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The pelvic floor is the group of muscles, ligaments, and connective tissues located at the base of the pelvis. This plays a vital role in the anatomical structure of the pelvic floor. The pelvic floor supports pelvic organs like the uterus, bladder, and rectum. These muscles control bowel and bladder functions, supporting core stability and sexual functions.

The pelvic floor plays a vital role in our body. Its proper functioning is crucial for a healthy life. The following are some essential functions of the pelvic floor. 

The primary function of the pelvic floor is to support the pelvic organs, including the uterus in the female bladder and rectum.

The pelvic floor muscles play an essential role in controlling urine from the bladder.

During coughing, laughing on the pelvic floor helps prevent urine leakage.

Pelvic floor muscles also control the anal sphincters, which is essential for preventing involuntary bowel movements.

These muscles are also crucial for sexual arousal and support organs.

Overall, the pelvic floor maintains the pelvic girdle and spine stability and proper spine posture during different movements.

These muscles also play an essential role during pregnancy and childbirth. In pregnancy, due to these muscles, the uterus grows, and during birth, these muscles help move the child toward the birth canal.

Different core muscles are included in the pelvic floor, like abdomen muscles and diaphragm muscles, that play an essential role in the support and sustainability of the body.

These muscles also prevent the prolapse of pelvic organs.

These muscles are also crucial for running, jumping, and other activities.

These muscles are also involved in the healing of muscles after childbirth.

 

PELVIC FLOOR THERAPY : 

Pelvic floor therapy is the particular area of physical therapy whose primary focus is treating and assessing conditions related to the pelvis region. The pelvic floor is the bundle of muscle, connective tissues, and ligaments that support the pelvis's organ, including the uterus, bladder, and rectum. A physical therapist performs pelvic floor therapy, which is an excellent alternative to surgical procedures. Every individual with pelvic floor problems needs special training to get the best results. Pelvic physical therapy is designed to address issues such as pelvic pain, pelvic organ prolapse, incontinence, sexual dysfunction, and other disorders related to the pelvic floor.

WHAT TO EXPECT IN PELVIC THERAPY 

Pelvic floor therapy is very suitable for those who have a high-tone or low-tone form of pelvic floor dysfunction and pelvic floor-related muscle pain. So, under treatment, you may go through different medical treatments.

INITIAL EXAMINATION :  

On pelvic floor therapy, the therapist brings the patient to a private room for evaluation. The specialist goes through the patient's medical history to start any treatment. 

The therapist can do physical examinations as well. The physical examination consists of internal and external components. 

EXTERNAL EXAMINATION : 

The physical therapist does an external exam of the patient in which the therapist accesses the patient's lumbar spine, muscles, and joints that link to the pelvis and lower spine, including the iliopsoas ( a muscle in the interior part of the thigh) and piriformis ( a flat, narrow muscle ) to check them for pain and tightness of the muscles. In this examination, physical therapists check overall body pain, go through the patient's medical history, and then decide the best mode of treatment for the patient. 

INTERNAL EXAMINATION :  

In an internal examination, the therapist will assess the patient's pelvic floor muscles to check pain, tightness, elasticity, and tone of muscles. They also contain the vagina and rectum to palpate the pelvic floor muscles from the inside. The lubricant is used to reduce discomfort. The physical therapist also examines pelvic floor movement with breathing patterns. The ability to perform relaxation and contraction of pelvic floor muscles The therapist examines the patient to diagnose the main problem, then makes a clinical assessment according to the patient's symptoms and causes, and then schedules follow-up sessions and works on patient treatment.

EDUCATION AND EXERCISE PROGRAM: 

The therapist educates the patient about pelvic anatomy and functions of pelvic muscles and tells them how they relate to their condition. The therapist set the goal to treat patients according to their needs and concerns. The therapist tells the patient-specific exercises that help to relax and strengthen pelvic floor muscles. These exercises may include kegel exercises, bio feed, and other therapeutic exercises to treat specific issues.

MANUAL THERAPY: 

The therapist uses hands-on techniques to relax and reduce muscle pain in the pelvic floor muscles and connective tissues . Manual therapy is internal and external based on patient comfort and the therapist's approach. The therapist suggests behavior strategies to manage symptoms, such as bladder and bowling training. 

The therapist gives home exercises to the patient to continue progress between sessions. Consistency with home exercises is adequate for the betterment of the pelvic floor. The therapist will have an open conversation with the patient and create a comfortable environment so the patient can tell their concerns quickly.

