Section 3: Treatment Techniques in Pelvic Physical Therapy

Treatment techniques in pelvic physical therapy can include pelvic floor muscle training, manual therapy, and behavioral modifications. These techniques aim to improve muscle function and alleviate symptoms.

Therapeutic Exercise for GSM

Diaphragmatic Breathing

Learn proper breathing techniques to support pelvic floor function.

Pelvic Floor Training

Perform targeted exercises to strengthen and relax pelvic muscles.

Physical Exercise

Incorporate general fitness to enhance overall pelvic health.

Quality of Life Improvement

reduced symptoms and enhanced well-being throughExperience consistent practice.

When it comes to pelvic floor muscle training, Kegel exercises are the most commonly referenced. Kegels is a term many people hear about but don’t actually know how to perform. Performing them properly requires understanding not just how, but when to contract and relax the pelvic floor.

Specifically, a pelvic floor contraction should feel like you are pulling your pelvic floor upward and inward. It should NOT feel like you are squeezing, and you should not feel like you are using your buttock muscles or your belly. If you cannot find your pelvic floor or have any pain doing them: STOP. A pelvic physical therapist can help you figure that out.  

Kegel/ Pelvic Floor Exercises (pg.196-200 in the Musculoskeletal Mystery: How to solve your pelvic floor symptoms)

Kegel Exercises: A Key to Pelvic Health

Step 1

Find a comfortable position, preferably lying down.

Step 2

Contract pelvic floor muscles as if drawing up through a straw.

Step 3

Hold briefly, then relax completely.

Step 4

Practice isolating pelvic floor muscles.

Caution

If unable to control or experiencing pain, consult a pelvic PT.

Biofeedback is another tool that pelvic physical therapists may use. This is a device that allows the therapist to record the pelvic floor muscle activity and this in turn will be displayed on a screen for the patient to see. It gives a great visual to the patient’s pelvic floor contraction and relaxation. This allows the therapist to cue the patient and can help them improve either contractions or relaxation.

Biofeedback in Pelvic PT

Another feature of pelvic rehab includes behavioral changes and self-management. These techniques are a great way to teach the body and brain new ways to perform daily routines that can completely change and improve symptoms. For example, when you have urge incontinence or overactive bladder, we may teach urge drills or techniques to avoid leakage when water is running or you come in the front door of your house.  We may include stress strategies that can reduce leakage when coughing or sneezing, or we can include proper bowel movement positioning. Yes, there is a better way to have a bowel movement!

Self-Management Strategies for GSM

Lifestyle Changes

Modify diet, quit smoking, and manage stress to improve overall pelvic health.

Bladder Training

Practice urgency drills and proper toileting techniques to manage urinary symptoms.

PelvicCare

Learn colon massage and avoid straining to support bowel health.

Vaginal Health

Implement strategies to maintain vaginal tissue health and comfort.

Your therapist may also teach you about better pelvic floor/vaginal moisturizers to help improve tissue health.

When working with your pelvic floor therapist, you will learn how to make all these changes while at the same time your therapist is providing you with both manual techniques and exercises. These techniques often help resolve many different symptoms such as stress and urgency incontinence, fecal incontinence, pelvic pain, prolapse, and sexual dysfunction, which are all commonly associated with GSM.