What the pelvic floor does
The pelvic floor is composed of muscles that support the reproductive and urinary tracts and control bladder and bowel function. Together with tendons and connective tissue, these muscles hold the urinary and reproductive organs in place, in women, the bladder, vagina, and rectum; in men, the bladder, bowels, rectum, and urethra.
These muscles can become weak and tight for a variety of reasons: aging, pelvic surgery, being overweight, pregnancy, or overuse or injury of the pelvic muscles. This weakening or disorder is called pelvic floor dysfunction, and its symptoms can include incontinence, constipation, frequent urination, painful sex in women, and erectile dysfunction in men.
How pregnancy and childbirth affect the pelvic floor
Pelvic floor dysfunction commonly affects women, who may notice weakened pelvic muscles, pelvic pain, decreased libido, incontinence, pain when urinating, back pain, constipation, and muscle spasms. During pregnancy and childbirth, the intense pushing of the baby down the birth canal can put pressure on the pelvic floor and cause overstretching or tearing, leading the muscles to soften and sink. This isn’t limited to vaginal birth, childbirth by C-section can weaken the pelvic floor too, since cutting the muscles during surgery can leave connecting nerves numb and muscles weak for months or even years afterward.
During pregnancy, the baby’s growing weight pushing down on the pelvic area can also cause urinary incontinence or leaks, and bladder weakness is commonly seen with aging and obesity as well. Decreased sexual sensation is another symptom of weakened pelvic floor muscles, since stronger pelvic muscles generally mean more pleasurable sensation, this reduced sensation can diminish libido or interest in sex, which in turn can affect relationships and contribute to depression.
How pelvic floor physical therapy helps
Pelvic floor physical therapy aims to rebuild strength in the pelvic floor muscles, reduce symptoms, and restore activities that dysfunction has gotten in the way of. This specialized form of physical therapy addresses pelvic floor dysfunction directly, strengthening the muscles, easing tightness, and helping them relax.
Your physical therapist will evaluate your current condition, including core muscle strength and endurance for physical activity, and may check muscle coordination through a variety of activities. From there, they’ll build a treatment plan customized to your needs.
What a treatment plan may include
Treatment can include electrical stimulation to reduce pelvic spasms or pain; trigger point therapy, which applies pressure to trigger spots and sometimes anesthesia injections; Kegels, which contract and relax the pelvic floor muscles; and biofeedback, which uses a device to measure pelvic floor muscle contractions.
The goal throughout is to restore normal function as much as possible: controlling the bladder and preventing incontinence, reducing discomfort during sex, returning to sports and other activities, and strengthening the pelvic floor muscles overall.
Care built around you
Tribeca Physical Therapy can evaluate your pelvic floor and design a treatment plan suited to your needs, especially for women navigating pregnancy, childbirth, or the natural effects of aging on the pelvic floor.