Pelvic Mobilization: Improving Pelvic Floor Health

By Dr. Zarina Vitebsky, DPT, MSPT, PRPC, TPS, LPF, DN on 2/14/2024

Overview

Definition of Pelvic Mobilization

Pelvic mobilization is a technique used in physical therapy to improve the mobility and function of the pelvic region. It involves gentle, hands-on movements to the bones, muscles, and connective tissues of the pelvis to restore balance and alignment.

Explanation of Pelvic Floor Physical Therapy

Pelvic floor physical therapy is a specialized form of physical therapy that focuses on the muscles, ligaments, and tissues of the pelvic floor. This area of the body plays a crucial role in supporting the bladder, uterus, and rectum, as well as controlling bowel and bladder function. Pelvic floor physical therapy aims to improve the strength, coordination, and flexibility of these muscles to alleviate pain and improve overall pelvic health.

Importance of Pelvic Floor Health

The pelvic floor plays a vital role in our daily lives. A strong and healthy pelvic floor is essential for bladder and bowel control, sexual function, and overall stability and balance. When the pelvic floor is weak or dysfunctional, it can lead to a variety of issues, including urinary incontinence, pelvic pain, and sexual dysfunction. Therefore, maintaining good pelvic floor health is crucial for overall well-being.

Understanding the Pelvic Floor

Anatomy of the Pelvic Floor

The pelvic floor is a group of muscles, ligaments, and tissues that form a sling-like structure at the bottom of the pelvis. It is made up of three layers: the superficial, middle, and deep layers. The superficial layer consists of the bulbospongiosus, ischiocavernosus, and superficial transverse perineal muscles. The middle layer includes the urogenital diaphragm and the deep layer contains the levator ani muscles.

These muscles and tissues work together to support the pelvic organs, including the bladder, uterus, and rectum. They also play a role in controlling bowel and bladder function, sexual function, and stability of the pelvis and spine.

Functions of the Pelvic Floor

The pelvic floor has several important functions, including:

• Supporting the pelvic organs and preventing them from prolapsing (dropping down)

• Controlling bowel and bladder function through relaxation and contraction of the muscles

• Aiding in sexual function by providing support and control during intercourse

• Stabilizing the pelvis and spine to maintain proper posture and movement

Common Issues with the Pelvic Floor

There are several conditions that can affect the pelvic floor, including:

• Pelvic organ prolapse, which occurs when the pelvic organs descend and push against the vaginal walls

• Urinary incontinence, which is the involuntary leakage of urine

• Fecal incontinence, which is the inability to control bowel movements

• Pelvic pain, which can be caused by muscle tension, nerve irritation, or other underlying conditions

How Pelvic Floor Dysfunction Can Affect Daily Life

Pelvic floor dysfunction can have a significant impact on daily life. It can cause discomfort, pain, and embarrassment, and may limit a person's ability to participate in daily activities. For example, someone with urinary incontinence may avoid social situations or physical activities for fear of leakage. Pelvic pain can also interfere with sexual function and lead to emotional distress.

In addition, pelvic floor dysfunction can contribute to other issues such as constipation, difficulty with childbirth, and pelvic floor muscle weakness. It is important to address these issues through pelvic floor physical therapy to improve overall quality of life.

Indications for Pelvic Mobilization

Conditions that can benefit from pelvic mobilization

Pelvic mobilization is a technique used in pelvic floor physical therapy to address various conditions related to the pelvic region. These conditions may include pelvic pain, urinary or fecal incontinence, pelvic organ prolapse, and sexual dysfunction. Pelvic mobilization can also be beneficial for pregnant women experiencing pelvic discomfort or preparing for childbirth.

Symptoms that may indicate the need for pelvic mobilization

Individuals experiencing symptoms such as pelvic pain, difficulty with bladder or bowel control, pain during sexual intercourse, or a feeling of heaviness or pressure in the pelvic area may benefit from pelvic mobilization. These symptoms can be indicative of pelvic floor dysfunction, which can be addressed through pelvic floor physical therapy techniques, including pelvic mobilization.

How pelvic mobilization can help with pelvic floor dysfunction

Pelvic mobilization involves gentle, hands-on techniques to manipulate and mobilize the pelvic bones and muscles. This can help improve pelvic alignment, release tension in the pelvic floor muscles, and improve blood flow and nerve function in the pelvic region. By addressing these underlying issues, pelvic mobilization can help alleviate symptoms of pelvic floor dysfunction and improve overall pelvic health.

When to seek pelvic floor physical therapy

If you are experiencing any of the symptoms mentioned above or have been diagnosed with a condition that may benefit from pelvic mobilization, it is recommended to seek pelvic floor physical therapy. A trained physical therapist such as the ones on our specialized team can assess your pelvic floor function and determine if pelvic mobilization is an appropriate treatment for your specific needs. It is important to seek treatment from a qualified professional to ensure safe and effective use of pelvic mobilization techniques.

