Treatment combines several elements and may include the following:
Pelvic Floor Muscle Training (PFMT): These are exercises tailored to restore function, enabling both voluntary and involuntary muscle contraction and relaxation. PFMT success is often maximized when training is supervised by a health professional versus being self-administered.
Education and Behavioral Interventions: Counseling involves providing lifestyle advice and specific strategies, such as:
Bladder Training: Includes scheduled voiding and using urge suppression techniques (like quick PFM contractions to quiet the bladder detrusor muscle).
Dietary Modifications: Assessing fluid intake (type and amount) and potential bladder irritants.
Proper Toileting Techniques: Instructing patients to sit on the toilet, lean forward, and position their feet on an elevated surface so the knees are higher than the hips to ease voiding or defecation.
Whole-Body Integration: Core, Posture, and Breathwork
Pelvic floor health doesn’t exist in isolation—it’s deeply connected to the strength, mobility, and coordination of the entire body. Treatment often includes:
Core and Hip Strengthening: Targeted exercises for the glutes, deep abdominals (like the transversus abdominis), and hip stabilizers to support pelvic alignment and reduce compensatory strain.
Postural Re-education: Addressing habitual postures that may contribute to pelvic floor dysfunction, including rib flare, anterior pelvic tilt, or collapsed thorax positioning.
Breath Mechanics: Teaching diaphragmatic breathing and coordinating breath with movement to optimize intra-abdominal pressure and pelvic floor responsiveness.
Functional Movement Training: Integrating pelvic floor awareness into daily activities like lifting, squatting, and transitional movements to build resilience and confidence.
This whole-body approach helps patients move beyond symptom management and toward sustainable, empowered function—whether that means returning to sport, parenting with less pain, or simply feeling more at home in their body.
Biofeedback: This is an important adjunct (not a standalone treatment) that measures the muscle response to contraction. Biofeedback systems, such as Surface Electromyography (sEMG), use visual or auditory signals to help the patient identify and modulate electrical activity in the PFM, which is beneficial for cases of underactivity, overactivity, or poor coordination.
Electrical Stimulation (E-Stim): Electrical devices may be used internally (vaginal or rectal electrode) or externally (Transcutaneous Electrical Nerve Stimulation, or TENS).
If you are experiencing any symptoms related to incontinence, pelvic heaviness, chronic pain, or difficulty with bowel/bladder function, speaking with a physical therapist specializing in pelvic health may be your first step toward improvement. Success in PT often correlates strongly with motivation and adherence to a prescribed program.
