The term pelvic floor describes the muscles at the base of your pelvis (the lowest part of your torso). These important muscles support organs like the bladder, uterus, vagina, prostate (for men), and rectum – as well as the functions associated with them.
When our pelvic floor muscles weaken due to age, pregnancy or other reasons, we may have trouble relaxing or controlling them, which can disrupt our bodily functions. Doctors call this pelvic floor dysfunction, and there are treatment options to help improve it, including pelvic floor therapy.
Symptoms of pelvic floor dysfunction
Pelvic floor dysfunction can cause discomfort or interfere with your daily life. Talk to a health care professional if you have any of the following:
- Pelvic pain (pain in your low abdomen, pelvis or groin area)
- Frequent urination
- Painful urination
- Difficulty emptying the bladder
- Leaking urine or stool (incontinence)
- Constipation or painful straining during a bowel movement
- Erectile dysfunction (ED) in men
- Pain during sex, for women
- Lower back pain with no clear cause
While both men and women experience pelvic floor dysfunction, research shows that it affects women more often. The percentage of women with pelvic floor disorder increases with age, and it’s estimated that one third of women experience it in their lifetime. Doctors may treat pelvic floor dysfunction with a combination of pelvic floor physical therapy, lifestyle changes, medication or surgery if needed.
What is pelvic floor therapy?
Pelvic floor therapy is a form of physical therapy that helps you target and strengthen specific muscles in your pelvic floor. Based on your symptoms, your therapist will help you determine which muscles may be too weak or too tight. Then they’ll help you learn exercises to strengthen or stretch them to improve coordination and relieve symptoms.
When to get help for pelvic floor dysfunction
If you’re experiencing symptoms, or have questions about your pelvic floor health, it’s a good idea to talk with your primary care doctor or OB-GYN as a first step. They can often diagnose what’s happening or refer you to a urogynecology specialist or urologist if needed.
If you already know you need a specialist and would like to schedule a consult, you can make an appointment with a HealthPartners or Park Nicollet urogynecologist or urologist without a referral. (But keep in mind that you will need a referral for pelvic floor physical therapy.)
Note: Some health insurance providers require a referral in order to cover a visit to a specialist. If you’re not sure what your health insurance covers, call the number on the back of your insurance card to get the details about your coverage.
Julie’s story: How physical therapy improved her pelvic pain
*A fictitious name has been used to protect patient privacy.
As a cyclist, Julie* was used to dealing with soreness after a long ride. In fact, she’d visited experts for leg and back pain brought on by cycling. But last fall, she began to have a very different kind of pain.
“I thought I had a bladder infection that wasn’t going away,” she recalled.
But Julie didn’t have a bladder infection. In fact, the issue was with her pelvic floor and pudendal nerve (a main nerve in the pelvic area). After many years of biking, the pressure had finally gotten to Julie.
“I wasn’t aware that biking could cause this kind of issue for me as a woman,” she said. “But I was biking upwards of 2,000 miles a year, so it makes sense that the muscles were impacted.”
Finding the right care
Julie found her way to physical therapist Mary Prechel, PT. Prechel (now retired) was a physical therapist with Park Nicollet for more than 30 years, and for more than 20 of those years she specialized in pelvic health.
“Pelvic pain is a lot more common than people think,” Prechel said. “In Julie’s case, the prolonged sitting on a bike seat led to a lot of compression on her pudendal nerve. This caused pain and muscle tightness. This can also happen to men and women who spend a lot of time in the car, or who sit at a desk for work all day.”
Prechel also saw patients who were experiencing pelvic pain for other reasons, including childbirth, hip or back injuries, or abdominal surgeries. She said people often live in unnecessary pain due to the sensitive nature of the injury and the treatment.
“There are several physical therapists in our system who do this type of therapy for both men and women. We all respect people’s modesty,” she said.
Once the issue was identified, Julie and Mary began working together on a plan to relieve her pain.
Julie’s experience with pelvic floor treatment
Prechel explained that pelvic floor physical therapy involves soft tissue releases surrounding the nerve, and exercises to help loosen the muscles. She also gave recommendations for lifestyle changes, including suggestions on how to improve posture. Patients often say they can feel relief in a few sessions.
“I got relief quickly,” Julie said. “It’s more than just the physical side of therapy. It’s also understanding what causes your pain and how to change your activities and behaviors to prevent it from coming back or getting worse.”
Julie chose to make the switch from a traditional bike to an elliptical bike. That allows her to continue to enjoy cycling while keeping the pressure off.
“The important thing for women or men experiencing this type of pain is knowing that there’s a way to manage it,” Prechel said.