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Pelvic Floor Physical Therapy for Men and Women

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Paper Abstract

Bowel Dysfunction

While there can be many medical reasons for bowel disorders, physical therapists at Zion Physical Therapy are able to evaluate and treat the musculoskeletal components of bowel dysfunction. Physical therapy can be successful in identifying and treating musculoskeletal dysfunctions such as tightness or weakness in the abdomen, low back or pelvic floor musculature caused by IBS, constipation, and other bowel disorders.  Treatments such as myofascial release, biofeedback, trigger point release in the abdomen, back, gluteals, and pelvic floor, and neuromuscular re-education of these muscle groups can be very successful in minimizing and/or eliminating symptoms.

Your physical therapist will coordinate care with your gastroenterologist and dietician or nutritionist to address all aspects of bowel dysfunction.

Bowel symptoms/diagnoses:

Dyssynergia: failure of pelvic floor muscles to relax, sometimes with a paradoxical contraction of the pelvic floor muscles with defecation.

Bowel frequency, bowel urgency, bowel retention, and/or incomplete emptying

Constipation: May result from tight and/or weakened pelvic floor and abdominal musculature or due to incoordination of these muscles called “dyssynergia”

Rectal pain, low back pain, hip pain, stomach pain and/or abdominal pain

Rectal pressure or rectal spasm

Fecal incontinence: can be due to pelvic floor muscle weakness

Coccyx pain or a feeling of fullness in the rectum

Irritable bowel syndrome (IBS)

Levator ani syndrome

Anal fissure: A tear in the skin of the anal canal, commonly caused by overstretching of the tissue sometimes due to tight pelvic floor musculature and hard stool.

Treatments for bowel dysfunction include but are not limited to:

External and internal manual therapy if necessary

Patient education regarding pathology potential dietician consulting

Biofeedback for relaxation and/or strengthening training

Core strengthening

Strategies to complete elimination

Relaxation techniques

Diaphragmatic breathing

Therapeutic exercise

Trigger point release

Modalities as needed

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Sexual Dysfunction

Sexual Symptoms/Diagnoses In Women:

Dysparunia: Pain with initial penetration, deep penetration, thrusting. May be due to lack of lubrication, superficial vaginal scarring, vaginal adhesions, skin irritation, or levator ani muscle tenderness.

Levator Ani Syndrome: pain, pressure, or ache in the vagina, sacrum, coccyx, and/or rectum caused by abnormal tension in the levator ani muscles.

Vulvodynia: Vulvar discomfort characterized by burning, irritation, rawness, and inability to have penetration without pain.

Vaginismus: Inability to penetrate the vagina to due muscle spasm

Pubic Bone Pain

Sexual Symptoms Diagnosis in Men:

Inability to achieve or maintain an erection

Pain with ejaculation

Physical Therapy Treatments Include:

Manual therapy to pelvic floor muscles, hip, abdominal, low back muscle

Internal manual therapy if needed

Trigger point release

Biofeedback

Relaxation exercises

Bladder retraining

Strengthening exercises

Dilator training

Coordination with OB/GYN and/or other health professionals

Paper Abstract

Pre-natal Physical Therapy

The pregnancy term is divided into three trimesters and ranges between 37-40 weeks. Many physical changes occur as early as the first trimester.  For example, postural changes occur to accommodate the growing fetus/uterus, ligaments become more lax, hormone levels change (specifically Relaxin), the abdominal wall weakens, and the posterior core muscles or hip muscles may tighten.  These changes can all contribute to the symptoms listed below. Most physical symptoms experienced during pregnancy can be treated with physical therapy.

Pre-natal symptoms:

Pubic symphysis pain: May require an SI belt recommendation

Sciatica

Diastasis Recti: A separation that can occur of the rectus abdominus muscle away from midline. >2 cm separation is considered significant.

Pain in hips, pelvis

Lower back pain, SI joint pain and/or upper back pain

Trouble transitioning positions from sit to stand, lying down to sitting up, rolling in bed

Shortness of breath due to inability of diaphragm to descend all the way.

