Pelvic Floor Disorders In Women: Physical Therapy Can Help

  • It can be tough to admit you have a bladder or bowel control problem. And because it’s not a subject most people like to talk about, you may not realize how common pelvic flood disorders (PFDs), such as incontinence, are. According to the American Urogynecologic Society, 1 in 4 women age 20 or older experiences a PFD.

    But here’s the most important thing to know about PFDs: “They are treatable,” said Jeannie Kozempel, PT, DPT, MS, manager of Physical Medicine and Rehabilitation at Fox Chase Cancer Center.

    And one of the most beneficial treatments is physical therapy.

    What is the pelvic floor?

    This group of muscles acts as a hammock across the pelvis. With the surrounding tissues, the pelvic floor holds the pelvic organs in place so they can function correctly. Those organs—including the bladder, urethra, small intestine, and rectum—stay in the right spot thanks to the pelvic floor. The same is true with the uterus, cervix, and vagina in women.

    Problems with the pelvic floor occur when the pelvic muscles and connective tissue are weakened or injured. This can happen for a variety of reasons, ranging from age to lifestyle. Pelvic surgery—such as a hysterectomy—and radiation treatments can also play a role, which means it’s not unusual for female cancer patients to face PFDs.

    PFDs fall into three general categories:

    • Bladder control problems: These include leaking urine and having a sudden, strong urge to go.
    • Bowel control problems: This is the leaking of liquid or solid stool from the rectum.
    • Pelvic organ prolapse: A prolapse happens when the pelvic muscles can’t support one or more organs. This causes the organ to fall or press into the vagina. For instance, in the case of uterine prolapse, the cervix and uterus can drop into the vagina and may even come out of the vaginal opening.

    What is the role of physical therapy?

    Medication and surgery can be used to address PFDs, but these aren’t the only treatment options.

    “If you look at the literature, physical therapy is one of the most—if not the most—effective ways to treat these disorders,” Kozempel said.

    Physical therapy is personalized for each individual. It can include Kegel exercises—which involve squeezing and relaxing the pelvic floor muscles—biofeedback, muscle-strengthening exercises, or electrical stimulation. Dietary changes may be recommended as well, Kozempel said.

    The next step is to meet with a physical therapist. Ask your doctor for a referral.

    “We always perform an initial evaluation of a patient and ask very specific questions: when did the problem begin, what treatment have they received for it, and what they’re currently doing about it,” Kozempel said. “We provide surveys because it is difficult for many people to explain their symptoms.”

    This frank conversation is followed by a physical exam.

    “We take a holistic approach, looking at everything from posture and strength down to the pelvic floor,” Kozempel said. “Based on our findings, we develop a treatment plan with the patient. We’re here to help people find a way to address their pain or issue.”

    It’s a whole-person approach that pays off.

    “It doesn’t matter how long a cancer patient has had these issues,” Kozempel said. “We can still help you. We’ve had cancer patients who’ve dealt with a PFD for years before they got a referral for physical therapy, and we still made a difference.” 

    Learn more about physical therapy at Fox Chase Cancer Center.