Role of Physical Therapy in Treating Pelvic Pain

A physical therapist trained in pelvic health may use hands-on techniques to release trigger points and re-educate muscles affected by pelvic pain.

Physical therapists are trained to evaluate and treat dysfunction in the joints, muscles, nerves and scar tissue.  Physical therapists specifically trained in pelvic health can identify the possible musculoskeletal causes of your pelvic pain and develop a treatment plan specific to your condition. 

What to expect at your first physical therapy appointment: 

Your first visit will include an initial evaluation in a private room by a therapist who has undergone advanced education and training in the evaluation and treatment of pelvic muscle dysfunction. The therapist will obtain a detailed history of your health, pain and activity limitations. She will also ask you about any bowel, bladder and sexual difficulties as these are in part controlled by the pelvic muscles.  The therapist will then take a look at your posture, the mobility of your spine and hips and the strength and flexibility of your pelvic girdle muscles.  She will examine any scar tissue and trigger points in your pelvic region muscles. 

The therapist will also specifically examine the pelvic floor. Your pelvic floor consists of a group of muscles that attach behind the pubic bone in the front to the tail bone in the back. They are responsible for providing support to the pelvic joints and organs, relaxing to allow the passage of urine, stool and gas and contracting to prevent the loss of urine, stool and gas as appropriate.  In order to best examine these muscles you will be asked to undress from the waist down and be covered with a sheet.  The therapist will use a lubricated, gloved finger to identify painful muscles around and in your vagina or rectum then instruct you to contract and relax these muscles to assess how the muscles are functioning.  Care is taken to make you as comfortable as possible during the exam. 

Your therapist will discuss the evaluation results with you and provide you with education regarding your specific condition and expectations for therapy.  She will answer all of your questions and will work with you to establish a treatment plan based on the results of the evaluation and your goals for therapy.