10 Misconceptions about Pelvic Physical Therapy

J U L Y 2 0 1 8 , P A G E 1

DID YOU

KNOW…?

N E A R L Y O N E - T H I R D

O F A M E R I C A N S A G E S

3 0 - 7 0 H A V E

H A D S Y M P T O M S F O R

L O S S O F B L A D D E R

C O N T R O L A T S O M E

P O I N T I N T H E I R

L I V E S

P E L V I C P H Y S I C A L

T H E R A P Y I S N O T

J U S T F O R W O M E N —

O N E C L I N I C I N

A U S T I N , T X

R E P O R T E D T H A T I N A

S I N G L E D A Y , 3 0 % O F

T H E I R P E L V I C F L O O R

P A T I E N T S W E R E

M A L E

1. Only women who have just given birth to a child need to see

a Pelvic Physical Therapist. When it comes to Pelvic PT, the percentage of women being seen that are immediate-

ly postpartum is usually less than 15%! In reality, both men and women are treated

with Pelvic Physical Therapy and can have a range of symptoms, including: urinary

incontinence, difficulty urinating, urinary urgency/frequency, bowel incontinence, con-

stipation, abdominal pain, low back/SI pain, hip/groin pain, painful intercourse, erectile

dysfunction, pelvic pain, coccyx pain, vaginal/rectal pain, penile/testicular pain, as well

as men and women who will need to have or who have already had pelvic surgeries

(hysterectomy/prostatectomy) or abdominal surgeries (C-section, hernia repair, etc.).

2. Pelvic Physical Therapists do not treat men. This is completely FALSE. It may be true that there are usually more female patients at

certain clinics but a number of clinics have estimated that 20-30% of their schedule is

male patients. The majority of these patients come in for post-prostatectomy related

issues or male pelvic pain, but men can also be treated for bowel dysfunction, urinary dysfunction, tailbone pain,

and sexual related pain.

3. If a person is leaking urine, they definitely need Kegel exercises. This is a very common misconception. Urinary incontinence is not just because of weak pelvic floor muscles.

Sometimes these muscles are too tight, or contain trigger points which contribute to pain, weakness, or both.

Plus, there is a whole system in place—a well functioning pelvic floor muscle group, abdominal muscles, hip mus-

cles, diaphragm and low back muscles– that all need to work together to allow for optimal bowel/bladder func-

tion. These strong, yet flexible, muscles need to be able to tighten and relax when they’re supposed to. Two

different people may have the same difficulty holding back urine and require two entirely different treatments. A

Pelvic Physical Therapist will perform manual techniques to restore optimal pelvic floor muscle tone and function,

in addition to prescribing the right exercises that will best help each individual person.

4. If a person has tried “Kegel exercises” and they did not work, Pelvic PT won’t be able

to help them. An alarmingly large number of people seem to believe that

Kegel exercises are the primary treatment in Pelvic Physical Therapy.

This is far from the truth! Rehabilitating pelvic muscles is much more

complicated than simply doing Kegel exercises. It involves improving

muscular support around the hips, pelvis, and low back, improving die-

tary habits, coordinating proper breathing patterns, learning healthy

bladder habits, building confidence, and retraining muscles to achieve

optimal function.

5. If your mother/grandmother/great-grandmother also

had constipation/urinary incontinence/diarrhea/etc., then

it must be genetic and can’t be helped. While genetics may play a role, there is ALWAYS something that can be

done to help with these symptoms! Working with a team of healthcare

professionals, including a Pelvic PT, is the best way to ensure optimal

bowel/bladder/pelvic health!

B O T H O R T H O P E D I C A N D

P E L V I C F L O O R P H Y S I -

C A L T H E R A P Y A R E O F -

F E R E D W H I C H M E A N S

C O N D I T I O N S T R E A T E D

R A N G E F R O M H E A D -

A C H E S , B A C K , K N E E ,

H I P A N D F O O T P A I N T O

U R I N A R Y I N C O N T I -

N E N C E / F R E Q U E N C Y /

U R G E N C Y , O B S T E T R I C S ,

C O N S T I P A T I O N , A N D

P E L V I C / G R O I N P A I N

C O L D A N D C O M P R E S -

S I O N S Y S T E M C L I N I C A L -

L Y P R O V E N T O I M P R O V E

P A I N R E L I E F , I N C R E A S E

M U S C L E S T R E N G T H A N D

R A N G E O F M O T I O N ,

W H I L E R E D U C I N G

S T I F F N E S S A N D P A I N

I N T E N S I T Y — N A T U R A L L Y

A N D W I T H O U T

N A R C O T I C S

J U L Y 2 0 1 8 , P A G E 2

6. The education required to become a Physical Thera-

pist is the same as any other 4-year degree. Most licensed physical therapists have either a Masters or Doctoral degree

in physical therapy. In addition to 6-7 years of formal education, specializing

in Pelvic Physical Therapy involves attending numerous post-graduate con-

tinuing education courses, performing research/case studies, and passing a

rigorous written/practical exam in order to achieve the full skill set needed

to treat this patient population.

