From celebrities to Cosmopolitan magazine, it seems like everyone is starting to talk about the benefits of doing "pelvic floor exercises". Many times, these sources are talking about doing Kegels, or voluntary, repetitive contractions of the pelvic floor muscles. Just because people are talking about how "everyone" should be doing pelvic floor exercises, does that mean that you should be too? Is there such a thing as too tight of a pelvic floor?

In short, yes! Just as any other muscle in the body can get, or feel tight, your pelvic floor is no different. However, because the pelvic floor plays a crucial role in continence, sexual intercourse and support to our organs, tightness in the pelvic floor can have significant effects on bowel, bladder, sexual function and pain. 

When we are talking about evacuating our bowels or bladder, or during penetrative intercourse, our pelvic floor must relax. Failure of these muscles to relax can result in constipation, urine retention, painful intercourse and orthopedic conditions such as lower back pain and tailbone pain.  Therefore, for patients struggling with these symptoms, the ability to relax the pelvic floor plays a much more significant role than its ability to contract. 

Want to find out more information about how to relax your pelvic floor? Call us!

Real-time ultrasound (RTUS) is starting to become more popular in physical therapy clinics as a means to assess how muscles contract and relax.  RTUS helps identify whether a patient is activating the correct muscle during an exercise.

With RTUS, the therapist places a probe on the area of assessment and the probe connects to a computer which then displays an image. The image displayed shows the many layers of muscles and surrounding tissues in real time. As the patient activates their muscles, the image will show which muscle layer is contracting. 

As pelvic floor physical therapists, we look to visualize the layers of the core, back and pelvic floor- all which can be assessed with the probe placed on the abdomen. We utilize RTUS to visualize the many layers of muscles to ensure that patients are activating muscles correctly and avoiding compensations which could be putting too much stress on the pelvic floor and surrounding tissues. 

When a patient is compensating, the image shown will display an activation pattern that results in increased pressure and bearing down on the pelvic floor. By seeing the muscles in real time, patients are able to use a visual cue to allow the to have a deeper connection with their body.

We use RTUS to teach patients how to recruit their core and pelvic floor properly and then apply that during challenging and functional exercises. By applying a proper core and pelvic floor contraction to exercise, we are able to assist patients with improving their symptoms during real movements and functions. 

Want to learn more about how real time ultrasound can help you? Call us!

The pelvic floor is a group of muscles and ligaments that line the bottom of the pelvis and give support to the organs above. When you are sitting down, the tissue that you are sitting on is the pelvic floor. Regardless of age or gender, you have a pelvic floor (it is a common misconception that females are the only ones who have a pelvic floor).

The pelvic floor supports and provides structure to the external genitalia and is heavily controlled by our nervous system (hence why symptoms can be worse when you are stressed). The pelvic floor muscles sit like a hammock and start at the pubic bone in the front to the tailbone and sacrum in the back and have both voluntary control (meaning you can contract and relax the muscles) and involuntary control (meaning your body can contract the muscles without your control) . There are 3 layers of muscles that sit in the pelvic floor and they help provide sphincteric control to the bladder and bowels, aid in sexual function, help support the organs from above and help stabilize our pelvis during movements such as walking.

When the pelvic floor is not working properly, you can experience:

• Bladder symptoms such as pain with urination, urine retention, urine leakage, and overactive bladder
  
• Bowel symptoms such as constipation, fecal urgency, fecal incontinence, pain with bowel movements, hemorrhoids and fissures
• Sexual symptoms: such as inability to orgasm, pain with intercourse, erectile dysfunction (in males)
  
• Orthopedic symptoms: such as hip pain, back pain and pelvic pain
  

Pelvic floor therapy is therapy performed by a licensed physical therapist or occupational therapist and is targeted at improving function of the pelvic floor muscles in order to abolish the symptoms listed above. Just as if you were to get physical therapy after having knee surgery or a knee injury, pelvic floor therapy helps to rehabilitate the pelvic floor after surgery, childbirth or injury to the pelvis or pelvic floor.

The goal of pelvic floor therapy is to allow patients to fully recover from symptoms of  pelvic floor therapy and thus allow patients to be as active as possible without worrying about their symptoms. Treatment should be dynamic and help coordinate how the pelvic floor functions not only in isolation, but also how the pelvic floor works with the rest of the body. This is the key to improving your symptoms long term!

So how do you know if you would benefit from pelvic floor therapy? The symptoms noted above are very common after surgery, pregnancy, with hormone changes and after trauma. However these symptoms are never normal. Therefore, if you struggle with any of the listed symptoms. Please call us at (267)685-6368 and we would be happy to help you. Not local? Call us anyway, we have a large network of likeminded clinicians and would be able to find someone that can!

Pelvic floor therapy is gaining popularity and rightfully so! Even as little as five years ago it wasn't nearly as popular as it is today. Pelvic floor therapists specialize in improving the function of the bowel, bladder and reproductive systems. Patients with concerns in these areas will tell you how life changing pelvic floor dysfunction can be.

With more awareness to dysfunction in the pelvic floor comes more professionals wanting to get trained in therapy to the pelvic floor. Sometimes physician offices offer "pelvic floor therapy" or "pelvic floor training". While it is wonderful that there are many professions getting on board with the benefits of pelvic floor therapy, it is important to note that not all therapy to the pelvic floor is created equal. 

So what should you look for in a pelvic floor therapist?

• Someone with a rehabilitation background: A licensed physical therapist (PT) or occupational therapist (OT) are licensed rehabilitation therapists that  have a background in rehabilitating conditions of the pelvic floor and will be able to help teach you how to use your pelvic floor during function.
• Someone that assesses how the pelvic floor is functioning with the whole body: The pelvic floor doesn't work in isolation, but rather works with other areas of the body. Therefore it is important that your therapist assess how the pelvic floor is working with the rest of the body.
• Treatment that will consist of more than Kegels with biofeedback: Kegels are repetitive contractions of the pelvic floor. Biofeedback is a computer used to assist patients with awareness to the pelvic floor. However, piggybacking off our last point, ensuring that your provider addresses how you pelvic floor functions with the rest of your body is the key to success. Only working on training a pelvic floor contraction will have little carryover to improving your symptoms. 
• Someone who focuses their career on rehabilitating pelvic floor conditions: A specialist is key when it comes to pelvic floor rehab. You want a PT or OT that focuses their practice to diagnoses affecting the pelvic floor. This means that all of their training and continuing education is focused on the pelvic floor. This ensures that you are getting a therapist that is well versed in your condition, is up to date with research and who has diverse training in the latest techniques for rehabilitating the pelvic floor.  
• Someone who has taken more than 1 pelvic health course: Many pelvic floor therapy practices require therapists that have taken 1 pelvic health course in order to start seeing patients with pelvic floor concerns. At Vivid, our therapists have taken eight courses before seeing a single patient. 
• Someone who will see you for an hour with treatment consisting of hands on treatment: You want to be your therapist's only patient during your treatment time. This means that all of your needs will be addressed and you therapist will have ample time to work on all of your concerns. 

We hope that you find this information helpful! Any questions? Reach out to our team at (267)685-6368.