Frequently Asked Questions

Pelvic health pelvic floor therapy targets musculoskeletal dysfunctions in the pelvis, hips, abdomen, and neighboring joints. In addition, treatment may involve restoring posture, strengthening the core and hips, practicing relaxation and down-training techniques, and providing manual therapies to the internal and external muscles, such as myofascial release, scar tissue mobilization, and visceral mobilization. The ultimate objective of pelvic pelvic floor therapy is to optimize the length, function, and activation of these muscles, allowing for unrestricted participation in daily activities such as coughing, sneezing, and laughing without worry of unwanted loss of urine.

During the initial visit, we will review your medical history, birth history, bowel, bladder, and sexual function, and any other factors that could affect your function and ability to return to activities. Then, we will perform a physical exam of your orthopedic and pelvic floor muscles to identify contributing factors to your symptoms and develop your personalized treatment plan. An internal assessment may be recommended, but is never required at any visit.

Subsequent visits vary depending on the initial exam findings but typically include stretches, strengthening exercises, and educational information. For patients with vaginal, rectal, or lower abdominal pain, routine internal assessments are typically the most effective method of treatment, but external muscle groups may also benefit even if the diagnosis primarily involves internal muscles.

Typically, most patients require one visit every 1-2 weeks for a few weeks, and then they can decrease the frequency to every few weeks as they improve and become more comfortable with the exercises.

This approach provides enough time to work through the exercises and practice new strategies, preparing for the next set of exercises. If you have significant orthopedic aches and pains, it may be beneficial to schedule two visits per week until things are better managed. Then, we gradually decrease the frequency until you feel you have all the tools necessary to succeed and feel better overall.

Many individuals have tried Kegels in the past in efforts to relieve their symptoms without success. We have found that oftentimes Kegels are actually not what an individual needs to see results. In fact, if a person has an overactive pelvic floor (too much muscle tone and tension), Kegels can exacerbate symptoms and make things worse. Our pelvic floor therapists have extensive knowledge and understanding of how to assess what your individual needs are and develop a treatment plan specific for you. Many times, this treatment plan does not include Kegels and focuses on other factors such as managing intra-abdominal pressure, addressing postural imbalances, improving general strength, and regulating breath patterns.

After delivery, there is still work to be done as it takes time for the body to recover and adjust to a new normal. While some women may return to physical activity without issue, orthopedic issues that arose during pregnancy may not always resolve after delivery. Additionally, some women may experience new aches from the added stress of caring for a newborn. However, gentle stretches and exercises can often completely alleviate pain and discomfort.

Even if you have a cesarean delivery, your pelvic floor muscles are still affected by pregnancy. During pregnancy, these muscles have to support more weight from the baby and uterus, which places greater stress on them. Your posture changes significantly during pregnancy and this alters your muscle recruitment pattern.

However, after delivery, it is important to retrain and relearn how to properly use your muscles, focus on your posture, and regain strength. Additionally, if you had a cesarean delivery, your abdominal wall was cut, which can greatly impact the strength and recruitment of these muscles. Our pelvic floor therapists can guide you through your postpartum recovery, address and reduce pain and discomfort, and help you reach your fitness goals!

There is an array of symptoms that may occur. Pelvic health therapy can address the following, but is not limited to:

• Coccyx pain

• Constipation

• Diastasis Recti Abdominis

• General weakness following pregnancy

• Hip, low back, shoulder pain and/or headaches

• Vaginismus

• Nursing considerations

• Painful intercourse

• Pelvic Organ Prolapse

• Urinary / Fecal Incontinence

• Urinary Urgency / Frequency

• Vaginal pain or tightness

You can begin pelvic health pelvic floor therapy as soon as you feel ready. If you have orthopedic issues that are affecting your ability to care for your baby, it may be helpful to start sooner to address any limitations. However, for an internal pelvic floor assessment and treatment, it is best to wait until your six-week postpartum checkup to ensure proper healing. Before that, we can discuss various techniques and strategies to promote healing and improve bowel and bladder function, which are commonly affected after delivery.