Pelvic Floor Physiotherapy
Nathalie Godart
Pelvic floor related physiotherapy
Pelvic floor rehabilitation is a specialized field of physiotherapy that focuses on the assessment, treatment, and management of pelvic floor dysfunction. The pelvic floor is a group of muscles, ligaments, and connective tissues that support the organs in the pelvic area, including the bladder, uterus, and rectum. Dysfunction in the pelvic floor can lead to a variety of issues, such as urinary incontinence, pelvic pain, and sexual dysfunction. In this context, the role of a physiotherapist is crucial in helping individuals regain control and function of their pelvic floor muscles.
The various activities, such as teaching classes, competing, playing in a orchestra and/or as a soloist, have a considerable tear and wear mechanism on the body. Like athletes, musicians suffer from overuse injuries or from an unbalanced overload on specific joints, ligaments and muscles. Moreover, sustained posture has a tremendous impact on the body’s ability to cope with the work-load on the long-term. All too often, pain then sadly becomes a familiar feeling, which is accepted on a daily basis.
We see women with:
- Stress incontinence – urinary leaking with certain activities.
- Overactive bladder – having a sudden desire to go to the toilet immediately with possible leaking of urine before reaching the toilet. There may be a need to visit the toilet more frequently than normal.
- Mixed urinary incontinence – a combination of stress incontinence and over active bladder.
- Prolapse: Small to moderate prolapseof the front and/or back vaginal wall(s) – weakening of the support structures that support the vagina, resulting in bulging of the pelvic organs into the vagina.
- Pain related pelvic floor dysfunction e.g. chronic pelvic pain syndrome, vulvodynia, vaginismus…
- Post-partum rehabilitation: incontinence, weakened muscles (abdominal and pelvic floor), pelvic girdle pain, perineal trauma, diastasis rectus abdominus, Improve cardiorespiratory fitness, going back to sport..
- Pre partum rehabilitation: During pregnancy, 20% of women experience discomfort in their pelvis and hips (pelvic girdle pain or PGP) and approximately 50% women experience back pain. If your symptoms are affecting your ability to complete everyday activities or to continue working you have an indication to physiotherapy.
Treatment process
A physiotherapist begins by conducting a thorough assessment to understand the patient’s medical history, lifestyle, and specific pelvic floor issues. Physical examinations may include assessing muscle strength, tone, endurance, coordination, and flexibility of the pelvic floor muscles. Specialized assessment tools like biofeedback or ultrasound may be used to provide objective data about muscle function. Based on the assessment findings, the physiotherapist develops an individualized treatment plan tailored to the patient’s needs and goals. Treatment plans often include a combination of exercises, manual techniques, and lifestyle modifications.
- Education:
One of the primary roles of a physiotherapist in pelvic floor rehabilitation is to educate the patient about their condition and how the pelvic floor functions. Patients are taught strategies to improve pelvic floor muscle control, such as proper breathing techniques and posture. - Pelvic Floor Muscle Training:
Physiotherapists teach patients specific pelvic floor muscle exercises, such as Kegel exercises, to improve muscle strength and endurance. They guide patients in performing these exercises correctly and monitor progress over time. - Manual Therapy:
In some cases, manual therapy techniques, such as myofascial release or trigger point therapy, may be used to address muscle tension and discomfort in the pelvic area. - Biofeedback and Electrical Stimulation:
Advanced techniques like biofeedback and electrical stimulation can help patients gain better awareness and control of their pelvic floor muscles. - Lifestyle Modification:
Physiotherapists provide guidance on lifestyle changes, including dietary recommendations and bladder retraining, to manage symptoms like urinary incontinence. - Pain Management:
For patients with pelvic pain conditions, physiotherapists may use techniques such as relaxation exercises, heat therapy, or acupuncture to alleviate discomfort.