What is Pelvic Floor Physical Therapy?

As part of our comprehensive approach to the diagnosis and care of pelvic floor disorders (PFD), we offer pelvic floor physical therapy as a non-surgical treatment option to help address pain, weakness, or dysfunction in the pelvic floor muscles. At Memorial Hermann, our experienced physical therapists aim to restore your pelvic health, and can provide treatment for common conditions such as:

No referral is required to schedule an initial evaluation.  Your physical therapist will determine if you are a candidate for physical therapy, and will provide a plan of care designed to meet your goals.

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How does a physical therapist decide how to treat incontinence?

Urinary incontinence is a condition experienced by thousands of women. There are two major types — stress incontinence and urge incontinence — and some women may have a combination of the two. To treat this, the therapist may begin by having the patient keep a “bladder diary” for about a week, writing down how often she went to the toilet as well as any accidents and what triggered them. Therapists will use exercises and bladder retraining techniques to help reach specific goals and reduce accidents. The therapist will work with each patient to establish specific goals for the number of times and amount of urine to be voided throughout the day and night, based on the patient’s age and specific condition. 

What is bladder retraining, and how does it help?

Bladder retraining is based on the notion that the patient can control her bladder rather than the other way around.

  • A plan will be devised combining scheduled toilet visits and behavior modification. Regular, scheduled toileting will help keep the patient dry and reduce the need to delay voiding or resist the urge.
  • Fluid management, diet management and weight loss all affect incontinence. The patient may benefit from dietary changes such as reduced caffeine to eliminate bladder irritants and increased fiber to avoid constipation. The bladder usually takes three to four hours to fill before signaling the need to urinate. A person can normally override the urge to urinate, but continence is a learned behavior and some patients may need retraining of the brain/bladder signals.

In urge control training, the patient may be instructed to:

  • Stop all activity and sit or stand still.
  • Use pelvic floor muscle exercises as instructed by the therapist.
  • Relax the rest of the body — do not panic — and concentrate on suppressing the urge sensation.
  • Walk to distract attention from the urge until it subsides.

What kind of exercises can help prevent incontinence?

Pelvic floor muscle exercises, known as Kegel exercises, are easy to do and can be done lying down, standing or sitting, without anyone else noticing. Many women do Kegels before, during and after pregnancy to strengthen the muscles that support the bladder.

  • To learn how to do a Kegel, stop or slow the flow of urine while urinating, and notice which muscles that action involves. To do a Kegel, contract those same muscles for three seconds and then relax them.
  • The therapist may also recommend the use of vaginal cones or weights to assist in strengthening the pelvic floor muscles, and will provide instructions on how to use and where to purchase them.

Night Time Voiding Techniques

  • Avoid fluids two to three hours before bedtime to decrease the need to get up in the night.
  • Increase fluids during the day/afternoon.
  • If leg edema is present, elevate legs for one hour before bedtime or wear compression stockings during the day.
  • Use urge reduction techniques before going to sleep.

How can biofeedback help relieve incontinence?

Biofeedback techniques may assist in the use of Kegel exercises to strengthen affected muscles. Sensors are placed outside or within the vagina to monitor muscle activity and provide the patient with visual or auditory feedback to guide her efforts.

Discharge Goals

The therapist will work with each patient to establish specific goals for the number of times and amount of urine to be voided throughout the day and night, based on the patient’s age and specific condition.

Ready for Relief?

If you’re interested in finding relief through physical or occupational therapy, the licensed therapists at Memorial Hermann Sports Medicine & Rehabilitation are here to help. Request an initial evaluation appointment with one of our physical or occupational therapists by filling out the form on this below or calling call (713) 521-0020 or 1-888-301-8477.


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