We look at the various treatments we offer as our tool box. We aim to provide the best variety of treatment options so we can help you achieve symptom relief and then progress toward changing patterns and eliminate the factors which contributed to your symptoms in the first place. It is always a delicate recipe which depends on who you are and your unique journey.
Vaginal and Rectal Internal Manual Treatment
If you have been referred to pelvic physical therapy, you may have heard that internal exams are an aspect of this care. It can be useful but it is ALWAYS up to you if and when we do internal work.
Learn more about what internal exams and treatments are and why we use them
Biofeedback Training
Your provider may have referred you specifically for this treatment. This is a tool that can be helpful to train your pelvic floor muscles to coordinate properly but is only one of many. You can speak to your therapist about where in your treatment plan this modality may be helpful and they will review the process with you prior to your consent to proceed with this modality.
There are also several home units that can be reviewed with your therapist.
This tool can serve as a “wake up” for your muscles and nerves in order to connect your brain to the pelvic floor muscles again. It often feels like a slight buzz in the region where the electrodes are placed. Your therapist will work with you to incorporate this modality into your treatment plan.
In this technique, a small, soft balloon is inserted into the rectum and is attached to a large syringe that will inject either water or air into the balloon, causing the balloon to enlarge within the rectum. This training technique allows the patient to provide feedback about the sensation of rectal filling including when the patient perceives urges to defecate. The patient can practice expelling the balloon, and in the event of a dyssynergic pattern of pelvic floor muscles, the balloon would not be expelled due to increased muscle tension and shortening of the anorectal area. In this manner, the patient is trained to bring awareness to the anorectal area, and to respond with healthy patterns of defecation.
How often do you go to the bathroom? Do you have urgency or leak or just seem to go all the time, or rarely? Filling out a diary is so helpful to understand our baseline and add awareness to when we actually go and why!
We teach you how to use these tools to help you understand your anatomy or improve muscle awareness in the vaginal or rectal region or to desensitize the area. They can be very useful to train your muscles and nerves for penetration as well.
The pelvic floor is a group of muscles and they have the ability to contract and relax, shorten and elongate just like any muscle. The difference with this group is that they operate to control bladder, bowel and sexual function as well. And although you can control this region, there are very important automatic functions that optimize this region. Many of our patients have “tight” pelvic floors. They are shortened and in a spastic state. Think if you squeezed your hand all day long. How would it feel to open your hand again? If you are in this camp, your treatments will focus on elongating or relaxing your pelvic floor (opening your hand). Once you are able to contract and elongate your pelvic floor, which will feel like it goes up and down, often your symptoms will also dissipate. We use many of our tools to help achieve this objective.