Pelvic floor physical therapy is a highly specialized area of therapy focused on treating the muscles of the pelvic floor. These muscles are a hammock-like sling that supports

your pelvic organs—including the bladder, bowel, and uterus (in women)—and play a vital role in urinary and fecal continence, sexual function, and core stability. Just like any other muscle in your body, the pelvic floor muscles can become weak, tight, or uncoordinated, leading to a host of problems.

There are two main types of pelvic floor dysfunction:

1. Hypotonic (Weak) Muscles: When the pelvic floor muscles are too weak, they cannot provide adequate support for the pelvic organs or effectively close off the urethra and rectum. This can lead to issues like stress incontinence (leaking with a cough or sneeze) and pelvic organ prolapse.
2. Hypertonic (Tight) Muscles: Conversely, the pelvic floor muscles can be too tight or in a state of constant contraction. This can lead to pelvic pain, pain with intercourse, urinary urgency/frequency, and constipation.

A pelvic floor physical therapist is a licensed therapist who has undergone extensive postgraduate training to become an expert in this intricate system. They are trained to perform a comprehensive evaluation, including a gentle internal and external assessment, to determine the exact nature of your muscle dysfunction. Based on this assessment, they create a personalized treatment plan to either strengthen and “wake up” weak muscles or relax and lengthen tight muscles.

Our Rainsville pelvic floor rehabilitation program, led by our specialist Karel Wilkerson, provides expert care for a wide range of conditions in both women and men.

For Women:

• Urinary Incontinence: Including Stress Incontinence (leaking with coughing, sneezing, laughing, or exercise) and Urge Incontinence (a sudden, strong urge to urinate).
• Pelvic Organ Prolapse: The descent of the bladder, uterus, or rectum due to weak pelvic floor support.
• Pelvic Pain: Chronic pain in the pelvic region, including conditions like vulvodynia, vestibulodynia, and interstitial cystitis.
• Painful Intercourse (Dyspareunia): Pain before, during, or after intercourse is often caused by tight pelvic floor muscles.
• Pregnancy and Postpartum Care: Preparing the pelvic floor for childbirth and rehabilitating the core and pelvic floor after delivery, including treatment for diastasis recti (abdominal separation).
• Endometriosis-Related Pain: Helping to manage the muscular pain and tightness associated with endometriosis.

For Men:

• Post-Prostatectomy Incontinence: Urinary leakage that is common after surgery for prostate cancer.
• Chronic Pelvic Pain Syndrome (CPPS): Persistent pain in the pelvic region, often diagnosed as chronic nonbacterial prostatitis.
• Erectile Dysfunction: In some cases, pelvic floor muscle dysfunction can contribute to erectile dysfunction.
• Fecal Incontinence: The involuntary loss of bowel control.

We understand that seeking treatment for a pelvic floor condition can be intimidating. Our first priority is your comfort and trust. Your entire course of treatment will be with a specialized therapist in a private treatment room. Your evaluation and treatment plan will be tailored to your specific findings and goals.

Your personalized treatment plan may include:

• Pelvic Floor Muscle Training (Kegels and Reverse Kegels): The cornerstone of treatment. Your therapist will ensure you are performing these exercises correctly. Many people perform Kegels incorrectly, which can make their problem worse. We will teach you how to properly isolate, contract, and, just as importantly, relax your pelvic floor muscles.
• Manual Therapy: Gentle, hands-on techniques, both externally and internally, to release tight muscles, mobilize soft tissue, and desensitize painful areas.
• Biofeedback: Using a special sensor and a computer screen, biofeedback allows you to “see” your pelvic floor muscles working. This is an invaluable tool for learning how to correctly contract and relax these muscles.
• Therapeutic Exercise: A comprehensive program to strengthen your core, hips, and back, as these muscle groups work in concert with your pelvic floor.
• Behavioral Strategies: Bladder retraining, dietary modifications, and urge suppression techniques to help you manage symptoms of urinary urgency and frequency.
• Patient Education: We will empower you with a deep understanding of your condition and provide you with the tools and strategies to manage it effectively for the long term.

Choosing to address your pelvic floor health can have a profound impact on your life.

• Regain Bladder and Bowel Control: Reduce or eliminate leakage and regain the confidence to live an active life without fear of accidents.
• Reduce or Eliminate Pelvic Pain: Find relief from chronic pain that may have been affecting you for years.
• Improve Sexual Function: Enjoy intimacy without pain and improve sexual health.
• Successful Postpartum Recovery: Heal properly after childbirth, address diastasis recti, and safely return to exercise.
• Avoid or Prepare for Surgery: In many cases, pelvic floor therapy can help patients avoid surgery for conditions like incontinence or prolapse. If surgery is necessary, pre-operative therapy can lead to better post-operative outcomes.