Preparing for Pelvic Mobilization

Initial Assessment by a Pelvic Floor Physical Therapist

Before beginning pelvic mobilization, it is important to have an initial assessment by a pelvic floor physical therapist. This will involve a thorough evaluation of your pelvic floor muscles, including strength, flexibility, and any areas of tension or dysfunction. The therapist will also assess your overall posture and movement patterns to determine the best approach for your individual needs.

Discussion of Medical History and Symptoms

During the initial assessment, your pelvic floor physical therapist will also discuss your medical history and any symptoms you may be experiencing. This will help them understand the underlying causes of your pelvic floor issues and tailor the treatment plan accordingly. It is important to be open and honest during this discussion to ensure the best possible outcomes.

Explanation of the Pelvic Mobilization Process

Once the assessment is complete, your pelvic floor physical therapist will explain the pelvic mobilization process to you. This may include using manual techniques to release tension in the pelvic floor muscles, as well as exercises and stretches to improve strength and flexibility. Your therapist will also discuss the expected outcomes and any potential risks or side effects.

Consent and Comfort Measures

Before beginning pelvic mobilization, your therapist will obtain your consent for the treatment. They will also discuss any comfort measures that can be taken to ensure a positive and comfortable experience. This may include using pillows or cushions for support, adjusting the treatment table, or using relaxation techniques.

Pelvic Mobilization Techniques

Manual Techniques

Manual techniques involve the use of hands-on methods to mobilize the pelvic region. These techniques are typically performed by a trained physical therapist and can help improve mobility, reduce pain, and increase function in the pelvic floor muscles.

1. Soft Tissue Mobilization: This technique involves applying pressure and gentle stretching to the soft tissues of the pelvic floor, including muscles, ligaments, and fascia. This can help release tension and improve blood flow to the area.

2. Joint Mobilization: Joint mobilization techniques focus on improving the movement and alignment of the joints in the pelvis. This can help reduce pain and stiffness and improve overall function.

3. Myofascial Release: Myofascial release involves applying sustained pressure to specific points in the pelvic floor muscles to release tension and improve mobility. This can be done manually or with the use of tools such as foam rollers or massage balls.

Instrument-Assisted Techniques

Instrument-assisted techniques involve the use of specialized tools to help mobilize the pelvic floor muscles. These techniques can be used in conjunction with manual techniques or on their own.

1. Trigger Point Release: Trigger points are areas of tightness and tenderness in the muscles that can contribute to pelvic pain and dysfunction. Trigger point release techniques involve applying pressure to these points to release tension and improve function.

2. Cupping: Cupping involves using suction cups to create a vacuum on the skin, which can help release tension and improve blood flow in the pelvic floor muscles. This technique can also help with scar tissue and adhesion release.

Stretching and Strengthening Exercises

In addition to manual and instrument-assisted techniques, pelvic floor physical therapy also includes a variety of stretching and strengthening exercises to improve pelvic floor muscle function and mobility.

1. Targeting Specific Muscles of the Pelvic Floor: These exercises focus on specific muscles of the pelvic floor, such as the pelvic floor muscles, hip muscles, and abdominal muscles. Strengthening these muscles can help improve overall pelvic stability and function.

2. Incorporating Breathing Techniques: Breathing techniques are often incorporated into pelvic floor exercises to help improve coordination and relaxation of the pelvic floor muscles. This can also help with pain management and stress reduction.

3. Progression of Exercises: As the pelvic floor muscles become stronger and more mobile, exercises can be progressed to challenge the muscles further. This can help improve overall function and prevent future pelvic floor issues.

Benefits of Pelvic Mobilization

Short-term and long-term benefits

Pelvic mobilization, also known as pelvic floor physical therapy, can provide numerous benefits for individuals experiencing pelvic floor dysfunction. In the short-term, it can help alleviate symptoms such as pelvic pain, urinary or fecal incontinence, and sexual dysfunction. Long-term benefits may include improved muscle strength and coordination, better bladder and bowel control, and reduced risk of pelvic organ prolapse.

Importance of consistency and follow-up appointments

Consistency is key when it comes to pelvic mobilization. It is important to attend all scheduled appointments and follow the recommended treatment plan to see the best results. Skipping appointments or not following through with at-home exercises can hinder progress and may lead to longer treatment times. Additionally, follow-up appointments are crucial to assess progress and make any necessary adjustments to the treatment plan.

Reach Out to Us

If you’re experiencing pelvic floor dysfunctions associated with the issues above, please reach out to us at Pelvic Health Center in Madison, NJ to set up an evaluation and treatment! Feel free to call us at 908-443-9880 or email us at receptionmadison@pelvichealthnj.com.

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