December 3, 2019 by Kristin Lingen, PT, DPT

Kristin Lingen, PT, DPT, and Jessica Lawrence, PT, DPT, treat pelvic pain. 

Pelvic pain among women is common and it often goes undiagnosed. According to the National Institutes of Health, one study showed about 15 percent of women of childbearing age in the U.S. reported having pelvic pain that lasted at least six months. Yet pelvic pain affects women of all ages – teenagers to post-menopausal.

Did you know physical therapy can help? Physical therapists are movement experts and can treat the symptoms of pelvic pain. We can help women reduce their pain by improving physical function. We start with a medical history review and physical examination. We can diagnose and identify the causes such as joint issues, muscle dysfunction and nerve involvement. Next, we develop a prognosis and treatment plan to help women optimize their quality of life.

Physical therapists can be part of a multidisciplinary team to treat pelvic pain. At Mankato Clinic, we work closely with our patients’ primary care providers and gynecologists.

Pregnancy and childbirth can affect pelvic muscles and joints. A shift in the pelvic organs, known as prolapse, pelvic joint problems, muscle weakness in the pelvic floor, changes in the muscles that control the bowel and bladder, and scar tissue from C-sections can all play a role.

A physical therapist can help treat pelvic pain and symptoms caused by endometriosis, polycystic ovarian syndrome (PCOS), chronic urinary tract infections (UTI), painful bladder syndrome and menstrual pain. Other conditions commonly treated by physical therapists include tailbone pain, SI (sacroiliac) dysfunction, pregnancy and postpartum pain, pain during intercourse, pelvic organ prolapse and muscle spasms in the pelvic floor.

The pelvic floor is a complex group of muscles, connective tissue and nerves on the bottom of the pelvis that can become dysfunctional. Pelvic floor dysfunction can cause incontinence, leaking, urinary frequency and urgency, constipation, pain during sex, inability to sit for normal periods of time. These issues can be treated by a physical therapist with specialized training.

Based on exam results, a physical therapist will customize a treatment plan. Physical therapy can help women identify and isolate the appropriate muscles – pelvic floor, abdominals and diaphragm – that can cause pelvic pain. We teach women how to coordinate body movements and breathing for daily activities as well as create mindfulness for pelvic floor function. Sometimes it means correcting posture. Manual therapy interventions are sometimes necessary to treat painful muscles.

Physical therapy often includes a personalized exercise program. For the pelvic floor, we teach women exercises to either stretch or strengthen the affected muscles. We work up to exercises that improve motor control. The exercises help retrain the muscles to work better together. We also offer techniques to improve alignment in the pelvic area.

Since pelvic floor dysfunction can sometimes impact the bladder, we address fluid intake, normal bladder function, bladder irritants, urge suppression, breathing strategies, and pressure management when necessary.

It often takes up to six months of consistently performing a home program for women to see results of physical therapy and at-home exercises. A physical therapist will often see a patient once a week for 3-4 weeks, then less frequently for another two to three months. This is tailored to each individual.

If you are experiencing pelvic pain, talk to your health care provider. Physical therapy can help reduce the pain and symptoms to make life better.

Kristin Lingen, PT, DPT, and Jessica Lawrence, PT, DPT, of Mankato Clinic Physical Therapy Department are trained to treat pelvic pain and pelvic floor dysfunction.