Bowel and bladder concerns are a major area of pelvic health. Urinary/fecal incontinence, frequent trips to the bathroom, and constipation are all common experiences that can benefit from pelvic health PT.

Urinary or fecal incontinence (leakage of urine or feces) can be due to muscle weakness, lack of muscle coordination, increased tension in the pelvic floor, environmental factors, increased urgency to go to the bathroom, behavioral factors, nutrition/fluid intake, and other reasons. Leaking can cause both negative physical and emotional consequences. Sometimes, frequent urination throughout the day can accompany urine leakage as well. Physical therapy for pelvic floor muscle training has been shown to reduce leakage episodes, decrease quantity of leakage, and improve quality of life.

Constipation can also impact the pelvic floor. In addition to contributors such as nutrition and fluids, other factors like posture while sitting on the toilet and control of pelvic floor and abominal muscles can make a difference in ease of bowel movements. People of many ages (children through older adults) can benefit from pelvic health PT to address constipation.

Your pelvic health physical therapist can work with you to identify contributors to your bowel/bladder concerns, optimize function of pelvic floor muscles, and learn strategies to implement in your daily routine to support bowel and bladder health.

Pregnancy and the postpartum period are times of major change. Your body adapts to these changes over the span of your pregnancy and after delivery, too. Pregnancy and vaginal delivery or cesarean section (C-section) all have implications for pelvic floor muscles.

During pregnancy, the pelvic floor undergoes increased pressure as it works harder to support your growing baby. Sometimes, those who are pregnant may experience hip or low back pain that can be addressed with physical therapy interventions like stretching, strengthening, and practicing strategies for improved positioning or lifting techniques in daily activites to reduce pain as your body undergoes these changes.

During vaginal delivery, pelvic floor muscles undergo a stretching process to allow the baby to exit through the vaginal canal. The pelvic floor can also undergo trauma during delivery due to episiotomy, forceps/vaccum assistance, or tearing. C-sections are major abdominal surgeries that can sometimes impact bowel and bladder function after recovery due to the close relationship between the abdominals and the pelvic floor. Changes to pelvic floor function after these events can sometimes lead to pain, difficulty controlling urine leakage, or other issues that can impact daily life.

While many aches and pains resolve on their own as the body recovers following delivery, some symptoms may persist for months or years and can be addressed with pelvic health physical therapy:

1. Pain in back, hips, legs, or other areas of the body

2. Pelvic pressure, pain, or feeling of “falling out”

3. C-section soreness that does not resolve after recovery

4. Pain with intercourse

5. Pelvic pain

6. Pubic symphysis pain

7. Coccyx (tailbone) pain

8. Frequency, urgency, or leakage of urine or feces (including leakage during coughing, sneezing, laughing, or exercise)

9. Constipation

Your pelvic health physical therapist can perform a personalized evaluation and work with you and your physician to address these symptoms to meet your personal postpartum goals.

​Male pelvic floors can benefit from physical therapy, too. Consider seeing a pelvic health PT if you have any of the following conditions:

1. Sexual dysfunction (e.g. erectile dysfunction, pain with ejaculation, premature ejaculation)

2. Penile/testicular pain

3. Urine leakage

4. Benign prostatic hyperplasia (BPH)

5. Prostatectomy (prostate removal)

Physical therapy interventions such as exercise, pelvic floor strengthening, education, and others can help manage your symptoms and will be tailored to your individual needs so that you can get back to the activities you enjoy."

Pain in the region of the pelvis (below the umbilicus) can affect people with male or female anatomy. Pain may or may not be present with activities such as prolonged sitting, sexual activity, urination/bowel movements, or others. Chronic pain, or pain lasting longer than 6 months, is not just a result of an injury to a body part, but is a complex body process that can be influenced by many factors. Stress, sleep disturbances, anxiety/depression, previous failed treatments, and other personal factors make your pain experience unique to you. Often, pelvic pain may persist even if other tests for the pelvic region such as advanced imaging come back “normal.”

Treatment of pelvic pain in physical therapy uses a personal approach with consideration to your experiences and needs. Your physical therapist can evaluate the musculoskeletal system to identify pelvic floor areas that should be addressed – for example, learning to lengthen pelvic floor muscles that are overactive or “too tight.” Restoration of painful body movements, strengthening, increasing flexibility, muscle control, and relaxation strategies incorporating mindfulness can all be helpful components of treatment for pelvic pain. Additionally, physical therapy interventions can support care from other healthcare providers (such as your physician or a mental health provider) as needed.

Sexuality is an important part of quality of life. Pain with sex can occur during intimacy, immediately after, or even for hours or longer afterwards. There are both physical and lifestyle factors that can contribute to painful sex. Physical therapy interventions can explore changes to positioning, address related muscle spasm or pain, and incorporate other lifestyle strategies to reduce pain.

Sexuality is an important part of quality of life. Pain with sex can occur during intimacy, immediately after, or even for hours or longer afterwards. There are both physical and lifestyle factors that can contribute to painful sex. Physical therapy interventions can explore changes to positioning, address related muscle spasm or pain, and incorporate other lifestyle strategies to reduce pain.