What exactly happens in pfd PT?

[RAS6]

My doctor thankfully treats Pelvic Floor Disfunction. My visit with him was such a whirlwind! He did the cystoscopy, confirmed that I have IC, and talked to me about the hydrodistention (which I am having on Friday) We also discussed Elmiron and he gave me the prescription plus more Ultracet.
He quickly brought up pelvic floor therapy because of my back pain and pain and burning between my legs. He said I can't start until November b/c of the Hydrodistention procedure.
In the meantime I was curious as to what this therapy is like. Is it mainly exercises or does it just depend on the therapist?
Thanks for sharing!
-Rachel

[Sarojini]

It depends on the therapist a little.

I know mine started with the therapist measuring the tension in my muscles and my ability to tighten and relax them. This consisted of placement of electrodes on my stomach, hips, and outside the pubic area. I was then asked to just sit there as she measured baseline, and then I was asked to do Kegels... some in quick succession, some I had to squeeze, hold, and release. A computer showed the readout in the form of a graph. This was repeated at times during the course of therapy to measure improvement in pelvic relaxation.

The therapy began with stretches that targeted the tight muscles (the therapist stretched me there, and taught me to do stretches on my own at home too). The stretching continued for a few weeks, and with it, we did E-stim and deep tissue heating with ultrasound.

The E-stim consisted of simply an electronic massage -- electrodes were placed on my back and butt to get to the pelvic floor, and then the machine was turned on and adjusted until comfy. It felt like a nice deep massage. The ultrasound heating consisted of the therapist placing a probe that emitted ultrasound waves on my various trigger points (outside my body) and this led to a feeling of warmth in the muscle. It, combined with the E-stim, was sooooo relaxing.

Later in therapy, when my pelvic floor tone relaxed more, we moved to some internal work, in which she gently inserted a finger into my vagina -- we did relaxation that way, and she could also massage internal trigger points.

I will say, it helped a lot!

[**Angie**]

One thing that helped me a lot was "how" to relax those muscles. I can't get them all the way down but I can definitely let go quite a bit. I go back every few months for a refresher--my muscles forget what they are supposed to do. :)

[kadi]

I did just the external stuff to tone & relax the pelvic floor. I asked the PT to create me a program I could do at home on my own. Stretches and strengthening movements. It's worked well and I've gone from needing rescue instillations daily to about one a week!

[IcyAngel23]

Well PT can be one of the most pianful things you will go through if you have really bad PFD. The most painful of the treatments is the manual stimulation of the pelvic floor mucles. Stretching and pulling. There are EMG biofeedback which is you really doing kegal exercises hooked up to this machine to learn to relax your pelvic floor. I had 2 sets of 16 week treatments and I saw no improvement. My PT just couldn't get my pelvic floor to respond. The best treatment is the heat ultrasound which feels good. It's a tough road but I hope it helps you.

[RAS6]

I had alot going on and was getting over a hydrodistention, which is why I am finally posting now! I just was able to talk to the therapist and she explained things pretty much like everyone else. The kegels for half an hour sounds rough, as well as the vaginal probe, but I am willing to do just about anything to stop all this pain. I start in November, so I will definately be back asking more ?'s, or at least giving an update.

Thanks again!
-Rachel

[rosesitty]

I've had nine treatments and I'm worse than when I started. They thought they'd see some improvement by now, but no such luck. I'm committed, but it's getting hard. It's good to hear that the PT has helped some of you. Internal work causes internal pain, external work causes external pain -- now it's both. I'm having massage therapy and acupuncture to try and get things settled down. Too soon to tell.
Stephanie:pray:

[Puppybreath]

I am a veteran of different types of PT. I don't think Kegels are the answer. As a matter of fact, tighting the muscles only makes my problems worse. I do much better with heat, warm soaks, and doing trigger point massage internally and externally. Stretches are good too.
I learned more from 4 days doing the Stanford Protocol than I did from any physical therapy or biofeedback.
You can learn a lot just by reading "Headache in the Pelvis." I was able to do a lot of releases and found a therapist who was willing to learn. It has made all the difference.
Beth, Miami

[IP freely]

I am a big fan of pelvic floor treatments,they are the only thing that has ever helped! I have been doing regular Kegels for a few years now and they work like a charm for me.

When I have a bad flare I do some deep breathing and kegels and they reduce my spasms greatly. I have had IC for over 20 years (two thirds of my damn life) so I have learned to manage my symptoms this way. It takes a lot of dedication and determination,and a high pain tolerance to get through the PFT's but it is so worth it in my opinion.

[Puppybreath]

I am glad you have found the way to manage your IC without all of these medications! I think that Kegels help maintain muscle tone in the abdomen.

I only commented that tightening up anything in the abdomen intentionally is contrary to the program that has helped me. The 42 tapes I left with all focused on learning to notice the tension we hold in the abdomen, then letting it go. It was suggested to me that the way to relax my pelvic floor was to keep tightening my rectum, then letting go. All I got was a very sore rectum.

I think the pelvic floor therapies are seriously underused because they are not moneymakers for urologists. David Wise's book "Headache in the Pelvis," opened my eyes. There is so much we can do for ourselves.

Since the program I take a hot bath every night. Just got a jacuzzi tub. It really helps prepare me for stretching.

The more we can do for ourselves, the happier we will be.

[IP freely]

I love hot baths too,they are such a lifesaver.

Tightening your rectum doesn't sound like much fun!

My physiotherapist explained the benefit of the kegels to me this way. Often during sex,you do kegels intentionally or sometimes unintentionally . When your muscles are engaged this way,your bladder can relax and thus your spasms decrease.

Conversely,When you urinate you are using a different set of muscles down there . It is impossible to do kegels and pee as you know,this stops the flow. So doing your kegels regularly not only strengthens your pelvic floor but they help your spasms decrease.

Strengthening your pelvic floor also prevents some instances of bladder or uterus prolapse which can be a big issue. Women who do them also have an easier time during childbirth.

So despite all that,all I know is when I do them I can feel spasms decreasing and it's awesome to feel like I have some control over my bladder!

You are very correct that tightening your abdomen is contrary to helping anything in your pelvic floor region. When you contract your abs you can't fully contract your pelvic floor muscles and vice versa. I am very aware of this because I lift weights and the strain can be very detrimental to your pelvic floor if you aren't careful.

My therapist wrote a book also,it's called I laughed so hard I peed my pants http://www.ilaughedsohard.com/ It covers a range of bladder related issues.

I'd never heard of "Headache in the Pelvis" before,I'll have to check it out.