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Outpatient Rehabilitation

Pelvic Floor Therapy

Pelvic Floor Therapy

For more information or to schedule an appointment

CALL (615) 284-PT4U

Saint Thomas Outpatient Rehabilitation offers specialized care for Pelvic Floor conditions.

 Pelvic Floor Therapy is offered at these locations:

To schedule an appointment, call 615-284-PT4U (7848). If you have questions, email us at STOR@sth.org.

Pelvic floor therapists are physical therapists who have advanced training in the evaluation and management of conditions unique to the male and female pelvis, such as:

  • Care for New Mothers

Although pain and generalized weakness in pregnancy is common, it is not normal.  Some women continue to have long-lasting effects after childbirth such as lower back and neck pain, pelvic organ prolapse, urinary incontinence, diastasis recti (separation of abdominal muscle) and generalized weakness of core muscles.  Many women want to get back their “pre-baby body” and often jump back into an exercise program only to find these symptoms worsen. PHYSICAL THERAPY can help alleviate these issues with management of muscle strength and endurance."

  • Urinary Incontinence
    Urinary incontinence is defined as the involuntary leakage of urine. This condition is so common that many women think incontinence is normal and just a natural consequence of childbirth and/or aging. Chronic pelvic pain, pelvic floor muscle weakness, aging and hormone changes are other common contributing factors that result in urinary incontinence.
    Research shows PHYSICAL THERAPY can play an important role in improving pelvic floor function to alleviate symptoms of urinary incontinence. Pelvic floor therapists work with each person to design a detailed plan to improve pelvic floor muscle strength, endurance and coordination needed in order to control bladder function.

  • Fecal Incontinence
    Fecal incontinence is the involuntary leakage of a stool. Frequently, the underlying reason for fecal incontinence is some form of injury or dysfunction of the rectal sphincter and/or pelvic floor muscles. Pelvic floor muscles are responsible for control of the sphincter that holds back a stool; therefore, muscles must be strong and coordinated enough to perform this role or leakage can occur. Injury during childbirth, vaginal muscle weakness, surgical interventions and hormone changes are other common contributing factors to pelvic floor dysfunction that can result in fecal incontinence. The focus of physical therapy is an individualized exercise program that isolates the pelvic floor muscles to regain the strength, endurance and coordination needed to control your bowels.
    Pelvic floor therapists instruct each patient in core and pelvic exercises that vary in difficulty and position, based on a woman’s symptoms and strength impairments. Therapists also provide education on diet and fluid intake to bulk up stools for better control and good commode posture.

  • Interstitial Cystitis
    Interstitial Cystitis is also known as the painful bladder syndrome. The pain is recurring and often felt around the bladder and surrounding pelvic region. Signs and symptoms of interstitial cystitis may include urinary urgency, frequent urination, and pain during intercourse, around the lower back and abdomen. It is common for the pelvic floor muscles to be very tight or start to spasm leading to pelvic pain and/or difficulty with urination.  
    PHYSICAL THERAPY can be very helpful toward easing the pain and urinary symptoms you may be experiencing.  PELVIC FLOOR THERAPY treatments include manual therapy to release tight muscles, biofeedback and exercises to promote pelvic muscle relaxation and patient education to improve urination and manage pain.

  • Pelvic Pain
    Pelvic pain is classified by pain that occurs anywhere below your belly button and above your legs. Pelvic pain can occur suddenly and be sharp but brief or occur over a long period of time. The pain can sometimes radiate into your low back and/or buttocks. Pain can be severe enough to get in the way of daily activities or it could only occur during intercourse.
    Physical therapy can be very helpful in the treatment of pelvic pain.  Interventions may include postural correction, therapeutic exercises to stretch and strengthen core and pelvic muscles, manual therapy to decrease spasms and restrictions in pelvic floor muscles, biofeedback to promote pelvic muscle relaxation and patient education regarding behavioral/activity modification to decrease pain.

  • Coccydynia (Tailbone Pain)
    The most common causes of tailbone pain include falls onto the coccyx, trauma during labor, and postural reasons (the “way” you sit may cause your coccyx to come out of position).  Pain and local tenderness at the tailbone are the major symptoms of coccydynia. This can lead to difficulty sitting, and tenderness at the tailbone area.
    Physical therapy seeks to eliminate pain associated with coccydynia by increasing mobility in the tailbone and decreasing muscle tension in the pelvic floor muscles.  Evaluation and treatment may consist of re-aligning the pelvis, ensuring the SI joints and hips are working properly.
  • Sexual Dysfunction
    Sexual dysfunction is defined by difficulty for a person to enjoy or to have sexual intercourse. It affects a person’s quality of life and can cause depression, anxiety, result in a lack of confidence or a feeling of inadequacy.
    Sexual dysfunction is different in men and women. Examples of sexual dysfunction in men are ejaculation problems and pain. In women, dysfunction can be attributed to pain, inadequate lubrication, lack of orgasm and improper pelvic floor muscle function.
    PHYSICAL THERAPY is a key part to treatment of sexual dysfunction in both men and women.  PELVIC FLOOR THERAPY techniques to help treat sexual dysfunction include muscle re-education, muscle trigger point release (internal as well as external), joint mobilization and therapeutic exercises.

