Pelvic health physical therapy can alleviate pain and improve the strength and function of pelvic floor muscles — enhancing quality of life, hygiene, safety and independence.

Sometimes therapy is all that’s needed to address pelvic-health-related conditions such as bladder or bowel control, stool or urine leakage, pelvic pain or pain during intercourse.

Physical therapy can be a first step for a patient prior to a referral to urogynecology.

No evaluation is required from a urogynecologist to attend pelvic health physical therapy, although a primary care physician or other health care provider’s referral is required.

Like any other muscle group, pelvic floor muscles can become overstretched or too tight, which can lead to pain and dysfunction.

Norton Specialty Rehabilitation Center – St. Matthews offers education and pelvic health physical therapy for all ages and gender identities. Patients who come to us receive a comprehensive assessment and are treated with a personalized plan to address their needs.

Patients typically come in once a week for a 60-minute session. They also receive homework —three or fewer exercises they can do daily. We also can offer therapy through Norton Telehealth when appropriate.

Our job is to make patients’ lives easier. We want to get them where they want to be. There’s no need for these patients to suffer in silence. In many cases, therapy can bring a sense of independence and confidence, which truly can be life-changing.

Usually with physical therapy, we see improvements fairly quickly. If we’re not seeing improvement in four to six weeks, then we need a change in plan of attack.

Pelvic health physical therapy-treatable conditions

• Back or abdominal pain
• Prolapse issues
• Nocturia
• Stress incontinence
• Urinary urgency/frequency
• Constipation
• Dyssynergic defecation
• Outlet dysfunction
• Conditions related to pregnancy and childbirth
• Postpartum weakness and diastasis rectus abdominis
• Prostatitis associated pain
• Post-prostatectomy pain or incontinence
• Some cases of erectile dysfunction
• Post-prostatectomy issues including pain and incontinence
• Enuresis in adults and children
• Constipation
• Neurological or orthopedic-related issues including but not limited to tethered cord, hypotonia, cerebral palsy

We also see patients with piriformis syndrome, sciatica and orthopedic conditions related to pelvic dysfunction.

In addition to traditional pelvic health physical therapy, we are trained in modalities and assistive device applications that can help. These include:

Dilator training

This therapy involves a tampon-shaped device patients can use to practice relaxing their pelvic floor muscles. Over time, the size of the dilator is increased.

Biofeedback

Visual and auditory stimuli lets patients know how well they are relaxing and squeezing.

Transdermal electrical nerve stimulation (TENS)

Simultaneous stimulus inputs to larger myelinated nerve fibers can block pain. TENS can also assist in treating constipation, urinary retention, and urinary urgency through neuromodulation.

Dry needling or trigger point needling

This technique uses monofilament needles to deactivate myofascial trigger points which contribute to pain, tension, and dysfunctional neuromuscular complexes.  By normalizing the resting state and promoting efficiency in muscle activity, we can decrease pain, improve mobility, and reduce symptoms including pain, urinary urgency, outlet dysfunction, and decrease compensatory movement patterns that can contribute to dysfunction.

Ultrasound for mastitis

By warming and eliciting cavitation in the soft tissues, ultrasound can help open milk ducts, reducing pain and swelling.

Lindsey Adler, P.T., DPT, CLT, WCS, is a physical therapist with Norton Specialty Rehabilitation Center – St. Matthews.