Postural evaluation and correction

Body mechanics evaluation and correction

Myofascial release

Deep tissue massage​

Stretching

Core strengthening

Physical Therapy Treatment Includes:

Our Services 

Urinary Dysfunction

Our treatments for urinary dysfunction are designed to help restore strength, bladder control, and improve overall bladder and pelvic health. 

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Bowel Dysfunction

Our physical therapy team specializes in treating bowel dysfunction, helping to restore normal bowel function. 

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Sexual Dysfunction

We provide individualized treatments to help you recover from issues such as low libido, erectile dysfunction, and pain during sex.

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Pre-Natal Physical Therapy

Services provided to help resolve pain and dysfunction related to the pregnancy period, while also preparing one for labor, delivery and what to expect in the postpartum period.

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Post Natal Physical Therapy

Services provided to help resolve pain and dysfunction from labor and vaginal or C-Section delivery. We focus on individual symptoms and goals, while helping you navigate taking care of an infant or child! 

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Abdominophrenic Dyssynergia

Treatment strategies both in office and through a home exercise program  to address the musculoskeletal causes of Abdominophrenic Dyssynergia. We also work with your other healthcare providers.

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Urinary Dysfunction

There can be many causes for urinary dysfunction. Once your doctor rules out any serious conditions with diagnostic testing, the physical therapists at Zion Physical Therapy focus on identifying and treating the musculoskeletal components (ie bone, joint, muscle, connective tissue and nerve) of your condition. In most of the bladder conditions listed, weakness and/or restrictions in the muscle tissue can occur, which can lead to irritation and trigger points (hyperactive areas of tight and shortened tissue). Physical therapy can help by identifying the areas of weakness and of decreased tissue flexibility, and by increasing awareness and strength of the muscles of the pelvic floor.

Urinary dysfunctions can include but are not limited to:

Urinary stress incontinence: Urine loss with activities that increase intra-abdominal pressure such as coughing, laughing, sneezing or exercising

Urinary urge incontinence: Urine loss due to a strong sudden urge to urinate.​

Mixed incontinence: Combination of stress and urge incontinence​

Pain in the urethra, bladder, low back, and/or pelvis.

Difficulty with initiating urination

Urinary frequency: Greater than 1 trip to the bathroom every 2-4 hours

Urinary urgency, hesitancy, retention and/or incomplete emptying

Nocturia- nighttime urinary frequency: More than 1 trip to the bathroom per night

Weak urine stream and/or a stream that stops and starts

Overactive bladder

Burning sensation with urination (urinary tract infection symptoms)

Functional incontinence: Incontinence that happens with activities of daily living, ie lifting, squatting, walking etc.

Treatments for urinary dysfunction include but are not limited to:

Manual therapy both external and internal if necessary

Biofeedback to promote relaxation or strengthening

Releasing abdominal/visceral restrictions​

Therapeutic exercise

Relaxation training

Core Strengthening

Re-educating the muscles to contract at appropriate times

Bladder Retraining

Trigger point release

Patient education regarding bladder irritants

Modalities (ie. Heat, ice packs, Electrical stimulation or US) if necessary

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Post-natal Physical Therapy

After childbirth, women may experience changes that may not have been present before the pregnancy.  Whether delivery was a Cesarean section or vaginal birth, most women can benefit from some post natal physical therapy following delivery. Along with teaching the best postures and body mechanics for feeding, lifting and carrying your new baby, therapists at Zion Physical Therapy can address these issues:

Post-natal Symptoms

Low back pain​

Pelvic pain

Hip pain

Sacroiliac joint pain

Pain with intercourse​

Urinary or fecal incontinence secondary to pelvic floor weakness​

Scarring after C-section, episiotomy or perineal tear​

Diastasis recti (Abdominal separation)​

Prolapse​

Abdominal muscle weakness

Post-natal Physical Therapy Treatment Includes:

Soft tissue mobilization

Myofascial release