Pelvic Floor Physical Therapy - Why Is It Not More Widely Adopted?

Posted by Clark Love on Nov 17, 2022 12:37:36 PM

Pelvic-Floor-Physical-Therapy-With-BiofeedbackPelvic floor muscles work with the pelvic bones to support your lower body. Like the muscles that help you lift, they stabilize your pelvis and spine while improving pelvic floor strength. They are extremely important, especially in women during pregnancy, delivery, and recovery. They can also help you with incontinence, sexual function, and even your ability to walk.

However, due to trauma and stress, the pelvic floor muscles can become weakened or tight, leading to pelvic floor disorders, such as stress urinary incontinence and pelvic organ prolapse. These disorders are widely known and can significantly impact women's health and quality of life.

Pelvic floor physical therapy has become a popular tool used in the clinical setting to help alleviate these debilitating side effects. Some physicians combine pelvic floor physical therapy with biofeedback to enhance treatment outcomes.

While this treatment benefits women's health, many physicians do not practice pelvic floor physical rehab. So, what's the problem?

This post will explore the reasons after helping you understand what pelvic floor physical therapy is and what it resolves. Keep reading to gain more insights on this topic.

What Is Pelvic Floor Physical Therapy?

Pelvic floor physical therapy is a specialized treatment performed by trained physical therapists focusing on the pelvic muscles. These muscles are important for bladder control and sexual function. In women, the pelvic floor muscles help support the uterus and bladder and are critical before, during, and after pregnancy.

Pelvic floor physical therapy involves a series of exercises that focus on strengthening and supporting these muscles to improve their function and strength. The goal is to improve the patient's ability to manage bladder and bowel incontinence.

How Does It Work?

Unlike other common physical therapy sessions, for instance, which focus on exercises that go from the toes to the head, pelvic floor physical therapy focuses on specific muscle groups and their functions. As such, this type of physical therapy is more intimate, and experts conduct it in a private setting.

To begin with, your physician will educate you on how the pelvic floor works and how you can correctly use the muscles in this crucial area.

After that, your physical therapist will thoroughly assess your physical and psychological health. Why is it important to do a psychological evaluation? Because emotional trauma or stress can sometimes lead to pelvic floor muscle pain. So, your physical therapist will also look into your emotional health to ensure a sound mind-body connection which is crucial in treating pelvic floor disorders.

The next step is conducting a musculoskeletal exam to determine the state of the pelvic and abdominal muscles, connective tissues, ligaments, and joints.

Finally, suppose you are at ease and agree with the next procedure. In that case, the practitioner will conduct an internal vaginal exam to identify the exact location of any trigger points causing the pain.

After the initial examination session, patients will work with a physical therapist on strengthening exercises specific to each person. Physicians perform these exercises through manual therapy, which includes massage, pressure, and other methods to mobilize joints, muscles, and tendons.

Some patients may also receive treatment by incorporating pelvic floor physical therapy with biofeedback, which uses sensors to help patients understand their pelvic floor muscles as they perform different exercises.

When Should You Consider Pelvic Floor Physical Therapy?

Pelvic floor physical rehab is a viable option for patients with pelvic floor disorders. Patients can use this treatment type to treat different conditions, such as;

  1. Stress urinary incontinence: This common disorder makes it difficult to control urine.
  2. Fecal incontinence: This is the inability to control bowel movements.
  3. Vaginismus: This condition incorporates muscle spasms that make using a tampon or sex painful.
  4. Pelvic organ prolapse: Occurs when one or more pelvic organs descend into the vagina, which can result from aging or giving birth (vaginal delivery).

These disorders can cause extreme discomfort and affect your quality of life. Therefore, if you experience the following symptoms, you should consider pelvic floor physical therapy:

  • Need to urinate frequently
  • The inability to control bowel movements
  • Severe pelvic pain
  • Feeling like the pelvis dropping
  • Pain during vaginal exams or sex

Why Don't More Physicians Utilize Pelvic Floor Physical Therapy?

Although pelvic floor physical rehab benefits women with pelvic floor disorders, a majority of physicians do not practice or prescribe this specialized treatment. There are various reasons for this, and this section will look at each in detail.

1. The Intimate Nature of Pelvic Floor Physical Therapy

It is one of the main reasons why practitioners do not widely practice this treatment option. As explained earlier, pelvic floor physical therapy is an intimate treatment most often used for women. The treatment goes to the extent of conducting a vaginal examination to look for trigger points causing the pain. As such, some women may find it uncomfortable to undergo this treatment due to its potentially embarrassing nature.

2. It Is a Challenge to Get Patients to Comply With the Treatment

Pelvic floor physical therapy has various steps and procedures, such as the preparatory stages (education, assessment, and training), which practitioners must perform before treatment. As such, this form of treatment requires the utmost commitment from the patient to be effective.

Exercises can be uncomfortable and require a lot of determination on the patient's part. Moreover, seeing your physician or physical therapist every week or two weeks may take a lot of work. In that case, some patients may be reluctant to commit to such a difficult treatment plan.

3. Physicians Don't Often Offer It In-House Within Their Practice

Most physicians do not offer pelvic floor physical therapy within their practice. As such, this requires some extra effort and coordination to allow this treatment to be performed by a third party specializing in pelvic floor physical therapy. This partnership between the practice and the 3rd party physical therapy provider is often difficult to setup and manage on an ongoing basis.

4. Low Reimbursement Rates

Most health insurance companies do not reimburse physicians adequately for pelvic floor physical therapy. This treatment plan is time-consuming and requires a lot of effort and patience on the part of the physician. As such, physicians expect to be compensated accordingly for all the time, effort, and resources involved in treatment.

However, some health insurance companies give physicians a relatively low reimbursement rate for this kind of treatment, making it hard for them to make money from this service. In the end, you will find that most physicians do not offer pelvic floor physical therapy for this specific reason.

5. Some Physicians Don't Fully Understand the Efficacy of Pelvic Floor Physical Therapy

Physicians may need help incorporating pelvic floor physical therapy into their practice. It is especially true for new physicians who may need to learn the ins and outs of this treatment option. As such, they may be reluctant to offer this treatment to patients because they need to be fully aware of the efficacy of pelvic floor physical therapy.

6. The Lack of Mandatory Curriculum in Physical Therapy Programs

Most physicians lack a mandatory curriculum in physical therapy that requires them to offer pelvic floor physical therapy. Due to this, they may be reluctant to provide this service in their practice.

7. Some Doctors May Not Know Anyone They May Refer Patients To

Some physicians may lack connections with physical therapists or physicians specializing in pelvic floor physical therapy. In that case, it would be difficult for them to get patients to see this third party. As a result, they may be reluctant to offer pelvic floor physical therapy in their practice.

Final Thoughts

Pelvic floor physical therapy is a viable and effective treatment option for pelvic floor disorders. This treatment is designed to increase the strength and function of the pelvic floor muscles, resulting in better relief from pain and improved physical function.

Despite its effectiveness, only a small minority of physicians offer this treatment as part of their practice due to its intimate nature and other challenges that may inhibit its effectiveness.

Regardless, it is beneficial for patients to know that pelvic floor physical therapy does exist and is an option for them. If you are experiencing pelvic floor issues and have difficulty finding relief, you should consider pelvic floor physical therapy.


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Topics: Urodynamics Testing, Pelvic Floor Physical Therapy

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