What to Expect From Pelvic Floor Physical Therapy

Pelvic floor physical therapy is a treatment option available that may help with pain related to endometriosis, polycystic ovary syndrome (PCOS), interstitial cystitis (IC) and other illnesses that can lead to pelvic floor dysfunction. It’s understandable that those who are struggling with endometriosis can have pelvic floor dysfunction as it’s hard to relax when your abdomen and/or other areas are in constant pain.

I was diagnosed with endometriosis in 2010 and never heard the words “pelvic floor physical therapy” until 2013, from a doctor at the Mayo Clinic. No gynecologist had even mentioned it to me before this time. When I first heard it, I had mixed feelings about it, but I was also desperate to be out of pain. I made an appointment with a pelvic floor physical therapist. The closest one to me is about a six-hour round trip.

I first started going once a week because my physical therapist felt this was the best option for me until I could get rid of some of my spasming and pain. She did an initial assessment for my first appointment to see where I was, so we could compare it when I was discharged and hopefully see improvement. During each appointment, she did internal biofeedback and connective tissue manipulation. Internal biofeedback helps patients to learn how to relax their pelvic floor and strengthen it. Something a lot of people who have pelvic floor spasms struggle to do is relax because of disease or trauma. This is why every time I had a pap smear, I would be in excruciating pain because I was unable to relax before they started the exam. In my case, the biofeedback sensor was connected to my therapist’s computer and inserted vaginally. A graph displayed to show how relaxed my pelvic floor was, which was very little during my first appointment. She would do stretches and exercises with me to help me learn how to relax as well as send me home with some to do to help in-between sessions.

Connective tissue manipulation involves stretching tissue to allow for more mobility and blood flow. She used this technique from my back and my stomach to my thighs. This would also help decrease my pelvic floor spasms because everything is connected. It can be difficult to do this on yourself because when you are rubbing your skin and feel pain, we tend to stop because we want the pain to stop.

Pelvic floor physical therapists may recommend you purchase a dilator to help with stretching at home as mine did and it was helpful.

“Heal Pelvic Pain: A Proven Stretching, Strengthening, and Nutrition Program for Relieving Pain, Incontinence, IBS, and Other Symptoms Without Surgery” by Amy Stein, M.P.T. is a great book that my pelvic floor physical therapist recommended I read.

Personally, I think anyone who has surgery, pelvic disease or gives birth should be referred to a pelvic floor physical therapist because these can all be traumatic to the pelvic area.

After about six months of going to pelvic floor physical therapy, I was discharged because my spasms had decreased significantly. However, some of my abdominal pain was still there because I had endometriosis on my ovaries. This was before I had my hysterectomy. I’m so thankful for my pelvic floor physical therapist as she made me feel comfortable during each of my appointments and was able to help me decrease my pain. I still do some of the stretches at home, six years later.

Talk to your doctor about referring you to a pelvic floor physical therapist if you think it would be helpful for you.

If you do go to pelvic floor physical therapy, I want you to know what to expect, know there is nothing wrong with you and know you are not alone. I felt so alone because, at the time, I hadn’t even heard of it let alone know anyone who had gone or was going.

Let me know if you have any questions! I hope you find this information helpful.