About the muscles
The muscles of the pelvic floor are located inside the pelvis between the pubic bone (in front) and the tail bone or coccyx (in back). They function as support for the internal organs, help control elimination from the bladder and the bowel, and are involved in sexual response.
How problems are diagnosed
The physical therapist does a manual exam, both externally and internally, of the muscles, as well as muscle biofeedback (EMG biofeedback) to help determine if your muscles are weak, if they have low endurance, or if they have elevated activity at rest (“spasm”). Internal structures will be examined by the Physical Therapist by inserting 1-2 fingers into the rectum/vagina. You may be asked to perform a series of muscular contractions to evaluate the strength of the pelvic floor musculature.
How the muscles contribute to your problem
Weak pelvic floor muscles may cause you to be incontinent of bladder or bowel. This may happen with coughing, sneezing, or other stressful events. Conversely, the muscles may have increased tension and may become painful if they are tightened for a long period of time. They may also spasm, causing a dull aching pain through the pelvis, buttocks or hips and occasionally down the leg. The pain may present itself as pressure, burning, or aching that is localized in the pelvic organs, genital region, and or bones of the pelvis or abdomen.
Responsibilities of the participant
Information you possess about your health status or your symptoms such as pain or pressure may affect the ability of the therapist to accurately assess the pelvic floor. You are responsible for fully disclosing your medical history, as well as any symptoms that may occur during the assessment.
A physical therapy evaluation will help decide the best approach to eliminating and managing pain, as well as strengthening weak muscles. Home exercises are frequently used to help strengthen the pelvic floor muscles. You might be instructed in exercises to help relax these muscles. Posture and therapeutic exercises are frequently recommended. It takes some time for you to build your awareness of the pelvic floor muscles and learn to either relax, or strengthen them. Biofeedback is helpful in this area. We use a sensor that we sell to you ($40.00) and you bring to each session (these are not covered by insurance).