Nerves, organs, and joints can lose their natural mobility over time and cause a whole host of symptoms from pain, to loss of range of motion, and poor functioning of the bodily symptoms. Skilled and specialized therapists can use a variety of active techniques (patient assisted) and passive techniques to free up restrictions in these tissues and organs and improve overall function.
The pelvic floor is a group of muscles--in both men and women--that support your spine, help control your bladder, and help with sexual functions. By identifying your pelvic floor, performing Kegels (a popular pelvic floor exercise), and practicing other pelvic floor exercises, you can rehabilitate these muscles. In time, you can gain the benefits of a strong pelvic floor, including reduced urinary incontinence, less back pain, more control of your core, and better sex.

Pain can emerge because of lifestyle factors and underlying medical problems. Sitting all day can affect the nerves in your saddle, which may translate into a burning pain in your vulva, explains Rhonda K. Kotarinos, DPT, a specialist in pelvic floor dysfunction in the Chicago area. The discomfort of chronic vaginal infections or holding urine all day long can also lead someone to “walk around with their pelvic floor clinched to their ears. It can make your pelvic floor very angry,” she says.


Perform bridges. Kegels are not the only way to strengthen your pelvic floor. There are numerous exercises you can do, and a great one is bridges. Start by laying on your back with your knees bent, keeping your feet about a fist distance apart. Then flex your lower abdominal muscles and lift your hips off the ground slightly. Your buttocks should barely be off of the floor and you should keep your inner core muscles flexed. Hold for 3 seconds and slowly return your hips to the ground.[10]
Pain can emerge because of lifestyle factors and underlying medical problems. Sitting all day can affect the nerves in your saddle, which may translate into a burning pain in your vulva, explains Rhonda K. Kotarinos, DPT, a specialist in pelvic floor dysfunction in the Chicago area. The discomfort of chronic vaginal infections or holding urine all day long can also lead someone to “walk around with their pelvic floor clinched to their ears. It can make your pelvic floor very angry,” she says.
Common causes of pelvic floor issues include pregnancy or childbirth, hysterectomy, certain sports, aging, or inactivity of the pelvic floor muscles, just to name a few. Once the pelvic floor has been compromised, problems such as incontinence, diminished sex drive, or even pelvic organ prolapse – when pelvic organs protrude into or outside of the vagina – can arise. The most common sign of a weak pelvic floor – which affects up to 25% of women – is involuntary urine leakage (incontinence). (2)
Look in a mirror if lying down doesn't work. If you are a guy, the lying on your back method for locating your pelvic floor muscles may not work. An alternative is for you to stand in front of a mirror naked. Look at your body as you attempt to flex your pelvic floor muscles. If you are contracting the muscles correctly, you should be able to see your penis and scrotum lift up. When you relax your pelvic floor, you should see these parts drift back down.[4]
During the internal exam, your physical therapist will place a gloved finger into your vagina or rectum to assess the tone, strength, and irritability of your pelvic floor muscles and tissues. Internal exams and internal treatment are invaluable tools that are taught to pelvic floor physical therapists. It can tell us if there are trigger points (painful spots, with a referral pattern or local); muscle/tissue shortening; nerve irritation and/or bony malalignment that could be causing your pain directly or inhibiting the full function of your pelvic floor muscles. We can also determine if your pelvic floor has good coordination during the exam. A pelvic floor without good coordination, may not open and close appropriately for activities such as going to the bathroom, supporting our pelvis and trunk, sexual activity, and keeping us continent.

Common causes of pelvic floor issues include pregnancy or childbirth, hysterectomy, certain sports, aging, or inactivity of the pelvic floor muscles, just to name a few. Once the pelvic floor has been compromised, problems such as incontinence, diminished sex drive, or even pelvic organ prolapse – when pelvic organs protrude into or outside of the vagina – can arise. The most common sign of a weak pelvic floor – which affects up to 25% of women – is involuntary urine leakage (incontinence). (2)

“I would recommend that people call the facility and maybe schedule the first appointment and see how you feel about it. I also think patient support groups tend to have closed Facebook groups and they can recommend people in certain geographical areas. I know people call [our practice] a lot and we try and get them paired up with somebody we trust in their area,” Prendergast says.
Physical therapists (PTs) are experts in movement and function, which sounds like a pretty broad topic to be an expert in, and it is. After physical therapists graduate PT school (now-a-days at the doctoral level), they find their niche and specialize. You can find PTs working with high-level athletes, children, infants, people who are recovering from injuries, people with neurological conditions and many other types of clients.

“I intentionally try and distract you during treatment, so that you don’t focus too much on the pain of the treatment. Furthermore, talking during our sessions continues to build rapport which is so important — it builds trust, makes you feel more comfortable, and also makes it more likely that you will return for your follow-up visits so that you will get better,” she says.


It is essential that we, as pelvic floor physical therapists, also include other assessments when we are examining our patients for the very first time. We employ the tried and true physical therapy exam practices to determine if there is an underlying condition elsewhere in your body, such as a strength deficit or alignment issue that could be affecting your pelvic floor. It’s wild to think of it, but something as seemingly unrelated as a flat foot or a hip injury can be enough to set off pelvic and abdominal pain!
Kegels: American gynecologist Arnold Kegel created this seminal pelvic floor exercise. To do a Kegel, contract your muscles that stop the flow of urine, hold for five seconds, then release for five seconds. Repeat this exercise 10–15 times, up to three times per day. Avoid doing Kegel exercises when urinating since stopping the flow midstream can cause some urine to remain in your bladder, putting you at a higher risk of urinary tract infections (UTIs).
×