Pelvic Floor Physical Therapy for Urinary Incontinence
Pelvic floor physical therapy is a specialized treatment that improves how your pelvic floor works and can reduce urinary incontinence. At our practice, we highly recommend it as a cornerstone of conservative treatment for many patients.
What Your Therapist Works On
Kegel exercises are an important part of pelvic floor rehab. A skilled pelvic floor physical therapist also works on:
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Breathing Techniques: How you breathe affects your pelvic floor. Your therapist will teach you to coordinate your breath with pelvic floor movements.
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Posture Correction: Your posture affects the position and function of your pelvic organs. Better posture can take stress off the pelvic floor.
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Mobility Work: Restrictions in your hips, lower back, or abdomen can affect pelvic floor function. Your therapist will work on mobility in these areas.
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Core Strength: A strong core works together with the pelvic floor. Your therapy will likely include exercises to improve core stability.
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Relaxation Techniques: Sometimes, the pelvic floor muscles are too tense. Learning to relax these muscles can be just as important as strengthening them.
“Pelvic floor physical therapy is about whole-body wellness. We look at how everything from your breathing to your hip mobility affects your pelvic health.” - Dr. Ryan Stewart
What to Expect in a Session
Each session is tailored to your needs and comfort level. A typical course includes:
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Initial Assessment: Your first visit includes a full evaluation of your pelvic floor strength, coordination, and overall physical condition.
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Customized Treatment Plan: Based on the assessment, your therapist will develop a personalized treatment plan.
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Education: You’ll learn about pelvic floor anatomy and how it relates to your symptoms.
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Exercises: Your therapist will guide you through exercises to do in the session and at home.
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Manual Therapy: This might include external techniques on your lower back, hips, or abdomen.
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Biofeedback: Some sessions may use biofeedback devices to help you visualize your pelvic floor muscle activity.
Your Comfort is Priority
You are always in control during your sessions.
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Consent: Any internal work, such as internal pelvic floor muscle assessment or treatment, will only be done with your explicit consent.
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Communication: Tell your therapist about any discomfort or concerns at any time.
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Flexibility: If you’re not comfortable with part of the treatment on a given day, your therapist can adjust the session.
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External Options: Many helpful techniques are external. PT can still help you a lot if you’d rather not have internal work.
“Your comfort and consent are our top priorities. We want you to feel empowered and in control throughout the entire course of your treatment.” - Dr. Ryan Stewart
Benefits of Pelvic Floor Physical Therapy
Patients often notice:
- Improved bladder control
- Reduced urinary urgency and frequency
- Better pelvic organ support
- Decreased pelvic pain
- Improved sexual function
- Better quality of life
Is Pelvic Floor Physical Therapy Right for You?
Pelvic floor physical therapy can help with many types of urinary incontinence, including stress incontinence, urge incontinence, and mixed incontinence. It’s often recommended as a first-line treatment or alongside other therapies.
During your consultation with Dr. Stewart, we’ll talk about whether pelvic floor PT fits your situation. We work closely with pelvic floor physical therapists and can refer you to one we trust.
PT takes time and steady practice. Most patients attend weekly or bi-weekly sessions for several weeks to months, and many notice improvement within the first few weeks of regular practice.
Schedule a consultation with Dr. Stewart to talk about whether pelvic floor PT belongs in your treatment plan.
References
- ACOG Committee on Practice Bulletins—Gynecology, American Urogynecologic Society, Kenton KS, et al. Urinary Incontinence in Women (ACOG Practice Bulletin No. 155). Obstetrics & Gynecology. 2015. doi:10.1097/AOG.0000000000001148
- Bo K, Frawley HC, Haylen BT, et al. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for the conservative and nonpharmacological management of female pelvic floor dysfunction. International Urogynecology Journal. 2017. doi:10.1007/s00192-016-3123-4
- Wallace SL, Miller LD, Mishra K. Pelvic floor physical therapy in the treatment of pelvic floor dysfunction in women. Current Opinion in Obstetrics and Gynecology. 2019. doi:10.1097/GCO.0000000000000584
- Wu JM. Stress Incontinence in Women. New England Journal of Medicine. 2021. doi:10.1056/NEJMcp1914037
- Sung VW, Borello-France D, Newman DK, et al. Effect of Behavioral and Pelvic Floor Muscle Therapy Combined With Surgery vs Surgery Alone on Incontinence Symptoms Among Women With Mixed Urinary Incontinence: The ESTEEM Randomized Clinical Trial. JAMA. 2019. doi:10.1001/jama.2019.12467
- Hagen S, Stark D, Glazener C, et al. Individualised pelvic floor muscle training in women with pelvic organ prolapse (POPPY): a multicentre randomised controlled trial. The Lancet. 2014. doi:10.1016/S0140-6736(13)61977-7
- Harm-Ernandes I, Boyle V, Hartmann D, et al. Assessment of the Pelvic Floor and Associated Musculoskeletal System: Guide for Medical Practitioners. Female Pelvic Medicine & Reconstructive Surgery. 2021. doi:10.1097/SPV.0000000000001121