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What is pelvic floor therapy?

Overcoming misconceptions and finding freedom from pelvic pain


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July 26, 2017

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*To protect patient privacy, a fictitious name has been used.

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 recalls.

That’s because Julie didn’t have a bladder infection. The issue was with her pelvic floor and pudendal nerve.

The pelvic floor is made up of the muscles, ligaments and connective tissues. These support the bladder, uterus, vagina and rectum in women. It helps maintain normal bladder and bowel function.

The percentage of women with pelvic floor disorder increases with age. Research shows the condition affects a third of all women.

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 says. “But I was biking upwards of 2,000 miles a year, so it makes sense that the muscles became impacted.”

Julie found her way to Mary Prechel, PT, a physical therapist with Park Nicollet Rehabilitation Services. Prechel has been a physical therapist with Park Nicollet for more than 30 years. And for more than 20 of those years, she has specialized in pelvic health.

“Pelvic pain is a lot more common than people think,” Prechel says. “In Julie’s case, the prolonged sitting led to a lot of compression on her pudendal nerves. 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 sees patients who are experiencing pelvic pain for other reasons. These include childbirth, hip or back injuries, or abdominal surgeries. She says people often live in unnecessary pain due to the sensitive nature of the injury and the treatment.

“There are 7 physical therapists in our system who do this type of therapy for both men and women. We all respect people’s modesty,” she says.

Once the issue was identified, Julie and Mary began working together on a plan to relieve her pain.

Prechel explains that treatment includes soft tissue releases surrounding the nerve and exercises to help loosen the muscles. She also gives suggestions to improve posture. Often, patients say they can feel relief in a few sessions.

“I got relief quickly,” Julie says. “It’s more than just the hands-on 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 enjoy cycling while keeping the pressure off.

“The important thing for women or men experiencing this type of pain is knowing that there is a way to manage it,” Prechel says.

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