What is Pelvic Rehabilitation?

Pelvic Rehabilitation is a very specialized type of Physical Therapy that addresses conditions involving the abdomen, lower spine, hips, pelvis, and perineum.  Pelvic Physical Therapists receive extensive post-graduate training to address a broad range of conditions including pelvic pain, bowel/bladder and sexual dysfunctions, and pregnancy and postpartum conditions.

Examples of diagnoses commonly seen by Pelvic Physical Therapists:

  • Dyspareunia or painful intercourse that occurs due to pelvic floor muscles that are “overactive” (carrying too much tension or in a spasm), perineal injury, scar tissue, or pelvic joint dysfunction, etc.
  • Various types of Pelvic Pain, including Vulvodynia, Endometriosis, Pudendal Neuralgia, Bladder Pain, Coccyxdynia (tailbone pain)
  • Sacroiliac Joint Dysfunction causing back, hip, groin, lower abdomen and pelvic floor pain
  • Pubic Symphysis Dysfunction/Pain
  • Interstitial Cystitis or Painful Bladder Syndrome
  • Urinary or Fecal Incontinence
  • Overactive Bladder or Urinary Urgency/Frequency
  • Pelvic Organ Prolapse – Uterine and/or Urethral, Bladder, Rectal
  • Pre-operative assessment of pelvic floor muscle awareness and function (prior to pelvic surgeries for organ prolapse or prostatectomy)
  • Following surgeries for Pelvic Organ Prolapse, Hysterectomy, Prostatectomy, Laparoscopy, and C-Section

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

  • Pelvic Floor Muscle Training to improve muscle strength and function
  • Manual Therapy:  techniques applied internally (vaginally or anally) or externally.  Examples are 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 or mobilizations.
  • “Down-training” of muscles” that have lost the ability to relax or return to normal resting tone;  reduction of abnormally high tone of the pelvic floor may reduce pain and allow strengthening once normal tone is restored.  (Kegels are not always appropriate for patients with pelvic floor muscle dysfunction and can actually sometimes exacerbate symptoms)
  • Biofeedback may be used with vaginal or anal sensor or with surface electrodes to improve pelvic floor muscle function.
  • Electrical Stimulation with vaginal or rectal probe to improve pelvic floor muscle strength and function

Resources

Below is a list of online resources useful for women when seeking information on pelvic rehabilitation and pelvic pain relief: