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Pelvic Health Conditions and Treatments

Our pelvic health specialists are trained in treating and educating patients to meet their unique needs and address concerns regarding muscular deficits, changes in the nervous system, movement patterns, and more. Pelvic health dysfunction may impact people of all genders at any stage of life, and any ability level, and our therapists are here to provide rehabilitation and management strategies.

Our therapists provide care in a comfortable, one-on-one setting. They evaluate the overall strength, coordination, and function of a patient’s pelvic floor and surrounding muscles. From there, a personalized plan of care is created with an individual’s needs and goals in mind.

Common conditions that can benefit from pelvic health physical therapy:

Musculoskeletal Conditions

  • Diastasis Recti
  • Pubic Symphysis Dysfunction
  • Sacroiliac Dysfunction
  • Round Ligament Pain
  • Hernia
  • Back, Hip, or Groin Pain
  • Inguinal hernia
  • Osteoporosis
  • Chronic Sciatica

Treatment options may include education, pain management strategies, and exercises.

Prenatal and Postnatal Care

  • Help prepare your body for labor and delivery
  • Assist with a postpartum return to life, exercise, and sport without pain
  • Abdominal or pelvic discomfort
  • Bladder/bowel dysfunction
  • C-section and perineal scar management

Treatment options may include education on body mechanics, pain prevention and management strategies, and individualized exercise programs.

Pelvic Floor Support Dysfunction

  • Cystocele: Condition where the bladder sinks into the vaginal wall. It may create the sensation of pressure, heaviness, or discomfort in the vaginal region and may be associated with bladder or pain symptoms.
  • Rectocele: Condition where the rectum sinks into the vaginal wall. It may create the sensation of pressure, heaviness, or discomfort in the vaginal region and may be associated with difficult or painful bowel movements.
  • Uterine/Vaginal Vault Prolapse: Condition where the uterus, cervix, and/or vaginal wall sinks into the vagina. It may create the sensation of pressure, heaviness, or discomfort and may be associated with pain, bladder, or bowel symptoms.
  • Rectal Prolapse: Condition where the rectum sinks on itself towards the anus. It may create the sensation of pressure, heaviness, or discomfort in the rectal region and may be associated with pain or bowel symptoms.

Treatment options may include education on management to strategize and minimize pelvic organ prolapse symptoms. Exercises to help coordinate and strengthen your pelvic floor and surrounding musculature will be provided, as well as manual therapies to reduce muscle tension and pain contributing to your prolapse symptoms.

Bladder Dysfunction

  • Stress Incontinence: Urinary leakage that occurs with activities like coughing, sneezing, running, or any similar activity that causes increased pressure through the abdominal cavity.
  • Urge Incontinence: Urinary leakage that occurs with a strong sense of urgency to empty your bladder. For example, leakage can occur when hearing running water, feeling cold, arriving home, seeing a toilet, etc.
  • Overactive Bladder: Bladder leakage associated with strong urinary urgency and increased frequency of voids.
  • Neurogenic Bladder: Bladder leakage that may be associated with neurological conditions such as Parkinson’s disease, multiple sclerosis, or spinal cord injury.
  • Urinary Retention: The inability to empty your bladder. It may be associated with other bladder symptoms like urinary frequency, hesitancy starting your urine stream, or pain with voiding.
  • Interstitial Cystitis: Chronic condition associated with pelvic or bladder pain that occurs with bladder filling, is relieved with voiding, and is often aggravated by dietary or behavioral factors.

Treatments may include education on behavioral, fluid, and dietary modifications, exercises to coordinate and strengthen your pelvic floor and surrounding musculature, manual therapies to reduce muscle guarding or pain associated with your bladder dysfunction, or biofeedback training.

Bowel Dysfunction

  • Constipation: The inability to empty your bowels regularly or entirely, which can sometimes be associated with poor pelvic floor muscle function.
  • Fecal Incontinence: Fecal leakage with or without awareness.
  • Anorectal Dyssynergia: A condition where the pelvic floor muscles and nervous system dysfunction create the inability to have a bowel movement This is often caused by or associated with chronic constipation.

Treatment options may include education on behavioral and dietary modifications, toileting techniques, exercises to coordinate, relax, or strengthen your pelvic floor and surrounding muscles, manual therapies to improve muscle tone and pain, techniques to stimulate motility or biofeedback training.

Pelvic Pain and Sexual Dysfunction

  • Dyspareunia: Genital pain before, during, or after vaginal penetration.
  • Vaginismus: A condition where the pelvic floor muscles surrounding the vagina are involuntarily tense or contracted. This may contribute to painful vaginal penetration.
  • Vulvodynia: A condition associated with pain within the vulva that is chronic and has no other identifiable cause. Symptoms may include burning, soreness, or aching, pain with sexual activity, and worsened pain with sitting or wearing tight clothing.
  • Genital Pain: Pain that is associated with local or referred pain in the genitals, including symptoms such as labial, scrotal, clitoral, penile, or anal pain.
  • Chronic Non-Bacterial Prostatitis: A condition also known as chronic pelvic pain syndrome, associated with symptoms such as pain with urination or ejaculation, difficulty starting or completing a urinary void, urinary urgency or frequency, pain behind the scrotum that is worse with activity or sitting.
  • Reproductive/Endocrine Changes: Conditions such as endometriosis, polycystic ovarian syndrome (PCOS), fibroids, menopause, etc. These conditions may have concurrent symptoms associated with pelvic floor dysfunction.
  • Coccydynia: Pain associated with the coccyx (tailbone) may be worse with extended periods of sitting.

Treatment options may include manual therapies to reduce pain and to guard your pelvic floor and to surround muscles, dilator or pelvic wand training, stretches to improve your lumbar and pelvic mobility and flexibility, and exercises to improve your pelvic floor function are all treatment options.

Pre- and Post-Surgical Conditions

Common genital procedures pelvic health therapy can treat include:

  • Abdominal laparoscopy
  • Bladder sling
  • C-section
  • Gender affirmation surgery (vaginoplasty, phalloplasty, metoidioplasty, +)
  • Genital surgeries
  • Hernia repair
  • Hymenectomy
  • Hysterectomy
  • Prolapse repair
  • Prostatectomy

Pre-operative care may include education on symptom management, post-operative expectations, and strategies to address any pain or bladder, bowel, or sexual dysfunctions before surgery.

Post-operative treatment may consist of manual therapies to improve adhesions/scar tissue, pain management, and exercises to restore and optimize function.

Oncological Pelvic Conditions

  • Breast Cancer
  • Prostate Cancer
  • Anorectal Cancer
  • Bladder Cancer
  • Uterine or Ovarian Cancer

Treatment may include education on management strategies to overcome side effects of cancer and cancer treatment (chemo, radiation, medications, surgery) and exercises to improve your bladder, bowel, and sexual function as you navigate your cancer diagnosis. Your pelvic health therapist may also refer you to one of our certified lymphedema therapists to holistically manage any swelling (edema) acquired as a result of your cancer treatments.

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