Setting the Record Straight About Pelvic Floor Physical Therapy

Pelvic floor issues are common (not normal), and so are the misconceptions about them and the care one may receive during a Pelvic Floor Physical Therapy visit. In this blog post, you may recognize or even find yourself currently still believing some of these common misconceptions surrounding Pelvic Floor Physical Therapy.

Here are 10 Common Misconceptions about Pelvic Floor Physical Therapy and Facts to Set the Record Straight...

MISCONCEPTION #1: Pelvic Floor Physical Therapy is only for females

FACT: All genders and ages can benefit from Pelvic Floor Physical Therapy. Just as we all have abdominal and gluteal muscles, we all have pelvic floor muscles that function to promote urinary, bowel, and sexual health. 

MISCONCEPTION #2: Pelvic floor assessments are painful and invasive

FACT: Pelvic floor assessments are much less invasive and often less uncomfortable compared to a pap smear or gynecologic exam requiring the use of a speculum. An internal assessment is a one finger vaginal or rectal assessment to assess the pelvic floor muscles and determine their function, which can always be modified or not performed at all depending on patient symptom response and consent. 

MISCONCEPTION #3: Pelvic Floor Physical Therapy always involves an internal pelvic floor assessment

FACT: As a patient, you always have the choice to deny an internal assessment. Other options to assess the pelvic floor muscles include an external perineal assessment, a visual assessment by the provider and patient with use of a mirror, the patient performing a self-assessment with verbal instruction from the provider, or use of technology on the low abdomen and pelvis such as an Ultrasound device. You can work with your provider to find the best option individualized for you. 

MISCONCEPTION #4: It’s normal to experience urinary leakage, pelvic pain and/or painful intercourse following pregnancy and labor and delivery

FACT: These issues are common, but not normal, and can be readily addressed and often even improved after just one visit with a pelvic floor specialist. Just because something is common, does not mean it has to be the new normal, nor a rite of passage into motherhood.  

MISCONCEPTION #5: Pelvic Floor Physical Therapy only includes performing pelvic floor exercises on a treatment table 

FACT: Pelvic Floor PT is and should be so much more than that. A comprehensive assessment and plan of care at Performance in Motion will include a postural and full body movement assessment, core, abdominal, hip and gluteal strengthening, full-body mobility, education on behavioral modifications (more simply, how to properly pee, poop and breathe), pelvic floor strengthening, lengthening and coordination training, and so much more depending on what your individual goals are.

MISCONCEPTION #6: Pelvic Floor Physical Therapy must be done in-person to be of benefit

FACT: A large majority of the education can be done virtually. It is often eventually useful to have one visit in person to perform a pelvic floor assessment to determine the true root cause of the symptoms; however, a lot can be done prior to this visit and vetting your provider first via a virtual appointment can ensure you have a good fit for you. 

MISCONCEPTION #7: I should wait to see a Pelvic Floor Physical Therapist until I am done having children so that all my work and progress can be lasting

FACT: It is important to take care of your body before and during pregnancy and to rehab properly following each birth. This includes addressing symptoms at the time of onset to prevent issues from worsening or new symptoms from arising. When you feel strong, empowered and connected to your body, you are less likely to experience symptoms. A simple analogy is this: imagine spraining your ankle and continuing to push through without proper management, rehab and healing. Your ankle would continue to hurt, that pain would likely worsen, and it could cause a sequel of additional pain complaints at the knee, hip or pelvis and low back due to altered walking patterns. This parallels to not properly addressing the bodily changes that occur during pregnancy, postpartum healing, and the high demands of motherhood that often result in pain and dysfunction. If not addressed, this can worsen any current symptoms or cause new pain complaints and pelvic floor related dysfunction to arise. 

MISCONCEPTION #8: Pelvic Floor Physical Therapy is best done in the postpartum period

FACT: Prenatal Pelvic Floor PT visits can be beneficial for the following: 

• Prepare the body for the changes that occur during pregnancy that often cause pain or discomfort
• Address any pelvic floor related dysfunction that may arise during pregnancy such as pelvic pressure, urinary leakage, bowel symptoms and much more
• Safely strength train – motherhood requires strength!
• Prepare for labor and delivery with education on positioning and body mechanics, breathing techniques and pelvic floor lengthening and coordination training
• Gain knowledge on proper practices to follow immediately postpartum to promote safe and effective healing prior to attending a postpartum Pelvic Floor PT visit

MISCONCEPTION #9: I know how to Kegel, so do I really need Pelvic Floor Physical Therapy? 

FACT: Yes! Properly performing a pelvic floor muscle contraction, aka Kegel, is only a piece of the puzzle. Like all other muscles in the body, the pelvic floor muscles need to be able properly contract, relax, lengthen, turn on/off quickly, sustain prolonged endurance holds and properly coordinate with our breath and other core, pelvis and hip muscles. Individuals can often perform a Kegel but lack the ability to properly coordinate and lengthen the pelvic floor muscles, sustain an optimal endurance hold time, and appropriately breathe in combination with all these principles. 

MISCONCEPTION #10: Pelvic Floor Physical Therapy doesn’t apply to me because I’ve never been pregnant or had a baby

FACT: Everyone benefits from pelvic floor PT, all ages and genders as mentioned above. Pelvic Floor PT can play a large role in preventative care. Just because someone is not experiencing symptoms currently, does not mean they wouldn’t benefit from learning how to properly activate their pelvic floor muscles and appropriately manage core pressures and breathing mechanics. The following groups of people would especially benefit from Pelvic Floor PT, symptomatic or not, due to the high demands placed on the pelvic floor and/or the hormonal changes that play a role in muscle function: pregnant, postpartum, menopausal, high-level athletes and weightlifters.