Pelvic Floor Physical Therapy

Lots of people stumble onto this blog while searching google for pelvic pain and physical therapy, things like that.  And one particular commenter was about to go in for some pelvic floor physical therapy and felt scared so I thought it might be useful to do a post about what to expect when you encounter the unknown world of pelvic floor physical therapy.  

Many women (some men too) go to pelvic floor physical therapists for bladder and bowel disorders like incontinence, painful intercourse, pelvic pain, IBS, etc.  When I started, I was very skeptical that this sort of thing could relieve pain.  I'm still not sure!  But for me, I do know that whatever my problem is, my muscles and ligaments have tightened and shortened beyond belief (both internally and externally) over the last few months due to pain and a PT is the only person that's able to help with that. 

Before I went in for my first PT session my Dad had been telling me how useful PT exercises were for him when he hurt his back - so I was expecting some exercises and stretches and off I'd go.  I was naive.  I didn't even know this type of PT existed so boy was I surprised when I ended up on the table with a hospital gown on and a non-MD getting more friendly with me than my OB-GYN.  What happened to my pants?   Where are the stretches like my Dad said? 

If you find the right PT, these women seem to have more knowledge about your anatomy (that they'll share with you) than you will find with any other Doctor you're working with.  The key is finding the right person - I think this is even more critical than with a doctor.  Do not give up if you see a couple of people and don't like them or don't like whatever technique they're using.  Keep looking.  And from what one of them said to me, something like: "we all get the basic training but then we all specialize in certain things so X you saw last week may have training in that but I have some training in Y."  That was very interesting to me.  So do not give up if you do not like the first few people you see.  These places are very used to their clients requesting certain people, refusing others. Don't feel bad about doing that.  You're getting treatment for sensitive areas, you're the boss! 

I pursued PT for a few sessions and saw 2 different people, I didn't particularly hit it off with them and I didn't feel like they were helping me.  I didn't leave the sessions feeling better or worse.  Just the same.  Which isn't a good thing.  So I gave up for about 2 months.  Fortunately, I decided to give it another try and I'm really glad I did because I made an appointment with someone new who so far has been a great match for me.  That's why I'm now a believer that PT is worth giving a good shot with the right person.  Now, will it help me cure my pain? Who knows.  Will it help resolve these muscle problems I have because of the pain and the scar tissue I have because of my surgery? It should definitely do that and I'll be happy with that result.  All that muscle tightness isn't something I feel until I'm on the table and someone gently tries to massage any muscle from below my chest to my ankles basically -- I never knew I had it until I went to PT so it could be playing into your problem...or resulting from your problem...

The first session is typically much longer - maybe an hour and a half - and will probably be your least favorite.  It's a full evaluation (looking at your spine, walk, hold up a knee, vaginal).  For me it wasn't particularly painful but I suppose it could be depending on your problem.  The modesty factor is the only uncomfortable part which you'll quickly get over soon as all of the PTs I have encountered have been quick to put you at ease. And I have found PTs are better than most OB-GYNs about making sure you are covered up even when they are doing an internal exam or internal work.  I have found PTs to take things slowly, explain what they are doing if you ask (while they're working on a particular muscle) and you can have a running dialogue during the session if you want to - I try to get info out of them while they're working! They'll tell you what they're doing before they do anything that may cause you any pain - I would imagine this is the case particularly if you are there for issues related to pain with intercourse.  

After that, my PT currently treats in 45 minute sessions.  The only pain I experience is when she is working on really tight muscles.  But when they do internal myofascial release (working on tight muscles inside) I really don't feel it.  They are also very gentle - so find the right place, the right person and give it a try.  It is worth it if you can help regain a part of your life back that has been taken away from you.

Please feel free to post any questions or contact me.