pelvic Floor Physical Therapy?

Your pelvic floor physical therapist will create a customized treatment plan designed to address the specific issues you are facing. At your initial visit, you will discuss your symptoms with your therapist, and they will carry out external and internal exams to assess your condition.

Although treatment plans vary, your plan might include the following components.

Exercises

Your therapist will teach you how to perform exercises that can strengthen weak muscles or relax any tight or spastic muscles. They will help you to increase your core strength and function and instruct you on movements that you can carry out at home.

Manual Therapy

Your therapist may also massage your pelvis, thighs, buttocks, or the tissue in your vagina in order to gently stretch it and release any trigger points that could be causing you pain.

Other Treatments

Your therapist might choose to use hot and cold therapies or electrical stimulation to address your symptoms. They will also suggest other treatments, such as relaxation techniques, acupuncture or yoga, that could help you feel better.

Reach Out To Raleigh Gynecology & Wellness, PA

Reach out to the women’s healthcare team at Raleigh Gynecology & Wellness to set up an appointment to discuss your postpartum issues and find out how pelvic floor therapy can help.

One of the most effective and least invasive treatments for a broad range of issues related to the pelvic floor is pelvic floor physical therapy. If you have seen a doctor or researched treatments for problems such as urinary and fecal incontinence, pregnancy and postpartum issues, pelvic pain, constipation, frequent urination, or pain during intercourse, there is a good chance that pelvic floor therapy was discussed. What does this therapy involve, and does insurance normally cover it? Here’s what you need to know about pelvic floor therapy and insurance coverage.

What Is Pelvic Floor Therapy?

This treatment can help people restore normal functioning and enjoy a better quality of life by relieving pain, discomfort, and the inconvenience of problems like incontinence. It is carried out by physical therapists who have received specialized training in the evaluation and treatment of pelvic floor issues.

The pelvic floor includes the muscles that support your reproductive and urinary tracts and controls your bladder and bowels. The muscles of your pelvic floor attach to your tailbone and pubic bone, which means the effects of pelvic floor dysfunction may be felt elsewhere in your body as well.

Does Insurance Cover It?

Because optimum pelvic floor health can prevent or alleviate many common medical issues and avoid the need for expensive surgery in many cases, most insurance carriers do cover pelvic floor therapy. However, it is important to keep in mind that every plan is different. Therefore, patients should contact their insurance carrier to find out if it is covered or call a pelvic physical therapist they are considering to inquire about which types of insurance are accepted and what the out-of-pocket costs for treatment will be. Even if services are covered, some of the costs may come out of your deductible.

Even if your policy does cover pelvic floor physical therapy, you should be aware that like doctors and other specialists, not all physical therapists will be included in your plan. In addition, some pelvic floor physical therapists work in cash-only clinics that do not accept insurance, although some may provide an invoice for those who wish to seek reimbursement from their insurance carrier. It is best to clarify all of this up front so there are no surprises when it comes time to pay for treatment.

How Can I Get an Appointment With a Pelvic Physical Therapist?

A primary care provider, gynecologist, or nurse practitioner can provide a referral or prescription for pelvic physical therapy. Many times, they can recommend a therapist who they feel is trustworthy and offers effective care.

Referrals are normally sent from the provider to the therapist on behalf of the patient. In some cases, however, the provider may issue you a paper slip with a referral that you must bring to the physical therapy clinic when scheduling your first appointment.

In many states, direct access to pelvic floor physical therapists is permitted. This means patients are free to call the pelvic physical therapy clinic of their choice and ask for an evaluation without a prescription or referral from their doctor, although this could impact your insurance plan’s willingness to cover the treatment.

What Is Involved In Pelvic Physical Therapy?

At the first appointment with a pelvic physical therapist, they will evaluate your medical history and discuss your current symptoms and goals. They will ask questions related to any medical conditions that prompted your visit, your childbirth history, and whether you have difficulty with urination, bowel movements, intercourse, or other types of pain.

They will carry out a physical examination that examines your posture and functional capabilities, paying particular attention to your pelvis, spine, and hips and measuring your range of motion. They may also assess how you breathe. In some cases, they will need to carry out an internal vaginal or rectal exam so they can test the strength of your pelvic floor, look for tender points, and address scar tissue. Patients who are uncomfortable with this exam may choose to skip it, but you should be aware that allowing it will enable your therapist to devise the most effective treatment plan for quicker results.

Pelvic floor physical therapy may include some of the following techniques.

