Most pelvic floor therapy techniques are hands-on and include both internal and external treatment. But since internal therapy does not appeal to some people, therapists are usually sensitive to the needs of every individual and do not begin with internal therapy until a patient is ready. External therapy techniques include nerve release, trigger point therapy, deep tissue massage (myofascial release), skin rolling, and joint mobilization.
Internal techniques may involve using specialized instruments or passing a finger through the rectum or vagina to do trigger point therapy. The therapy is then conducted by applying pressure on a specific point or injecting anesthesia into trigger points—injections are administered by a doctor or nurse practitioner and not a physical therapist. Besides, physical therapy does not always have to be the only treatment. It can be provided together with other forms of pain treatments, such as muscle relaxing medications or Botox injections.
The common techniques used include:
Patients are taught more about their pelvic anatomy and how different elements work alone and together. They also learn how hygiene and habits affect their symptoms.
Pelvic floor exercises
Patients learn to contract and relax pelvic floor muscles relative to other muscles. They also learn breathing and timing techniques that make the exercises more effective. The exercises are designed to stretch tight muscles, strengthen weak muscles, and boost flexibility.
A physical therapist uses hands-on massage and stretching to improve blood circulation, mobility, and posture.
Pelvic floor biofeedback
The biofeedback technique helps to observe how the pelvic floor muscles work. A probe is inserted into a man’s rectum or woman’s vagina and results are displayed on a computer screen.
Low voltage electric current is used to teach patients how to coordinate the contractions of their muscles, helping to reduce pain and muscle spasms. A therapist may perform the treatment in the office or provide an electrical stimulation unit to be used at home.
Tube-shaped plastic devices are used to help women learn to relax their pelvic muscles for easier penetration. The progressively sized tools are typically inserted into the vagina to help stretch tight tissues. Women who have undergone gynecological cancer treatment usually find vaginal dilators helpful in vaginal rehabilitation after their treatment