What is pelvic floor therapy? Your path to pelvic health

Women's Health

by Dr. Lorien Hathaway

Apr 9, 2024

I'm frequently asked about the benefits of pelvic floor therapy, or what's often colloquially referred to as “pelvic massage.” Pelvic floor therapy refers to a type of physical therapy focused on the muscles of the pelvic floor and abdomen.

While the terminology might vary, this therapy addresses a wide array of pelvic health concerns.

What is pelvic floor therapy?

It's a specialized form of physical therapy focused on the muscles of the pelvic floor and abdomen. Specifically, pelvic floor manual therapy (aka pelvic massage) is performed by specially trained physical therapists who focus on treating the pelvic floor muscles.

Pelvic floor muscles stretch like a hammock from your pubic bone to your tailbone and help support and restore function and balance in this area of the body. Manual therapy to the pelvic floor helps mobilize soft tissues, reduce pain and improve function. It’s just one possible part of a well-rounded treatment provided by a pelvic floor therapist.

Pelvic floor therapists employ a range of techniques to address specific issues. These may include internal and external manual therapy, exercises, biofeedback and more. Pelvic floor therapy can be beneficial for:

  • Abdominal muscle separation (known as diastasis recti)
  • Bowel and bladder incontinence
  • Constipation
  • Urinary urgency and frequency
  • Pelvic and abdominal pain
  • Discomfort during sex
  • Prolapse
  • Pain during and postpartum

Pelvic floor therapy for endometriosis

One of the primary areas pelvic floor therapy addresses is pelvic pain. Whether you experience discomfort during intercourse or general pelvic pain, pelvic floor therapy can provide significant relief for many types of pelvic pain.

One common condition that can cause chronic pelvic pain is endometriosis. Research shows that people with endometriosis experience improved pain management with pelvic floor therapy.

This is because your discomfort from endometriosis can come from the muscles and tissues in the pelvic area that often protectively contract to guard the area of pain caused by the endometriosis. Pelvic floor therapy can help to address the pain and dysfunction these muscle issues can cause.

Pelvic floor therapy during pregnancy

While bringing a baby into the world is such a wonderful experience, pregnancy brings about numerous changes in the body. For many women, this can lead to issues like back pain, urinary incontinence and pelvic discomfort. Pelvic floor therapists work with expectant mothers to alleviate these symptoms and prepare you for childbirth.

During pregnancy, this type of therapy can help address areas of low back or pelvic pain or pressure, resolve issues with leakage of stool or urine, and teach exercises and techniques to help prepare your body and pelvic floor for delivery. 

Pelvic floor therapy postpartum

After you give birth, postpartum, pelvic floor therapy is typically focused on your pelvic floor and the abdominal muscles, as these muscles often become strained during pregnancy. Childbirth may also stretch and weaken the pelvic floor muscles, whether you have a vaginal delivery or C-section.

In the postpartum period, pelvic floor issues can manifest as:

Research shows that physical therapy can address these concerns by strengthening a weak pelvic floor and relaxing any tight muscles. 

When to start pelvic floor therapy after birth

After giving birth, any issues with pelvic floor muscles should be resolved by four to six weeks postpartum. If you continue to have problems after six weeks, you should consider seeing a pelvic floor therapist. Recovery looks different for every woman, so speak to your OBGYN to understand how pelvic floor therapy can help.

What does pelvic floor therapy entail?

Each pelvic floor physical therapy session will be tailored to you and your needs, but the initial evaluation will assess general posture, strength, alignment and movement. It may be necessary, initially and periodically, for a pelvic floor therapist to perform an internal pelvic floor muscle examination.

How many sessions for pelvic floor therapy?

Like many aspects of healthcare, the right amount of pelvic floor therapy sessions varies from person to person. Initially, weekly sessions may be recommended, gradually tapering off as you make progress.

Ultimately, the goal of pelvic floor therapy is to equip you with the tools and knowledge to continue your pelvic health journey independently with an at-home exercise program. 

Is pelvic floor therapy right for me?

Whether it's addressing specific concerns or optimizing your overall well-being, this form of therapy offers a holistic approach to pelvic care.

If you’re living with pelvic pain or discomfort, pelvic floor therapy can be an effective tool to improve your daily well-being. But pelvic floor therapy isn't just about addressing existing problems—it's also about prevention and maintenance. By strengthening weak pelvic floor muscles and or addressing muscle imbalances, pelvic floor therapy helps decrease your risk of future issues and promotes long-term pelvic health.

If you're experiencing pelvic issues or simply want to prioritize your pelvic health, reach out to a pelvic floor therapist today.

About the Author

Lorien Hathaway PT, DPT is a women’s specialist and a lymphedema therapist at Baylor Scott & White Institute for Rehabilitation.

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