Exercises and Movements

Your physical therapist will recommend specific exercises that target and strengthen the muscles in your pelvic floor that need support. These may include toe taps, heel slides, and other movements, as well as diaphragmatic breathing and certain poses.

Kegels

Kegels are a popular type of exercise that can strengthen the pelvic floor muscles through relaxation and contraction. These exercises are useful for controlling incontinence and relieving pain during intercourse, and a physical therapist can show you the right way to perform these moves to get the most out of them and heal more quickly.

Electrical Stimulation

This technique can reduce muscle spasms and pelvic pain. It may be carried out by your physical therapist in their office, or you may be given special equipment and instructed how to use it at home.

Trigger Point Therapy

Trigger point therapy involves placing pressure on specific spots in the body known as trigger points to promote healing.

Contact the Pelvic Care Professionals

If you have any questions or concerns about your pelvic floor health or are experiencing any symptoms of pelvic floor dysfunction, get in touch with the women’s healthcare professionals at Raleigh Gynecology & Wellness to set up an appointment. The team can also assist with any insurance coverage questions.

If you are planning to begin pelvic physical therapy soon, you may be wondering what to expect. It is normal to be nervous ahead of your first appointment, but keep in mind that pelvic floor physical therapists are highly trained professionals who not only possess extensive experience helping people with pelvic conditions, but also the compassionate approach needed to help people through what can sometimes be an uncomfortable process.

Initial Assessment

The specific steps involved in this type of therapy depend on your condition. Your physical therapist will tailor each session to help you progress toward your goals. The first appointment will be devoted to assessing your condition so they can design an effective treatment plan to restore your mobility and reduce your pain.

During the exam, your physical therapist will be looking at your breathing patterns, posture, and the flexibility and strength of your spine, abdomen, and hips to determine what can be contributing to your issues.

Provide your therapist with as much information as possible about the symptoms you are experiencing and where you feel pain so they can best address your problem. Patients are encouraged to bring detailed notes to their sessions in addition to providing information about anything that alleviates or improves their pain. The therapist will also conduct a thorough review of your medical history.

Your therapist will ask you to move around so they can assess certain functions. Therefore, patients are advised to dress comfortably for each session. You will be asked to stand, sit, and walk to pinpoint potential issues in your joints, bones, and muscles that could be causing or contributing to your dysfunction or pain.

There will also be a physical examination, which may include an internal exam. Physical therapists are aware that this can be uncomfortable for some patients, so they carry out each step slowly and deliberately and inform you what they are doing at every moment.

Although you may pause the exam at any time or ask to skip it, it is recommended because it provides the therapist with valuable information that can help pinpoint the cause of your dysfunction or discomfort, which means they may be able to treat it more quickly so you can get back to normal sooner.

How Many Times Do You Have To Go?

Like all types of physical therapy, pelvic floor physical therapy is a journey. Although it is very effective, the types of problems that it addresses cannot be solved in just a session or two. The first session represents a big step toward full recovery, but patients should not expect to notice a big difference afterward.

The precise amount of time that it takes to heal varies depending on the issue being addressed. However, many patients will start to experience noticeable relief after six to eight one-hour sessions.

Treatment Approaches

Pelvic floor physical therapy relies on a variety of treatment tools, techniques, and exercises that will be selected by the therapist depending on the patient’s condition and treatment goals. Here is a look at some of the components that might be included.

Pelvic Floor Exercises

Also known as Kegel exercises, these movements strengthen the muscles in the pelvic floor by contracting and relaxing them. They are particularly suited to those with stress urinary incontinence, and they can also improve sexual pleasure and health by improving blood circulation to the vagina, relaxing vaginal muscles, and increasing lubrication.

Electrical Stimulation Therapy

This technique delivers painless electrical impulses through electrodes on the skin aimed at treating muscle spasms, pain, swelling, and weakness. It may also be carried out at home using a portable unit.

Biofeedback

Biofeedback is a common approach to retraining the muscles in the pelvic floor. It uses special sensors to monitor these muscles while you relax or clench them. The feedback that it provides to the therapist can point to which muscles need to be strengthened to improve control over your pelvic floor muscle functioning.

Relaxation Techniques

Many therapists will use relaxation techniques such as deep breathing, meditation, yoga, and acupuncture to help calm your mind and body. This can reduce your pain and emotional distress while also relieving certain other symptoms.

Weighted Vaginal Cones

Depending on your problem, your therapist may ask you to use cone-shaped devices of increasing weight that are inserted into the vagina and held in place with pelvic muscle contractions to help increase strength.

Is Pelvic Floor Physical Therapy Painful?

