6 pelvic floor physical therapy exercises

Your pelvic floor is composed of muscles and other soft tissue that support and protect organs in your pelvis, such as your bladder, large intestine and uterus/reproductive system. The pelvic floor allows you to use the bathroom and have sex. Working with your other muscle groups, your pelvic floor also helps your body absorb pressure from actions such as lifting and coughing. 

What can cause pelvic floor dysfunction?

An estimated 1 in 4 women experience pelvic floor dysfunction. Some research shows that as many as 50% of women can experience pelvic floor dysfunction during their childbearing years. Up to 25% of yearly gynecological visits are due to pelvic floor pain. Pelvic floor dysfunction can occur in response to:

• Soft tissue strain during labor.
• Vaginal delivery.
• High-impact exercises.
• Pelvic area surgery.
• Obesity.
• Painful bladder surgery.
• Heavy lifting.
• Menopause.
• Pelvic muscle overuse.
• Traumatic pelvic injury.
• Chronic coughing.
• Chronic constipation.
• Nerve damage. 

What disorders and conditions are associated with the pelvic floor muscles?

You can experience a variety of disorders and conditions in your pelvic floor muscles. These can be caused by your pelvic floor muscles being weak (too loose) or too tight.

Weak pelvic floor muscles can cause conditions such as:

 

• Stress incontinence — Stress incontinence can occur due to childbirth or injury to your pelvis. It results in peeing or dribbling in response to laughing, sneezing, coughing, or lifting. 
• Urge incontinence — Urge incontinence causes you to have the urgent sensation of urination and the inability to hold it. 
• Fecal incontinence — Fecal incontinence is the inability to control your bowel movements. 
• Anal incontinence — Anal incontinence refers to the inability to control passing gas. 
• Pelvic organ prolapse — Pelvic organ prolapse occurs when unsupported pelvic organs (uterus, bladder or rectum) bulge into your vagina, resulting in a protrusion in your vaginal opening. This condition is associated with menopause. 

Hypertonic pelvic floor, or having pelvic floor muscles that are too tight, can result in difficulty in having bowel movements; pain in your pelvis, back, hips, or legs; pain during intercourse; and urinary frequency or difficulty.

Physical therapy for pelvic floor muscles

If you’re struggling with pelvic floor dysfunction, physical therapy is a great option for help and relief. A physical therapist can help you learn the correct way to do pelvic floor physical therapy exercises to help improve your pelvic floor.

During your initial appointment, your physical therapist will do an exam and then design a custom treatment for your symptoms. This exam can include an internal and external exam of your pelvic area. 

Pelvic floor physical therapy exercises

Your physical therapy treatment may include a combination of modalities, including exercises. Exercises are not universal between weak and tight pelvic floor muscle treatments. Your physical therapist will explain which exercises fit your condition. Pelvic floor physical therapy exercises can be like building a puzzle. Working the pelvic floor to strengthen or relax the muscles involves external and internal stretches. 

Physical therapy exercises that can help weak pelvic floor muscles include:

• Quick-flex Kegels — This exercise involves quick contractions of your pelvic floor muscles. This can help strengthen the muscles, allowing them to react more quickly to stop leaks when you cough or sneeze. 
• Heel slides — When lying on the floor and practicing heel slides, it can help strengthen your pelvic floor by encouraging contractions while also engaging your deep abdominal muscles. 
• Toe taps — Toe taps in a prone position can help encourage pelvic floor contractions to strengthen it and help increase your core’s stability. 

Physical therapy exercises that can help hypertonic or tight pelvic floor muscles include:

• Happy baby — This stretch can be beneficial for stretching and helping release tight pelvic floor muscles. It is done by lying on the floor on your back, lifting your legs into the air, bending at the knees and grabbing your feet. 
• Diaphragmatic breathing — Practicing diaphragmatic breathing can help strengthen the working relationship between the pelvic floor and the diaphragm. This technique can also be beneficial for stress release. 
• Reverse Kegel — Opposite to the strengthening Kegel exercises, the reverse Kegel works on the relaxation of the pelvic floor muscles. 

Additional physical therapy modalities for the pelvic floor muscles include:

• Manual therapy — Manual therapy for pelvic floor dysfunction is used internally and externally to help relieve tension in the pelvic floor. This release can help improve the range of motion, which can boost muscle contraction and relaxation. 
• Electrical stimulation — Electrical stimulation can be beneficial in helping pelvic floor dysfunction. Up to 36% of those who use electrical stimulation can see an increase in the contraction and relaxation of their pelvic floor muscles, which can help their struggles with incontinence. 
• Trigger point release — Trigger points are knots of muscle tissue that can be found in the pelvic floor. Trigger point release can be used to apply gentle pressure to the affected pelvic floor muscles to help relieve pelvic pain and can help improve muscle function. 

Whatcom Physical Therapy can help you with your pelvic floor muscle dysfunction

Our Whatcom Physical Therapy team of certified physical therapists can help you find relief from your pelvic floor dysfunction. We can design a customized treatment of exercises and other physical therapy modalities that can help strengthen weak pelvic floor muscles or help relax hypertonic pelvic floor muscles. 

Contact our team today for more information or to schedule an initial appointment.