What is Pelvic Rehabilitation?

Pelvic Rehabilitation is a specialized area of Physical Therapy that addresses male and female pelvic pain, bowel, bladder and sexual dysfunction, and conditions affecting pregnant, postpartum, and menopausal women.

Examples of diagnoses commonly seen by Pelvic Physical Therapists:

  • Dyspareunia or painful intercourse involving abnormal tension within the pelvic floor muscles
  • Vaginismus (pain/difficulty with pelvic exams, insertion of tampons, or penetration during intercourse)
  • Diastasis Recti (separation of the abdominal muscles)
  • Pelvic Pain:  Vulvodynia, Vestibulitis, Coccydynia (tailbone pain), Pudendal Neuralgia, and pelvic pain that has no known origin
  • Endometriosis, Interstitial Cystitis or Painful Bladder Syndrome, and Prostatitis
  • Joint Dysfunction:  Pubic Symphysis, Sacroiliac Joint, Sacrococcygeal Joint
  • Urinary or Fecal Incontinence (leaking of urine or feces)
  • Overactive Bladder or Urinary Urgency/Frequency 
  • Pain with Urination or Bowel Movements
  • Constipation
  • Painful C–section or Episiotomy Scars
  • Lichens Sclerosis 
  • Pelvic Organ Prolapse – Uterine, Bladder, Urethral, and/or Rectal
    • Feeling of pressure and/or “falling out” of pelvic organs
    • Bowel or Bladder Dysfunctions associated with prolapse

Examples of some of the treatment techniques that Pelvic Physical Therapists use:

  • Pelvic Floor Muscle Training to improve muscle strength, endurance, and function
  • Manual Therapy:
    • Stretching, trigger point release, myofascial release, connective tissue mobilization, soft or deep tissue mobilization, strain-counterstrain, muscle energy, nerve gliding, manual traction, and joint oscillations/mobilizations
    • Manual techniques may be applied externally or internally (vaginally or rectally)
  • “Down-training” of muscles” – restoring the ability of the muscles to relax in order to decrease pain and improve function
    • Sometimes strengthening exercises are not always appropriate and may exacerbate symptoms
  • Biofeedback 
  • Electrical Stimulation 

Resources

Below is a list of online resources for information on pelvic health and rehabilitation: