You suspect or are told you have pelvic floor dysfunction and are wondering how to find a pelvic floor therapist or where to get a pelvic floor therapist. You may think you know who does pelvic floor therapy but this blog will discuss how there is more than pelvic floor physical therapists that treat patients with pelvic floor dysfunction. In this blog, you will get your answers to these questions and learn what to look for.

Where Is The Pelvic Floor?

Imagine a bowl! Your pelvis is a bowl with the bottom of it being the pelvic floor. The pelvic floor consists of the anus, penis/vagina, and perineum (the tissue between the two). The pelvic floor is not suspended in the air but is attached to the pelvic wall, therefore, when it comes to  the treatment of the pelvic floor, focusing on just the ‘floor’ will only provide temporary relief if any at all.

The stability of the pelvis has to be restored for pelvic floor therapy to be effective and long-lasting. As obvious as it seems, when it comes to the treatment of pelvic floor dysfunction, most of the work is spent by the therapist to relax or strengthen the muscles of the pelvic floor when it is equally or more important to stabilize and strengthen the ‘house’ that pelvic floor is the ‘floor’ of.


What Are The Subtle Signs Of Pelvic Floor Dysfunction?

As discussed in detail in my blog, What are pelvic floor dysfunction symptoms, the following are the subtle signs and symptoms that people experience missing the connection to pelvic floor dysfunction:

  • “Lower back pain
  • Pain in the back joints of the pelvis (SI Joints)
  • Pain in the front pubic area
  • Arched lower back
  • Slouched lower back
  • Slouched mid-back or hunchback
  • Military posture with the chest pushed out
  • A V-stance where the torso is positioned behind the hip joints on the side view
  • Chronic forward neck
  • Inability to bend down below the knees
  • Habitually standing on one leg with the other leg bent
  • Chronic one-sided pain in the lower extremity
  • Hip pain on one or both sides”

Who Treats Pelvic Floor Dysfunction?

While pelvic floor therapy is mostly done by trained physical therapists, pelvic floor dysfunction goes beyond the muscles of the pelvic floor. The focus should be instead of focusing on just the floor, the whole pelvis, and biomechanics of posture and movement need to be considered for the holistic treatment of the region. Unfortunately, almost all physical therapists involved in the treatment of the pelvic floor are either focused on just the manual treatment (mostly internal) of the floor or breath incorporation and some exercises that have to do with just the pelvic floor primarily.

The pelvic floor is attached to the rest of the pelvis and therefore the whole pelvis and the impact of posture/movement on the pelvis have to be considered, assessed, and worked on. From what I have seen, it is a small group of physical therapists that spend the time on each visit in one-on-one treatment, and chiropractors trained in the field of pelvic floor that seem to make note of this important connection and spend the necessary time to make the corrections.

What Is The Treatment For Pelvic Floor Dysfunction?

The blog:  “Are Yoga Exercises Good for Pelvic Floor Dysfunction“, explains that the most holistic approach to pelvic floor dysfunction treatment must include the following:

  • “Behavior modification which is always part of the solution list to all issues (your behavior about life changes how you do everything in life), is not going to correct any dysfunction fully but addresses some of the feeders of the problem.
  • Postural Neurology: Movement is like a concert and the body parts are like the musicians; in that the musicians not only need to know their part but to know when to chime in and phase out. That means the pelvis and pelvic floor need to know how to ‘play’ with the rest of the body if they are to sustain their strength and integrity. This is what Postural Neurology is all about.
  • Functional Movement: Common sense says that the most authentic way to move is the way babies move. After all, all babies from all over the world go through the same developmental stages of movement (Developmental Kinesiology) which means that we are hard-wired to move that way. So if the issue is movement-related or supported, then we should see how we compare to the way we moved as babies. All discrepancies are then highlighted and can be corrected through Dynamic Neuromuscular Stabilization (DNS) exercises which are baby movements.
  • Kegels? There are machines like the Emsella Chair that do 400 Kegels per minute involving all of the muscles of your pelvic floor and not the ones that you hope to be engaging. Note that Kegel exercises are not for all types of incontinence and pelvic floor muscle issues.
  • Breathing is what babies do automatically and that is what we need to do in order to sustain the bottom of the breathing apparatus, the pelvic floor!
  • Internal manual work which ideally should be done to assess the muscles inside the pelvis BUT does not have to be done in all cases.
  • Nutrition:  Avoid Citrus, caffeine, soda, artificial sweeteners, spicy foods and take collagen, Vit. C, Vit. D, Omega 3, protein if no conflict with any other conditions that suggest their avoidance.
  • Ergonomics: Sit on an exercise ball vs a chair, get a keyboard that is as wide as your shoulders, limit your sitting to no more than one hour and alternate with standing, and make sure the middle of your monitor is at eye level to name a few.
  • Postural Awareness: It is important to pay attention to the posture and catch yourself when not standing on both feet, slouching, or shifting the pelvis forward and in front of the ankles. Best to associate the increase in attention with activities done each day; for instance, when talking to someone pay attention to the feet and pelvis positioning.
  • Sleeping habits: do not sleep on the stomach and if you are a stomach sleeper, get a body pillow to minimize that.”

If you have pelvic floor dysfunction and the treatment has not been to your satisfaction or you need help with your treatment, do not hesitate to contact me.

Dr. Shakib

Recommended Reading:

5 Best Exercises to Release Tight Pelvic Floor At Home

How Is Pelvic Floor Therapy Done?