7. If a person has already had surgery or is planning to

have surgery, pelvic physical therapy won’t help them. While surgical intervention can definitely correct anatomical issues, taking

part in Pelvic Physical Therapy is most beneficial in ensuring that pelvic floor

muscles are properly rehabilitated following any abdominal/pelvic-related

surgery. Research has consistently shown that physical therapy treatment both prior to and after surgery plays a

vital role in positive outcomes while also reducing the possibility of surgery in the future.

8. A physical therapist doing vaginal or rectal exams is weird and NOT conventional. The majority of the pelvic floor muscles are located internally. Although pelvic

muscle function can be assessed through external observation, an internal

assessment is the only technique supported by current medical research. Many

patients who opt out of the internal assessment initially, end up agreeing to it

later after they gain a better understanding of the treatment involved and once

they feel more comfortable with their Pelvic Physical Therapist.

9. If a person has a “medical cause” of his/her pelvic pain or

bladder/bowel issue, Physical Therapy will not help. Certain medical diagnoses can have musculoskeletal involvement. For example, if

a patient has a history of urinary tract infections, he/she may have accumulated

trigger points or excessive tension in the pelvic floor musculature which may

contribute to urinary frequency, urgency, or pelvic pain. Manual therapy tech-

niques, performed by a Pelvic Physical Therapist, can release these trigger points

and restore normal tone and strength to the pelvic floor muscles, which alleviates

pain, eliminates incontinence, and restores normal function to the bladder.

A N O N - I N V A S I V E

T R E A T M E N T A P P R O A C H

I S U S E D T O H E L P

I N D I V I D U A L S W I T H

S Y M P T O M S R E L A T E D T O

I N N E R E A R A N D

B A L A N C E D I S O R D E R S

S U C H A S L I G H T H E A D -

E D N E S S , D I Z Z I N E S S ,

P O S I T I O N A L O R

P E R S I S T E N T V E R T I G O ,

N A U S E A , A N D

I M B A L A N C E

F D A A P P R O V E D ,

A D V A N C E D T H E R A P E U -

T I C T E A C H N O L O G Y

W H I C H S P E E D S U P

H E A L I N G T I M E A N D

R E D U C E S I N F L A M M A -

T I O N , S W E L L I N G , A N D

T A R G E T S D A M A G E D

T I S S U E . T R E A T M E N T S

A R E S A F E , P A I N L E S S

A N D F A S T . E F F E C T I V E

I N T R E A T I N G N E W

I N J U R I E S A N D C H R O N I C

C O N D I T I O N S L I K E

S C I A T I C A , N E U R O P A -

T H Y A N D A R T H R I T S

T R E A T M E N T T E C H -

N I Q U E W H I C H A L L O W S

S P E C I F I C T A R G E T I N G

O F M U S C L E G R O U P S

T H A T A R E H A R D T O

R E A C H I N T R A D I T I O N -

A L M A N U A L T H E R A P Y .

A L L E V I A T E S K N O T S

A N D P A I N I N M U S C L E S

I N A Q U I C K A N D

E F F E C T I V E W A Y B Y

I N C R E A S I N G L O C A L

C I R C U L A T I O N A N D

C H A N G I N G T H E

C H E M I C A L M A K E - U P O F

T I G H T A N D I R R I T A T E D

T I S S U E

A L O W E R B O D Y A L I G N -

M E N T A S S E S S M E N T I S

P E R F O R M E D T H R O U G H

L A S E R T E C H N O L O G Y T O

P R O V I D E A F U L L

S C R E E N O F L O W E R

B O D Y A L I G N M E N T A N D

R E L A T E D M O V E M E N T

P A T T E R N S , A N D A S U B -

S E Q U E N T C U S T O M

O R T H O T I C I S C R E A T E D

B A S E D O F F F I N D I N G S .

I N D I V I D U A L S W I T H

P L A N T A R F A S C I I T I S ,

S H I N S P L I N T S , K N E E /

H I P / B A C K P A I N B E N E -

F I T F R O M C U S T O M

O R T H O T I C S

10. A person’s habits (eating, drinking, etc.) are not related to

pain, urinary or bowel dysfunction. Oftentimes, it is someone’s daily habits that may be contributing to a person’s symptoms—even if those symptoms

are new. Because of this, it is important for a Physical Therapist to discuss all daily habits with a patient, whether it’s

sitting all day at work, exercising too vigorously, eating an abundance of sugary foods, consuming bladder irritating

beverages, or not drinking enough water.