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Pelvic floor dysfunction, once thought to be an issue of women, who had gone through pregnancy and childbirth and then aging, is a thing of the past! Pelvic floor dysfunction has no age or gender preference and in my practice, I see plenty of male patients with no urinary incontinence who still have pelvic floor dysfunction. I go as far as to say that over 80% of adults over 18 have pelvic floor dysfunction. Chances are what you think pelvic floor dysfunction is and what it is are not necessarily the same. I suggest you read my blog on the subtle signs of pelvic floor dysfunction before reading on.

This blog is going to explore who treats pelvic floor dysfunction, how to choose the correct, competent provider that handles all aspects of pelvic floor dysfunction treatment, and what you can do on your own to address your pelvic floor dysfunction. Let’s dive in.

Who Treats Pelvic Floor Dysfunction?

This question was answered in my blog bear in mind that not every clinician with the title is the qualified person to go to. I, for instance, am a chiropractor trained in the field of pelvic floor dysfunction treatment and work on pelvic stability BEFORE anything else because working on the ‘floor’ when the ‘house’ (pelvis) is unstable does not make the results last. Unless my patients ‘see’ what I see, ‘predict’ what I predict, and ‘prevent’ what I would prevent, they will have a chance of losing the stability that we work hard to achieve. Not every provider is into patient education or talking as much as I do. Choosing the right provider who not only knows about pelvic floor dysfunction but understands the many ‘faces’ it may have and focuses on the holistic and comprehensive approach is the key. Here is the list of common providers that provide treatment for pelvic floor dysfunction:

  • Physical Therapists

Physical therapists specializing in pelvic floor dysfunction are experts at assessing and treating musculoskeletal issues. Almost all physical therapists that work on the pelvic floor do internal manual work addressing the muscles they can reach with their index finger. There is always some work on coaching how to breathe and some exercises that their patients are shown to do, but the majority of the work is done internally.

  • Chiropractors

Chiropractors focus on the musculoskeletal system and its impact on overall health. Some chiropractors undergo additional training in pelvic floor therapy with the focus on stabilizing not only the pelvis but the whole spine and functionality in movement. At our clinic, we use postural neurology and developmental exercises that work on the whole body, postural presentation, and stability in movement.

  • Occupational Therapists

Occupational therapists are trained to help individuals achieve independence in daily activities. Those specializing in pelvic health can provide valuable insights into how pelvic floor dysfunction may affect daily life and offer strategies to manage symptoms effectively.

  • Nurses

Some nurses undergo specialized training in pelvic floor therapy, particularly in women’s health or urology. They play a crucial role in patient education and lifestyle changes. This may assist in coordinating care with other healthcare professionals.

  • Physicians Trained In Pelvic Floor Therapy

Certain physicians, such as urologists, gynecologists, or physiatrists, may have additional training in pelvic floor therapy. They primarily recognize the correlation between the symptoms that would otherwise be missed by other physicians as separate and unrelated conditions.

How To Choose The Right Person To Treat Pelvic Floor Dysfunction?

When it comes to my health, I generally do my due diligence to learn about the condition. I then investigate the best person to learn how to. In my opinion, it is worth the time and money investment for instance to do one-on-one training with for instance a Pilate trainer, Yoga trainer, or Personal trainer when I delve into Pilates, Yoga, or workouts. The same is true when it comes to learning how to stabilize the pelvis. First thing first, pelvic stability comes before expecting the pelvic floor that is tight to become more relaxed or when weak to become stronger. That is because when chasing the ‘why’ I want to know why- not the incident that appears to have caused the issue- but what that incident (if I know of it) has done to the condition of the floor. No matter what, an unstable pelvis is always the step before the weakness or tightness of the floor.

When it comes to finding the right provider, I suggest that you read the website, and reviews and contact the office to talk to the receptionist. If you can meet with the clinician for a short time it is even better because it gives you insight as to whom you will be working with. If the provider does not participate in your insurance plan, do not write them off. While many good providers may be in network with your plans, the ones that are good at what they do go out of network because what it takes to ‘fix’ the issue (using the term carefully), takes more than what the insurance company allows or compensates for and THAT is the reason to go out of network in most cases.

Can I Do Pelvic Floor Therapy On Myself?

Yes! Just like everything else in life, the question to ask is: ‘ Do you know what your issue is?’; not what your symptoms are but do you know what is going on and do you understand the core of what is happening? Not that your pelvic floor is weak but WHY your pelvic floor is weak for example. If you have incontinence, for example, is it the nerves exiting your spine and going to the bladder not working, is it too much pressure on the bladder that is causing an issue, it is too weak or too tight of pelvic floor that is the culprit?

In order to do any therapy yourself you need to chase the why and that typically needs seeking care from the right provider. See the previous section on that, however, always make sure what you hear makes sense; if not, ask questions and if the provider gives you an attitude, leave! It is you, your body and your life that is the subject and as a provider, I can tell you that I LOVE patients that ask questions and want to know more. Those are the only patients I take on because otherwise, the work done won’t last.

Once you understand the why behind the issue, then I always start with Biological breathing and stabilization of the pelvis and functional movement. Without that, you are working on something that will fall apart because the structures above and connected to it will cause instability there. The method I use to bring in stability and functionality in movement is the Developmental Kinesiology, the way all babies including you years ago, move. I use Dynamic Neuromuscular Stabilization as the method to bring in functionality and stability in movement. After all, no babies ever go to the gym, use weight, see any trainers or providers to go from helpless infants to running toddlers. That must be how we are programmed to do it and why reinvent the wheel if we already have the proven method.

You can take a look at my IG page for some of what I share do with my patients; what is important to note is that you ought to understand what the principles of movement are, how to bring them into your movement patterns, how to apply them across your chores and then be mindful not because you have pelvic floor dysfunction but because you don’t want to always deal with issues, injuries and pains. I use the same concepts across all patient presentations, from hypermobile and bendy patients to those with the most stiff and rigid joints, from athletes to those with sedentary lifestyle.

If you are ready to take control of your pelvic instability issues leading to your pelvic floor dysfunction, from incontinence and sexual dysfunction to pain in the hips and sacroiliac joint and everything in between, contact me. Let’s chat to see if I can be of help.

Dr. Shakib

Recommended Reading:

Pelvic Floor Dysfunction In The HyperMobile Population

How Long Does It Take For Pelvic Floor Therapy To Help?