Greater Boston Urology Blog

Quick Primer on Pelvic Floor Physical Therapy at GBU

We're now offering pelvic floor physical therapy to GBU patients in our Dedham Care Center. Alicia Jeffrey-Thomas is our wonderful pelvic floor physical therapist.

Alicia recently sat down for a quick Q&A about what pelvic floor PT is, the conditions it treats, and what you can expect at your first appointment. 

What is pelvic floor physical therapy? 

The pelvic floor is a set of muscles that support the pelvic organs. (Both women and men have pelvic floors.) Sometimes these muscles weaken or sustain an injury. Pelvic floor physical therapy helps patients regain control of these muscles, just as traditional PT might help someone recovering after an injury or surgery. 

For decades in other countries, pelvic floor physical therapy has been the standard of care for postpartum women. Pelvic floor PT helps women retrain the muscles that control bowel and bladder function so they can return to regular physical activity.  

Pelvic floor physical therapy is now being recognized as a first line treatment in the United States. As your pelvic floor physical therapist, I'll work with you to develop a holistic plan to decrease or abolish your symptoms by looking at how your muscles are working, how you're breathing, and how you're moving. 

And remember, pelvic floor PT isn't just for women. Men have pelvic floor muscles and benefit from this line of treatment as well. 

I'd never heard of pelvic floor physical therapy until now. How come? 

Most people have no problem talking to friends or family about their recent bout of physical therapy for their knee or shoulder, but when it comes to their private parts, it's much less likely to be a topic of conversation at a party. It isn't easy for people to talk about things like pain or leaking "down there." I always strive to make my patients feel safe and comfortable so they can talk to me about what's going on with their bodies and their symptoms. 

What conditions does pelvic floor physical therapy treat? 

Some conditions treated by pelvic floor physical therapy include:

  • Bladder and bowel issues, such as incontinence, overactive bladder, constipation, IBS
  • Pelvic organ prolapse
  • Pelvic pain related to diagnoses, such as interstitial cystitis, endometriosis, and prostatitis
  • Sexual dysfunction
  • Pregnancy and postpartum recovery
  • Musculoskeletal aches and pains (involving the back, hips, SI joint, groin, abdomen, and sometimes limbs) 

What should I expect during my first pelvic floor physical therapy appointment? 

At your first appointment, we'll talk about what's happening with your body and your physical activity goals. I'll give a short anatomy lesson, explaining where the pelvic floor is and why it's important. And I'll conduct an external and an internal exam. 

For the internal exam, you'll undress from the waist down and lie on your back with a drape covering you. (If you're a woman, it's perfectly OK if you have your period.) I don't use any instruments—just gloves and lubrication. I go very slowly, using one finger to feel for the tone of the muscles that wrap around the vaginal canal (or the rectum, for male patients or for patients who cannot tolerate a vaginal exam). If you've ever had a pap smear, it's much gentler. I assess the area and ask the patient to do some funny things like cough, hold their pee, hold their gas, and do a Kegel to see how the area is responding. 

From there, we make a plan and establish some homework to begin working on addressing what we found during the exam. This plan may change based on how your body responds. You may need to have frequent appointments, especially at first, depending on your condition. I will try to give you an approximate timeline, though rehabilitation and healing is not always predictable. 

My main goal is to always give hope and confidence to patients seeking treatment for pelvic floor dysfunction. 

Thanks, Alicia! Pelvic floor physical therapy is currently available to GBU patients. Talk to your GBU physician about a referral.


Watch: How Does Pelvic Floor Physical Therapy Treat Interstitial Cystitis?



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