What does a pelvic PT actually do?

I was recently on a run with some friends and we were talking about pelvic floor PT and the recent launch of my practice in Syracuse. After sharing a little about the business, one of my friends ventured to ask, “So what exactly is pelvic floor PT? What does a pelvic floor physical therapist actually do?” These questions helped remind me that most people probably don’t have a good sense of what exactly a pelvic floor PT does or what types of conditions we treat! 

A pelvic floor physical therapist has sought additional training beyond her Doctorate in Physical Therapy to specifically learn more about the anatomy and function of the pelvic floor muscles and how to perform an internal assessment of this very important muscle group. A big difference between an examination performed by a pelvic floor PT vs. one performed at your OB or gynecologist is that we focus primarily on evaluating the condition of the pelvic floor muscles instead of the pelvic organs. 

A pelvic floor PT will evaluate your ability to turn these muscles on and off, their strength, endurance, how the pelvic floor is coordinating with your diaphragm (breathing muscle), and how these muscles are working as part of the core stabilization team. The actual internal portion of the exam itself is typically more comfortable than a pelvic exam at the gynecologist as it does not involve the use of any stirrups or a speculum. 

The types of conditions that a pelvic floor PT evaluates and treats can include a wide variety of symptoms and diagnoses. Some of these include:

• Stress urinary incontinence (leakage)
  
• Urge urinary incontinence
  
• Urinary urgency or overactive bladder
  
• Interstitial cystitis
  
• Painful urination
  
• Bladder, vaginal, uterine or rectal prolapse
  
• Post-op hysterectomy or pelvic organ surgery
  
• Postpartum pelvic floor weakness
  
• Pelvic pain during pregnancy
  
• Constipation 
  
• Pain with sex (dyspareunia)
  
• Vaginismus
  
• Vulvodynia 
  
• Low back pain
  
• Deep buttock or hip pain
  
• Sciatica
  

Some signs that you may benefit from a consultation with a pelvic floor physical therapist include:

• You leak urine when you cough, sneeze, laugh, or exercise
  
• You have a sudden urge to go to the bathroom that is difficult to control
  
• You are waking up more than once a night to go to the bathroom
  
• You find yourself going to the bathroom “just in case”
  
• You plan your shopping trips and driving routes based on the nearest bathroom
  
• You have pelvic, hip, buttock, or low back pain
  
• You have pain during sex, a pelvic exam, or with tampon use
  
• You have a heaviness or bulging feeling in your vagina
  
• You have delivered a baby via vaginal birth or Cesarean
  
• You have had a pelvic organ surgery
  
• You just want to know more about your body, your core, and the state of the muscles “down there”!
  

As you can see, there are many different conditions and symptoms that can result from or contribute to an issue with the pelvic floor muscles being overly tight, overly weak, or just not coordinating to turn on or off at the right time. It is my job as a pelvic floor physical therapist to discover the WHY behind your pain and get to the bottom of what is truly causing your symptoms. 

I love that I am able to help women solve problems that they were told they would “just have to live with” for the rest of their lives! It is truly amazing work and I am so grateful to be able to spread awareness to women about pelvic floor physical therapy as an alternative option to living with chronic pain or leakage, medications, and surgery. Please help spread the word to the women in your life and reach out to a pelvic floor PT in your area if you can relate to any of the conditions or symptoms listed above!