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The American Physical Therapy Association (www.apta.org) can provide referrals to physical therapists in your area who are experienced in pelvic floor assessment & therapy.

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Created: Oct. 28 1999
Jill Osborne

Revision: 02/28/06 - kj

You are here: IC Network > Patient Handbook > Treatments > Pelvic Floor Therapies

Pelvic Floor Therapies

The pelvic floor is composed of an overlapping series of muscles which form a sling or funnel that holds the pelvic organs in place. Frequently, these muscles can be strained by childbirth, bicycle riding, accidents and even ballet, thus creating either painfully tight trigger points or weak, unsupportive muscles.

Pelvic floor therapies first came to the attention of the mainstream IC community in the mid 1990's. Upon therapy, some IC patients reported dramatic reductions in symptoms. Dr. Jerome Weiss (UCSF Medical School), a recent guest speaker on the IC Network, is one physician who actively assesses muscle tone and then may use direct manual manipulation and/or biofeedback to assist the patient in restoring muscle tone and health. Dr. Weiss offered a fascinating insight into pelvic floor functioning and therapies. Read the chat transcript here.

For IC patients, the health of the pelvic floor muscles merit a second glance particularly if they haven't been active for a period of time due to pain or frequency. Just the inactivity of an IC patient in a flare could lead to poor muscle tone. Signs of muscle weakness may be: (1) an uncomfortable feeling of pressure or heaviness, (2) leaking of urine when coughing, laughing, running or doing exercise, (3) bulding of the bladder into the vagina (cystoscele), (4) bulging of the rectum into the vagina (rectocele) and (5) the dropping of the uterus into the vagina. Therefore, a proactive approach to maintaining pelvic floor health can be a vital tool in an IC patient treatment arsenal and can prevent future bladder problems (i.e. stress incontinence, leakage) from developing.

If you are interested in learning more about your pelvic floor, your first goal is to obtain a pelvic floor assessment by a physician or physical therapist who is familiar with the latest in pelvic floor theories. Generally, the examination is done both externally and internally. The therapist may do an examination of the abdominal and perineal muscles to locate tender muscle areas. For women, a vaginal exam will allow the therapist to palpate the various internal pelvic floor muscles. Men will have their pelvic floor assessed through a simple rectal exam.

If your care provider finds that you have muscle problems, there are three common approaches to pelvic floor treatment: (1) myofascial release, (2) biofeedback and (3) kegel exercises.

  • Myofascial release is used to directly massage and reduce any myofascial trigger points (muscle knots) found. It may take several (many) sessions of physical therapy to reduce the tension in those muscle areas. In some cases, doctors may inject a local anesthetic directly into the muscle knot to relieve and reduce pain. Remember, muscle knots are tender. This therapy may be initially uncomfortable. Heat or ice may help reduce symptoms. If they are uncomfortable, talk with your care provider about how you can reduce your symptoms.

  • Biofeedback involves the use of a small machine and a wand, gently inserted in the vagina. It measures muscle tone and offers a pitched, audible sound to help patients relax the proper muscle areas. This can eventually be done at home, after proper training.

  • Kegels are simple exercises that help strengthen the perineal muscles. These are the muscles around the vagina and urinary opening. Kegels are simple, easy to do several times a day. The US NIDDK offers several excellent resources for patients who wish to learn more about kegel exercises. Read their resources here!
Does pelvic floor therapy cure IC?
No. Pelvic therapy is not a complete cure for IC, but it can dramatically reduce symptoms for patients who are experiencing muscle pain. It can also facilitate good muscle health and tone for men and women as they get older.

The ICN has had several guest presenters who have discussed and/or advocated pelvic floor therapies, including:

There are several new web sites that offer information on pelvic floor therapies, including:

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