  • Constipation
    Constipation is a common problem, and can be classified by straining to empty a bowel for more than 3 months. If you have been experiencing difficulty with bowel movements, there are conservative techniques to help alleviate symptoms.
    There are many reasons for constipation, but once any major disease (blockage) and any structural abnormalities (narrowing of the intestine, rectum or megacolon) are ruled out constipation can be classified in following 3 subgroups:
    • Normal transit constipation
    • Defactory disorders
    • Slow transit constipation
    Physical therapists that are specially trained in PELVIC FLOOR THERAPY can help you normalize function. Some treatment techniques include abdominal massage, biofeedback therapy to help improve pelvic floor muscle function, techniques to improve posture and education to make life style changes.

  • Incontinence after Prostate Surgery
    Incontinence is a common problem for men who have prostate surgery, and may be compounded by radiation.  While some men may improve on their own in the first 3-6 months after surgery, some men continue to leak.  However, incontinence is a treatable condition and often responds well with physical therapy.  Research is showing that men who receive physical therapy treatment earlier tend to improve faster and more completely than men who wait to try physical therapy or do not receive therapy at all.  
    A PELVIC FLOOR THERAPIST can help men regulate bladder function by restoring muscle function, controlling bladder urges and leakage.  Each patient receives custom exercise strategies targeted to the muscles that manage urine flow to prevent incontinence.  These men are often able to stay dry during household chores, work, and exercise—including golf.
  • Pain and Incontinence after Anal/Rectal Cancer
    All types of cancer affect physical function. The ways medicine, radiation, surgery and chemotherapy interact with your body are specific to your own cancer type, staging, and location of the tumor(s).  Some commonly reported side effects for cancer in the anal/rectal region are: constipation; diarrhea; incontinence of gas or stool; pain with passing bowel movements; pain or difficulty sitting; and pain or difficulty with sexual function.  Physical therapy can help alleviate or decrease the occurrence of these issues.
    Working with a specialist in pelvic floor therapy will help you treat incontinence, pain and problems with sexual function.  By using targeted and specific exercises unique to your individual needs, your therapist will work with your oncology team to maximize your ability to tolerate treatments and limit side-effects.
  • Muscle Weakness
    The pelvic floor is composed of a small group of muscles that attach to the front, back, and sides of the pelvic bone and sacrum (the large fused bone at the bottom of your spine, just above the tailbone.)These muscles can become weakened with age, during pregnancy, after childbirth or for unknown reasons. When this occurs it can lead to or contribute to conditions such as urinary and/or fecal incontinence and pelvic organ prolapse. Pelvic floor therapy can help improve strength, sensation, muscle coordination and function in order to address these disorders.
    Pelvic floor therapist will work with you to create an individualized exercise program that isolates the pelvic floor muscles to regain the strength, endurance and coordination needed to improve your quality of life.
  • Muscle Spasm
    Muscle spasms or “hypertonic” pelvic floor muscles are common in disorders such as, but not limited to, pelvic pain, painful bladder syndrome, low back pain, SI joint dysfunction and painful intercourse. Myofascial trigger points can also form in the muscles which are painful areas that refer pain into other areas of the body.
    Pelvic floor physical can help decrease these issues by providing a specific program to address contributing factors to muscle spasms such as posture, hip and back range of motion, joint mobility, and muscle strength and flexibility.  Treatment approaches include manual therapy, exercise and breathing techniques to relax muscles and relieve painful symptoms.

Our pelvic floor therapy program was created to meet the special needs of each patient.

New Patient Intake Forms


Pelvic Floor Muscle Biofeedback, a technique where patients gain greater awareness and control of normally unconscious physiological processes such as bladder and bowel control, is now offered as a treatment option.


HELPFUL LINKS:
  • www.nashvilleallianceforsexualhealth.org: aids in identifying local resources for the community and professionals, provides information and education on sexuality and sexual health, education on current research
  • www.womenshealthapta.org: The APTA (American Physical Therapy Association) section on Women’s Health – dedicated to the improvement of women’s and men’s health globally. This website includes a PT locator to help a potential patient find a WH PT in his or her area.
  • www.hermanwallace.com: Herman and Wallace Pelvic Rehabilitation Institute website includes a variety of helpful information including practitioner directory and products that may be helpful to patients.
  • www.womensexandsanity.com: blog developed to educate women on issues that often affect women including bladder dysfunction, female sexual dysfunction, pelvic pain and pain with intercourse.
  • www.ic-network.com: the Interstitial Cystitis Network website
  • www.vaginismus.com: website whose goal is helping women overcome sexual pain
  • www.nva.org: the National Vulvodynia Association website
  • www.UrologyHealth.org: American Urological Association Foundation
  • www.prostatitis.org: The Prostatitis Foundation
  • www.cancer.gov: National Cancer Institute (NCI) Cancer Information Service