Reasons To See A Pelvic Floor Therapist

When you hear the words “pelvic floor therapist,” you might first think of Kegel exercises, which, if you have a vagina, someone has probably told you to be doing. Maybe you’re aware that many people who have given birth often have urinary incontinence afterward, or even that in France, it’s de rigueur to have a series of visits with a pelvic floor therapist postpartum.

For most of us, the pelvic floor is a poorly understood part of our anatomy that we can pretty much ignore when everything is working properly. And when it isn’t, we tend to stay mum about what’s going on because the symptoms can be embarrassing.

While it definitely makes sense to see a pelvic floor therapist after you’ve given birth, there are lots of other reasons to consult with one, regardless of whether you’ve had a baby or what kind of anatomy you have.

HuffPost asked two pelvic floor therapists to explain what they do and how they can help.

“The ‘pelvic floor’ consists of the facia, ligaments, and muscles around the pelvic bones,” Jessica McHugh Conlin, an occupational therapist who works with postnatal patients in Iowa, told HuffPost. Other parts of the body, such as the diaphragm and core muscles, support the pelvic floor, she said.

Conlin explained that we can think of the pelvic floor as having three main functions: It supports our internal organs, gives us bladder and bowel control, and helps us function sexually.

“Everyone has a pelvis, so anyone who poops, pees and is sexual will at some point in their lives have some impact on their pelvic floor,” Anietie Upke-Wallace, a pelvic floor therapist in California, told HuffPost.

The pelvic floor does a lot for our bodies, and its functions can be something of a mystery to us. But if you’re having any issues related to having sex or going to the bathroom, a pelvic floor therapist has a deep understanding of this region of the body and can help.

“A pelvic floor therapist can work with an individual who has dysfunction, injury, or pain with any of these areas,” Conlin said, adding that “issues are more common in children, women, and older adults, but men of all ages can have pelvic health dysfunction as well.”

A pelvic floor therapist is a trained professional and generally has a doctoral degree in physical or occupational therapy. They also have additional training in pelvic floor health and may specialize in working with a specific population, such as children, postnatal women/people or older adults.

It’s common for people to see a pelvic floor therapist after giving birth, but there are many other issues that a pelvic floor therapist can help with. Conlin and Upke-Wallace said that these may include:

1. Urinary incontinence, often experienced as peeing a little when you cough, sneeze or exercise. You may hear that this symptom is par for the course after having a baby, but “peeing with activities after having a baby is common, not normal,” Conlin said. It’s a treatable condition. A child may also see a pelvic floor therapist for help with bedwetting.

2. Urinary frequency, or feeling a frequent urge to pee.

3. Fecal incontinence.

4. Chronic constipation.

5. Diastasis recti, or separation of the abdominal muscles, which can make your belly bulge out. This is another common postpartum issue.

6. Pain or discomfort during sex.

7. Organ prolapse. This is when one or more organs in the pelvic area (bladder, uterus, rectum or intestine) drop or sag due to muscle weakness. You may experience this as pain, discomfort or bulging.

8. Menopausal symptoms, such as dry vaginal tissue.

9. Recovering from an injury, such as a broken tailbone.

10. Recovering from an illness, such as bladder or prostate cancer.

11. Recovering from surgery, such as prostate removal.

Upke-Wallce said that extended periods of sitting, which many of us do while we work, can also lead to tightness in our pelvic floor muscles that may cause symptoms.

Your therapist may meet with you in an office, at the gym or in your home. They will begin by taking a history and asking about your current bowel, bladder and sexual functioning and any symptoms you are having. Many people feel embarrassed to talk about these things, but Conlin said you should be reassured that “most pelvic health therapists have seen just about everything, and we talk about ‘pee, poop, and sex’ all the time!”

The therapist will also do a physical assessment, examining your “body alignment, pelvic, hip and spinal movement as well as core strength,” Upke-Wallace said. An internal exam, involving the therapist placing one or two gloved fingers into your vagina or rectum to assess the muscles for strength and tone, is sometimes done, although Conlin said this is not part of her practice, and Upke-Wallace noted that this would only be done with the patient’s consent.

After the exam, your therapist will discuss a treatment plan, including exercises for you to do at home. How long your treatment lasts will depend on the condition you’re being treated for.

Conlin said that for a postnatal patient with mild to moderate diastasis recti and urinary incontinence, visits are usually once or twice a week for the first few weeks, then reduced to once a week and eventually once or twice a month, for a total treatment duration of six to eight months. If you are coming in postpartum to have your pelvic floor assessed but don’t have these symptoms, Upke-Wallace said you may only need two to four sessions.

Your doctor, midwife or insurance company may be able to refer you to a pelvic floor therapist, though Upke-Wallce noted that there can be a long wait to see someone, especially if they are affiliated with a hospital. She recommended the following sites as another way of finding a provider: Pelvic Rehab, Pelvic Global, and Vagina Rehab Doctor.

Both Conlin and Upke-Wallace encouraged anyone who is experiencing symptoms to seek help. Upke-Wallace described how pain or incontinence can impact a person’s quality of life: “You either become too afraid to go out, you limit the foods you eat or are unable to enjoy activities that used to bring you joy,” she said. “Don’t ignore it and assume it will go away.”

A pelvic floor therapist will be able to understand your problem and come up with a plan for treatment.

“Often, we can provide activities and exercises that can make a huge impact on your daily life in a short period of time,” Conlin said.