Your doctor may advise you to receive physical therapy for urinary problems and pelvic floor dysfunction (PFD). This application of physical therapy in your pelvis is essentially the same as PT for other parts of the body (back, neck, or shoulder). However, since very few PTs are trained in this specialized area of treatment, you may not have known PT was even an option.
The truth is, physical therapy is an excellent tool in your recovery from pelvic pain, chronic muscle tightness, and a spectrum of urinary tract issues from urinary tract infections to interstitial cystitis.
If you’re having “trouble in your pelvis,” there can be a constellation of stressors at play. Sometimes these stressors begin with an injury to your low back, sacrum, or hips that leads to a muscular imbalance known as pelvic floor dysfunction. Then, for no apparent reason, you start to have urinary problems. What seems like two completely unrelated issues can actually stem from the same source, which is why it’s so important to heal the original injury and untangle the interlocking web of misaligned muscles in your pelvis.
Although using physical therapy to treat urinary tract issues such as interstitial cystitis and chronic prostatitis may seem counter intuitive, our experience tells us that once these underlying musculo-skeletal/biomechanical issues are improved, the urological symptoms often resolve themselves.
Some patients know what triggered their symptoms: childbirth, a car accident, prostate biopsy, riding too many miles on a bicycle seat designed by a sadist… For those patients, treatment is more straightforward. For others, tracking symptoms back to their source is a little more complicated. For example, a surgery you had 15 years ago plus the weight you’ve put on since then can lead to mechanical changes in the joints of the lower spine and pelvis.
In addition, as we age, our bodies naturally lose a certain amount of mobility. Because bodies are masters at compensation, they try to make up for a loss of mobility in one area with hypermobility in another, which can further complicate the problem by introducing bladder dysfunction and pelvic pain into the mix.
All of these changes can result in weak, misaligned, or constricted pelvic floor muscles. These muscles at the base of the pelvis are vital to your health in so many ways: elimination, sexuality, movement, posture, balance, and so on. In many indigenous cultures, this area is considered your foundation: the “seat of the soul.” (All the more reason to keep it healthy and functioning normally.)
Without proper support in this crucial area, the internal organs can drop down (prolapse) from their normal position. This change in the position of your organs adds to the weakness of the urinary and rectal sphincters, which leads to problems that often require surgery to correct.
Our in-house physical therapist, F.E. Boswell, MSPT, has been practicing PT since 1985 and specializing in pelvic floor disorders since 1998. We regularly see dramatic results with F.E.’s use of myofacial release points to help patients regain their strength, stability, and normal range of motion.