Three Things I Have Learned Practicing as a Pelvic Floor Physical Therapist
Dr. Hannah Lattanzio, PT, DPT
As my first year working at The Pelvic Institute comes to a close, I wanted to reflect on the things I have learned as a pelvic floor physical therapist and share them with you. I’ve compiled a short but important list of common themes that are pertinent to patient well-being and can serve as a resource - not only for you but also your families, friends, and other providers on your healthcare team.
Pelvic Floor Conditions Can Affect Any Body
I have briefly written about this topic before in another blog post but I believe it is worth repeating here. Many of us think that pelvic floor therapy is only for new moms. However with continued advocacy and rising awareness through social media people are becoming more aware of the scope of pelvic floor physical therapy. Pelvic floor PT is not only for new mothers (although they are an important and essential demographic) but also those who are pregnant and even trying to conceive! Pelvic PT can serve those of all gender identities who struggle with:
Urinary symptoms: urgency, frequency, pain and UTI-like symptoms, leakage, etc.
Bowel disorders: incontinence, IBS/Chron’s/IBD, bloating, etc.
Sexual dysfunction: pain with intercourse, vaginismus, vulvodynia, trouble achieving or pain with orgasm.
Pain: rectal, abdominal, low back pain, testicular pain, hip pain, and more.
Post-operative: endometriosis and fibroid surgery, gender affirming care, cesarean section, prostatectomy etc.
And many other symptoms and conditions! Still curious if pelvic PT is for you? Contact us!
Pelvic Floor Symptoms Can Seem Isolating - However They Are More Common Than You Think!
According to recent (but still limited) research around one fourth to half of all women, 1 in 10 men, and 50-75% of members of the LGBTQ+ community will experience pelvic dysfunction in their lifetime.
Some people may accept that these symptoms are normal and part of life, or may be embarrassed to share their concerns with providers or even friends. While pelvic floor conditions and symptoms typically do not cause physical harm, many suffer from anxiety and depression impacting their quality of life and happiness. Adding to this, these disorders are not always visible to others and unfortunately people may feel discredited, alone, or lost - as many do with chronic and “invisible” conditions. Again with the increasing awareness of pelvic floor dysfunction and physical therapy on social media, I am hopeful that people will begin to realize they are not alone in their symptoms and help is available.
The Realm of Pelvic Floor Often Dovetails with Mental Health
Have you ever felt a wave of emotion during pigeon pose? Upset during a massage or acupuncture session to your hips but unsure why? Or maybe tailbone pain when stressed? Working in pelvic floor physical therapy has taught me that there is an intimate relationship between emotions, trauma, and stress and pelvic floor muscle function. I’d like to clarify - this is not me saying your symptoms are “in your head.” Your pain, sexual dysfunction, urinary or bowel symptoms are very real and valid. What I mean is that we hold so much emotion in our hips, glutes and pelvis and when we are not feeling our best emotionally or we have past experiences of trauma, our pelvic floor muscles can become too tense which can lead to muscle dysfunction and contribute to or cause symptoms.
I think it is essential to work on the body, mind, and soul for optimal pelvic floor outcomes and a mental health provider is a very important member of a patient's healthcare team.
I am sure you have experienced a tight neck, have hiked your shoulders, or clenched your teeth during the day when anxious or stressed. What is different about these muscles is we can often see and feel when we are contracting them, allowing us to relax the shoulders or unclench the jaw. Like the muscles above, we can also subconsciously contract our pelvic floor, hip or gluteal muscles when not feeling our best. The problem is the pelvic floor muscles are not visible from the outside of our body and are hard to feel, making them even harder to consciously relax (which we can help with!).
Occasionally I am the last stop of the road for some of my patients, the last ditch effort to get answers and symptom relief. I have had many patients share their story, having seen countless providers over many years before being referred to pelvic floor physical therapy, or they had to do their own research to find out about pelvic PT. And when I perform my pelvic floor muscle assessment and am able to reproduce familiar pain, some patients get emotional, saying they have been told their symptoms are only due to anxiety or to just have a glass of wine before sex so it isn’t painful, some don’t even know why! They then become hopeful when I tell them and their pain is real and there are treatment options available.
Final Takeaway
My final message to anyone experiencing symptoms of pelvic floor dysfunction is you are not alone and there are providers who can help you. It can be hard and discouraging (don’t worry I know - I was a pelvic floor patient myself before becoming a provider) but do not give up, keep advocating for yourself, and surround yourself with good medical professionals. Feel free to contact us if you have any questions or want to learn more about pelvic floor physical therapy.
