Common causes of pelvic floor issues include pregnancy or childbirth, hysterectomy, certain sports, aging, or inactivity of the pelvic floor muscles, just to name a few. Once the pelvic floor has been compromised, problems such as incontinence, diminished sex drive, or even pelvic organ prolapse – when pelvic organs protrude into or outside of the vagina – can arise. The most common sign of a weak pelvic floor – which affects up to 25% of women – is involuntary urine leakage (incontinence). (2)
Some pelvic floor physical therapists may have the opportunity of getting a lot of time to speak one-on-one with a patient to determine possible causes of his or her symptoms, educate the patient and to guide them to other practitioners who may optimize their physical therapy results if necessary. We truly can find out so much by just listening to what our patients have to say. A fall, or infection can be significant as well as a patient’s feelings and knowledge about their current condition.
During the internal exam, your physical therapist will place a gloved finger into your vagina or rectum to assess the tone, strength, and irritability of your pelvic floor muscles and tissues. Internal exams and internal treatment are invaluable tools that are taught to pelvic floor physical therapists. It can tell us if there are trigger points (painful spots, with a referral pattern or local); muscle/tissue shortening; nerve irritation and/or bony malalignment that could be causing your pain directly or inhibiting the full function of your pelvic floor muscles. We can also determine if your pelvic floor has good coordination during the exam. A pelvic floor without good coordination, may not open and close appropriately for activities such as going to the bathroom, supporting our pelvis and trunk, sexual activity, and keeping us continent.
Squats: Squats are a great holistic exercise because they engage many muscles at once. To do a body-weight squat, stand with your feet shoulder-width apart, then slowly bend your knees, dropping your hips and glutes down and back, keeping your back straight, as if you’re sitting down on a chair. (You can place your hands on your hips or stretch them out in front of you for balance.) Bend your knees until your thighs are parallel with the floor, then return to an upright position. Repeat 10 times, up to three times per day.