Physical Therapy

If you followed my recovery story you know that I experienced some postpartum pain. Part of the pain that I experienced involved pain with intercourse. Once my granulated tissue healed I thought my postpartum pain was behind me but the first time my husband and I attempted intercourse I knew something was not right. My vaginal muscles felt extremely tight and somewhat clenched. It was time for me to go to my friend Google and see what was going on…

Once I googled my symptoms, “pelvic floor dysfunction” and “pelvic floor therapy” kept popping up.

What is your pelvic floor?

The pelvic floor stretches between the pubic bone and the tailbone and cradles your bladder, bowel, and uterus. It is a group of muscles in the floor of the pelvic area. These muscles support the organs in the pelvis, and some form a sling around the rectum and vagina. The pelvic floor also help you contract and relax your vagina during intercourse.

What is pelvic floor dysfunction?

Pelvic floor dysfunction is the inability to correctly contract (tighten) and relax the muscles in the pelvic floor. By contracting and relaxing the pelvic floor muscles, you enable bowel and bladder movements and relax during intercourse. People with pelvic floor dysfunction contract these muscles rather than relax them.

During delivery, a woman may experience a perineal tear, or need an episiotomy (that is a cut to the muscular area between the vagina and the anus made to enlarge the vaginal opening during delivery). These can cause pelvic pain after birth while sitting or during sex. Additionally, a woman who may have learned incorrect pushing techniques or experienced a prolonged labor may experience pelvic floor pain.

Symptoms of pelvic floor dysfunction may include:

  • The feeling that you need to have several bowel movements during a short period of time.
  • The feeling that you cannot complete a bowel movement.
  • Constipation, or straining pain with bowel movements.
  • Leakage of stool/urine with or without your awareness.
  • A frequent need to urinate. When you do go, you may stop and start many times.
  • Painful urination.
  • Pain in your lower back that cannot be explained by other causes.
  • Ongoing pain in your pelvic region, genitals, or rectum with or without a bowel movement.
  • Pain during intercourse (experienced by women).

I did not have most of the traditional symptoms that occurs with pelvic floor dysfunction. My main symptom was pain with intercourse so I decided to check out a physical therapist to see if in fact I had pelvic floor dysfunction. Read my story to learn more about my visit.

What to expect at the visit

  • During the initial examination, the therapist will take a detailed medical history from the patient.
  • After that, there’s a physical examination , which includes evaluation of the abdominal wall, respiratory diaphragm, hip muscles, lower back muscles, posture, pelvic joints and pelvic muscles. Pelvic muscles are evaluated internally, either vaginally or rectally, with a gloved finger for the tone and strength of the muscles. (Note: If the pelvic muscles are tight (mine were extremely tight), there may be some soreness with the evaluation, though it’s typically not extreme.)
  • If they are, the PT can work to release trigger points – areas where the tissues are stuck together rather than sliding easily against each other.
  • Finally, the therapist will discuss their findings with the patient and formulate a plan of care , usually a combination of in-office treatment and at-home care to help relax muscles that are tight and strengthen muscles that are weak. My at home care focussed on stretching and breathing exercises.
  • At follow-up sessions, any dysfunction is treated. The combination of manual therapy (hands-on), neuromuscular re-education and postural re-education makes up a one-hour session, held inside a private room.

How to Find a Physical Therapist