The goal of pelvic floor physical therapy is to improve symptoms, so your therapist will do their best to avoid causing you any pain. However, you may be asked to recreate positions that are currently causing you pain in your initial assessment. For example, if you feel pain in your lower back when you bend over, the therapist may want to see this movement to observe how your back is moving. However, these brief assessments should not aggravate symptoms or cause further pain.

Reach Out to Raleigh Gynecology & Wellness

To find out more about how to manage pelvic floor conditions such as prolapse, get in touch with the women’s healthcare professionals at Raleigh Gynecology & Wellness.

If you are experiencing pelvic organ prolapse, incontinence, or pelvic pain, your doctor may suggest pelvic floor physical therapy as a potential treatment.

The pelvic floor is a group of muscles that lines the pelvis and supports your pelvic organs, provides sexual function, and controls your bowel and bladder. Like all muscles, your pelvic floor can become weak or tight or lose motor control due to a wide variety of causes, and this can lead to pain and other health issues.

Pelvic floor physical therapy is devoted to evaluating and treating pelvic floor problems. It works in much the same way as traditional physical therapy for injuries to other muscles in the body and involves performing exercises and using other approaches to help restore normal functioning.

Top Signs of Problems That Can Be Alleviated With Pelvic Floor Physical Therapy

Here are some of the top signs that you may be experiencing a problem that pelvic floor physical therapy could help alleviate.

Urinary Leakage or Incontinence

One of the biggest signs that you may need pelvic floor therapy is leakage of urine with exertion. For example, if urine leaks in any amount when you sneeze, lift weights, cough, jump, or get up from a seated position, consult your doctor.

A Feeling of Heaviness or Something Falling From the Pelvis

If it sometimes feels as though something may be falling out of your pelvis or is not in the right place, you may need pelvic floor therapy. This may occur only with certain movements or it may be a constant sensation.

Frequent Urination

If you constantly need to use the bathroom and find yourself obsessively using the restroom before leaving the house or you awake frequently during the night to use the bathroom, it could indicate a pelvic floor problem that can be addressed by therapy.

Pelvic Pain

If you feel intermittent or constant pain in your pelvic region or pubic bone or you notice pain during gynecological exams when inserting tampons, or during sexual penetration, discuss your symptoms with your gynecologist.

Unresolved Lower Back or Hip Pain

If you have experienced lower back or hip pain in the past that was attributed to another cause but treatment was unsuccessful, the issue could stem from a pelvic floor issue that requires physical therapy to correct.

A Feeling of Incomplete Emptying

If you find yourself feeling as though you still have the urge to urinate even after recently emptying your bladder, this may indicate pelvic floor problems. Feeling a strong urge to urinate but being unable to empty the bladder is another sign.

Postpartum Issues

Pelvic floor scarring from tears during labor or an episiotomy, C-section scars, and diastasis recti are all common occurrences following labor and childbirth. Many women believe that these issues will go away on their own, but pelvic floor therapy can help to promote faster healing and prevent further complications from occurring.

What Should You Do If You Notice These Signs?

The first thing you should do if you are experiencing any of these signs is to make an appointment with your gynecologist to discuss them. They will review your symptoms and perform an exam to rule out other causes. Then, they will refer you to a pelvic floor physical therapist.

What Happens In Pelvic Floor Therapy?

At your first visit with your therapist, you will be asked to fill out questionnaires about your general health and pelvic floor symptoms to help your therapist understand your current condition and treatment goals.

Then, they will interview you and evaluate you with a physical exam to get a better idea of what is causing your problems and the most efficient approach to correcting them.

Your therapist will design an individualized exercise program that addresses your concerns. This often includes Kegel exercises, which can strengthen your pelvic floor and improve conditions such as prolapse and incontinence. You will learn the right way to perform these exercises and may be asked to do these at home.

You may also be asked to perform exercises aimed at improving your posture, hip flexibility, and back strength depending on the problems that you are experiencing. Biofeedback and other approaches might also be used.

How Long Does It Take to See Results?

The course of treatment varies by patient, but the average person will need around 8 to 16 hour-long sessions to restore normal functioning. If your condition is difficult to address, it may take additional sessions.

Therapists also teach patients the correct way to perform exercises and encourage them to do them on their own. This may mean that some women will need to continue performing certain movements after they have completed therapy.

Reach Out to the Women’s Healthcare Team

To discuss your symptoms and find out whether pelvic floor therapy can help, make an appointment with the experienced women’s healthcare team at Raleigh Gynecology & Wellness today.