Pelvic Floor Physical Therapy – PFPT and When to Use it

WHAT IS IT?

Pelvic floor physical therapy (PFPT) aims at lengthening, strengthening and realigning muscle and tissue in the pelvic region. PFPT can be used to address conditions that occur when the muscles of the pelvic floor are weak, tight, or there is an impairment of the sacroiliac joint, lower back, coccyx and/or hip joint. The tissues surrounding the pelvic organs may more or less sensitive and/or be irritated resulting in pelvic pain. While PFPT is most commonly considered to address issues of urinary and bowel problems, it can also be used effectively for a number of sexual dysfunctions including vaginismus, vulvodynia and vestibulodynia.

KEY POINTS:

  • Once a diagnosis has been determined for pelvic pain, a practitioner might want to consider referral for PFPT in the following situations
    • Vaginismus has been diagnosed and determined to be primarily due to tight muscles and less a result of fear
    • Vestibulodynia has been determined to be a result, at least partially, of tight muscles
  • A pelvic floor physical therapist may use
    • External and internal manual therapy including trigger point and myofascial release, manipulation of connective tissue, visceral manipulation
    • TENS unit electrical nerve stimulation and biofeedback
    • Cold laser, heat and cold therapy
  • Treatment may be
    • Once-twice weekly
    • Generally involves 5-20 weeks of treatment

Learn More- Primary Sources:

Pelvic Floor Physical Therapy for Vulvodynia: A Clinician’s Guide

Effectiveness of cognitive-behavioral therapy and physical therapy for provoked vestibulodynia: A randomized pilot study

A pilot randomized trial of levator injections versus physical therapy for treatment of pelvic floor myalgia and sexual pain