Whether it is external or internal, your therapist will make a recommendation as to which will be most appropriate. Our pelvic floor exams are different than the typical pelvic exam you may have at your gynecologist or general practitioner’s office. Most people are pleasantly surprised by the comfort of our exams. In its simplest form, a pelvic assessment evaluates the function, coordination, and strength of the pelvic floor muscles. We observe the tissue quality and overall health of the pelvic floor. If you have reservations regarding having an internal assessment, you and your PT can talk about other options or defer to a time when you both feel it is more appropriate.

Pelvic floor physical therapy doesn’t differ from regular physical therapy in its principles, strategies and outcomes. As physical therapists we are movement, strength, coordination and muscle experts. We have been trained to assess the strength, endurance, and coordination of skeletal muscle and the biomechanics of the body.  All of our pelvic floor physical therapists have received extensive post-graduate education to take that same knowledge and apply it in a very specific ways to the pelvic floor. Just like any muscle in the body the pelvic floor muscles respond really well to manual therapy, therapeutic exercises, and neuromuscular re-education. In addition to all of this, pelvic floor physical therapy also takes into consideration lifestyle and daily habits that play a role into your pelvic floor’s function. Pelvic floor PTs evaluate daily habits via a bladder or bowel log and sometimes a food log.

Every person is different. Every issue and individual responds at a different rate to treatment therefore making this a difficult question to answer. Generally, we see patient’s one time per week for the first month then reduce visits to once every two weeks, for a total of 6 to 8 visits. However, visits can range to as many as 16. You and your therapist will work together to get an initial estimate in the first few visits and will update this time frame as appropriate throughout your time of rehab.

The pelvic floor refers to a group of muscles that lies at the bottom of the pelvis. This “sling” of muscles attaches from your pubic bone to your tailbone. The primary function of the pelvic floor is to maintain continence by holding back urine, gas, and stool. They also play a role in sexual function and appreciation, as well as play an important role in core stability of our spine, pelvis and hips.  If functioning efficiently, a person is continent and free of sexual dysfunction and pain. Unfortunately, like any muscle in the body, the pelvic floor muscles can start behaving incorrectly. A person may start experiencing leakage, constipation, pelvic pain, sexual dysfunction, low back pain, tailbone pain, hip pain or pelvic organ prolapse. We refer to this as pelvic floor dysfunction. Most often people think this is a strengthening issue, however this is not always the case. Roughly half of our patients that have pelvic floor dysfunction have pelvic floors that are too tight and non-relaxing.

At Alpine, we use many different modalities to help patients strengthen, relax, and regain control of their pelvic floor muscles. One method that we frequently use is called Biofeedback. Biofeedback can be performed in many ways, however it usually refers to a machine that uses sensors and a computer screen to relay information about pelvic floor activity in real time through audio and visual feedback. This machine can be another avenue within PT for your body to learn the correct way to perform a pelvic floor contraction (aka kegel) with the aim of increasing your ability to perform them correctly and independently.

We get this question all the time and the answer is always yes! Why? Studies show that 70% of women with pelvic floor dysfunction perform a kegel incorrectly with verbal instructions alone. Many individuals (men, women, and children) adopt incorrect muscle patterns and compensations within or outside of the pelvic floor that can cause pelvic floor dysfunction. With our expertise we can help you find your pelvic floor muscles and ensure that you are using them in coordination with the rest of your body.

Yes! Men have pelvic floors too. Enlarged prostates and abdominal, low back, hip surgeries pain can be traumatizing to the pelvic floor muscles which can lead to leakage and/or pain in the penis, testes, and scrotum. At Alpine, all of our pelvic floor therapists have special education to assess and treat the pelvic floor in a way that is specific to the male patient.

Yes! Common diagnoses seen in the pediatric population include but are not limited to incontinence, bed wetting, voiding dysfunction, and constipation. Parents are always present during evaluation and treatment. Biofeedback can be a very helpful tool in this population and is often used. As a general rule, internal pelvic floor assessments are not performed on children under the age of 18.

Refer to the answers of question number 3 and 5. There is typically a combination of contributing factors to constipation that include muscular coordination and daily habits. We evaluate them within pelvic floor rehab to help many people improve (and sometimes resolve) their constipation.

We treat a wide variety of pelvic floor issues. Below is a brief list of what we treat:

• Incontinence of urine, feces, and gas
• Pelvic Organ Prolapse (POP)
• Male and Female Pelvic Pain
• Incomplete emptying of the bladder
• Constipation
• Interstitial Cystitis and Painful Bladder Syndrome
• Endometriosis
• Coccydynia and rectal pain
• Post-surgical and post-radiation pain and dysfunction
• Pre- and postnatal pain, dysfunction
• Pregnancy related pain and dysfunction

Sacroiliac Dysfunction