Nobody is going to be surprised to hear that Physical Therapists work with muscles. But we bet a lot of people would be surprised to learn that the muscles inside your pelvis are included. While the pelvic muscles don’t get as much attention as the biceps or hamstrings, they can still cause problems that need treatment. Here are a few examples:

Urinary Incontinence

Urinary incontinence is the involuntary leakage of urine. More than 13 million people in the United States have this issue. There are different types of incontinence, but the most common are stress and urge incontinence.

• Stress incontinence is when leakage happens during coughing, sneezing, or laughing.
• Urge incontinence is a result of the bladder being overactive or unstable. People with urge incontinence often often have triggers that cause the involuntary loss of urine, such as hearing running water.

Pelvic Pain

This is defined as any pain that occurs either internally or externally in the pelvic or genital area. Both men and women can be affected, but it’s more common in women.

What’s the Cause?

Most incontinence is caused by issues with the pelvic muscles – either weakness or tightness. There can be other contributing factors like spasms that cause bladder contractions, or conditions like anxiety may increase the urge to empty the bladder.

Pelvic pain is also usually attributed to either tightness or weakness of the muscles of the pelvic floor. The pelvis is made up of three bones, forming three joints where they meet. These joints need to be stabilized by an outside force. The job of the muscles and ligaments in and around the pelvis is to  provide that stabilizing force. If the muscles are too tight, the joints will have an excessive amount of compression on them. Too loose, and the joints of the pelvis can experience shear forces. Both conditions result in pelvic pain.

What can PT do?

Because incontinence and pelvic pain are usually musculoskeletal conditions, physical therapy can offer a lot of effective treatments. Some examples include:

Exercise – strengthening or stretching of the pelvic muscles or the core can help correct imbalances, improve pelvic stability and reduce pain.

Biofeedback – This involves using sensors placed on the body while doing exercise to help the patient identify which muscle groups are working and bring awareness to areas of tightness or weakness.

Education – For incontinence,  learning how the bladder normally functions can help you to understand changes that can be made to improve symptoms. Learning about posture and how to improve alignment of the pelvis and the trunk can help to reduce pain and improve tolerance for positions like sitting and standing.

Manual Therapy – joint mobilizations, trigger point release, soft tissue massage, myofascial release, and other techniques can help improve mobility of the pelvic joints, decrease tone in spastic muscles, and reduce pain.

If you’re experiencing pelvic problems, a specially trained physical therapist can complete a comprehensive evaluation, help determine the cause, and design a customized treatment plan to help.

References:

1. Research (peer-reviewed)
   1. Geriatric incontinence – https://pubmed.ncbi.nlm.nih.gov/34519024/
   2. Assess Pelvic Floor Guide – https://pubmed.ncbi.nlm.nih.gov/34807882/
   3. Pediatric pelvic floor – https://pubmed.ncbi.nlm.nih.gov/10458431/
   4. Using PTs for Pelvic floor – https://pubmed.ncbi.nlm.nih.gov/35353916/
   5. Urinary Incontinence prevalence – https://pubmed.ncbi.nlm.nih.gov/35173077/
   6. Physical Therapy Treatment of Pelvic pain – Physical Therapy Treatment of Pelvic Pain – PubMed (nih.gov)
2. Articles and Content
   1. Pelvic floor muscles and training – https://pubmed.ncbi.nlm.nih.gov/35036386/
   2. Exercise in pregnancy (helping incontinence – one of the symptoms – https://pubmed.ncbi.nlm.nih.gov/34478617/