The Pelvic Floor Rehabilitation Program of Upstate’s Regional Rehabilitation Center provides comprehensive services treatment to address symptoms of pelvic floor muscle dysfunction. These symptoms may include pelvic pain, urinary or bowel incontinence, urinary frequency, urgency or hesitancy, or pelvic organ prolapse.

These issues may occur at any age in men, women or children. Age related changes increase the frequency of some conditions. For example, 1 in 4 women experience some type of pelvic floor dysfunction in their lifetime, however this is 2x as common over the age of 80¹. In males, pelvic floor dysfunction has been reported to be as high as 16%².

When participating in pelvic floor rehabilitation, a specific plan of care is developed based on the findings of your clinical examination and your goals. Treatment by a physical therapist with training in pelvic floor rehabilitation has been shown to be 5-8 times more effective at improving or eliminating symptoms³ than self treatments without the guidance of a physical therapist.

Who can benefit from pelvic floor rehabilitation?

Regardless of age, or gender identity you may benefit from physical therapy if you experience any of the following:

Pelvic region pain Interstitial cystitis Painful sexual activity Tailbone pain Soft tissue pain (abdominal, genital, buttock, hip) Pelvic girdle pain (sacroiliac/SI joint, low back, or pubic symphysis) Urinary and bowel Incontinence (leakage) Urgency (strong desire to urinate) Frequency (urinating often) Pain with urinating or with bowel movements Constipation Pregnancy and postpartum Instability of low back, hips, or pelvis Diastasis Recti (separation of abdominal muscles) Pelvic organ prolapse ("dropping" of the bladder, uterus, or intestines) Painful scars (perineal/episiotomy, cesarean)

Pre and post-surgical care Abdominal surgery Bladder surgery Cesarean delivery Gender reassignment Hysterectomy Prolapse repair Colorectal surgery Cancer Care Post radiation Scar tissue management Post-surgical Pediatric Difficulty with potty training Bed Wetting Urine or stool leaks Constipation Urgency and frequency Painful urination Difficulty urinating due to hesitancy or incomplete emptying

Your physical therapist develops a plan of care based on the findings of your initial evaluation. Typically, visits are 60 minute private sessions. Duration of treatment will vary based on your individual condition, but may vary from a few visits to 8-10 visits. Typically frequency of visits are weekly to biweekly but ultimately visits will be determined following a discussion of your goals with your physical therapist.

Treatments

Provided by a license physical therapist with specialized training, treatments may include:

• Pelvic floor muscle reeducation and/or strengthening
• Manual therapy/soft tissue massage for reducing scar tissue or relaxation of muscle tightness
• Biofeedback and/or electrical stimulation for pelvic muscle retraining
• Behavioral modification
• Home exercise and self-care program
• Trunk stabilization
• Education

References

1. Hallock JL, Handa VL. The epidemiology of pelvic floor disorders and childbirth: an update. Obstet Gyncocol Clin North Am. 2016; 43 (1) 1-13.
2. Cohen D, Gonzalez J, Goldstein I. The Role of the Pelvic Floor Muscles in Male Sexual Dysfunction and Pelvic Pain. Sex Med Review. 2016; 4: 53-62.
3. Di Benedetto P. Can Pelvic Floor Muscle Training Versus No Treatment or Inactive Control Treatments Reduce or Cure Urinary Incontinence in Women?; A Cochrane Review Summary with Commentary. American Journal of Physical Medicine & Rehabilitation. 2020; 99 (2): 178-179.