The therapist schedules follow-up sessions to progress, adjust, and plan treatment according to the patient's needs and assess the patient's condition. The physical therapist sometimes collaborates with other medical specialists, such as urologists and gynecologists, to ensure comprehensive patient care. Collaboration with other healthcare specialists helps a lot during therapy. 

Pelvic therapy is used to treat all types of disorders that are linked with pelvic floor dysfunction. The increase and decrease in muscles can lead to pelvic floor dysfunction. Both of them are discussed below : 

LOW MUSCLE TONE :  

When a muscle has a low tone, it is more relaxed and looser than usual; it is difficult to make it actively contract. When muscles are weak due to low tone, it's difficult to actively correct them because the bladder cannot adequately support and control the core. The bowel movement may be affected as well. Low-tone pelvic floor disorder can be treated through pelvic floor therapy, which includes 

Pelvic organ prolapse, problem in pelvis organs 

Leakage of urine during activities like coughing, laughing, or sneezing 

Urgency in urine and incontinence in the bladder 

Leakage of gas, fluid, and stool from the rectum 

HIGH MUSCLE TONE : 

The muscles get tighter than normal when there is a high tone disorder. This can be the reason for pain because muscles can't relax due to excessive tightness. Due to increased tone, the pelvic muscle can also be affected, and women feel pain during intercourse. 

Physical therapy can be recommended due to high tone disorder that may include : 

Regular pain due to tightness of pelvic floor muscles 

Muscular contraction in the surrounding of the vagina 

Pain in the vagina due to intercourse 

Pain and discomfort in the vulva due to tightness and dysfunction of pelvic floor muscles. 

Therapists do pelvic floor therapy, and patients benefit from their assistance. They are specialized providers with a Certificate of achievement in pelvis therapy (CAPP) or extensive training and specialization in women's health clinical specialists (WCS).

CAUSES OF PELVIC FLOOR AND HOW PHYSICAL THERAPY HELP :    

The pelvic floor happens due to pregnancy, childbirth, the process of aging, and stress in women. Physical therapy helps patients with their specific conditions. 

Bladder problems like leakage and urgency of urine 

Bowel problems that include constipation and pain during bowel movement 

Postpartum changes in the pelvis and due to pregnancy 

Sexual dysfunction: In females, it is painful intercourse, and in males, it is erectile dysfunction 

Surgery: In some cases, the therapist can go for surgery If there is a major problem in the pelvis that can't be treated with therapy. 

Nerves-related conditions that can affect the pelvic

Cancer that may require rehabilitation after treatment. 

Pelvic floor therapy helps a lot after childbirth. There are many benefits of treatment during pregnancy. Some of them are discussed below. 

During pregnancy, the pelvic floor is shifting and changing continuously. The muscles get stretched and loose during this process, from increased hormones to the baby's weight. So this can lead to pelvic pain and discomfort. According to research, 20% to 70% percent of women suffer from urinary incontinence during pregnancy. Almost 35% of women suffer from sexual dysfunction during pregnancy, and 95% of women have regular lower back pain after pregnancy due to pelvic floor dysfunction. Pelvic floor therapy helps during labor, delivery, and the postpartum period. According to the research, women who start pelvic floor therapy at 32 weeks or earlier have ease in birth and after postpartum recovery. Some of these benefits are discussed below. 

Less chances of tearing during vaginal delivery 

More confidence during pushing 

Faster recovery after cesarean

Quick recovery between vagina and rectum tissues 

Less chances of organ prolapse  

Make the birthing process easier 

Improve postpartum recovery time 

Physical therapy reduces issues that occur after pregnancy 

Control urinary incontinence 

Reduce chances of lower back pain and sciatica

Improve sexual performance 

Less chances of constipation 

In conclusion, pelvic floor therapy is essential in keeping the pelvic floor muscles strong, easy movement and well-circulated. Physical therapy decreases the issues that occur during and after pregnancy. Pelvic floor therapy is a beneficial tool when planning prenatal care. Pelvic floor therapy stabilizes women with a support system that will provide education about their health and teach them how to resolve issues during and after pregnancy. Maintaining a healthy pelvic floor system is essential during pregnancy. During pregnancy, women need more energy to give birth to a child. They have to follow all the exercises that the therapist recommends.

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