After more than 20 shots and two surgeries, I’d given up hope that I’d ever have relief. Suffering from endometriosis, I sort of came to terms that pelvic pain was now a part of the norm for me.
That was until I was introduced to pelvic physical therapy.
I know what you’re thinking, it doesn’t sound like a real thing – I was thinking that too.
I associated physical therapy with sports injuries or rehabilitation after a surgery, and that was about it.
My doctor brought up pelvic physical therapy and I was referred to Michelle Benoit, a pelvic physical therapist with Novant Health Rehabilitation Center – Midtown.
During my eight appointments, I learned that pelvic physical therapy can help a lot of conditions.
‘We help anyone’
I’ve seen the countless adult diaper commercials and heard women joke about peeing when they laugh. Apparently, urinary leakage is something to just accept these days. It shouldn’t be.
Pelvic physical therapy can help with it among many other conditions. It benefits patients suffering from urinary urgency or frequency, bowel conditions, chronic pelvic pain, painful intercourse, as well as helping patients before and after some surgeries. Pregnant women can also get help both during and after pregnancy.
It isn’t just for older women either.
“What surprises people is that pelvic physical therapists don’t only work with women,” Benoit said. “We help anyone who has any difficulty with any pelvic concerns and that includes both men and children.”
For example, men who have had prostatectomies, where the prostate gland is partially or completely removed, can benefit from pelvic physical therapy to strengthen their pelvic floor muscles. This can help reduce any urinary leakage as well as help with erectile dysfunction.
In children, pelvic physical therapy can help with persistent bedwetting. It can also help with constipation.
Treatment plans for patients differ. Contrary to what Oprah Winfrey and Gwyneth Paltrow say, Kegels – where you squeeze your pelvic floor muscle like you are trying to hold in your urine or stop a stream of urine – aren’t necessarily the answer for everyone.
“The first thing we do with patients is figure out what’s the root of their pain, discomfort or condition,” Benoit said. “For example, in patients experiencing pain, we look for what’s driving that pain and teach strategies for pain management.”
The pelvic physical therapists work with patients to develop a treatment plan that can ultimately give them some pain relief or fix their condition.
In my case, and often with patients suffering from chronic pelvic pain, the weekly sessions last about 45 minutes. Because when people are in pain, their body is constantly in a fight or flight response where they are tense. I jokingly call it the “permanent Kegel.”
To alleviate the constant tension associated with pelvic pain, Benoit and other pelvic physical therapists try to coax the body out of that fight or flight mode through various massages, exercises and stretches. For instance, Benoit would ask me to tighten, relax and then bear down. This would ultimately help my body get out of the constant tension and know how to relax.
While it could actually do more harm to my condition, the Kegel exercises help those suffering from urinary leakage. Pelvic physical therapists use Kegels and other exercises to tighten up the pelvic floor muscles surrounding the urinary tract, which helps to reduce the leaking. With successful pelvic physical therapy, you no longer have to worry about a little leakage when laughing.
Like with most physical therapy, Benoit walked me through some “homework exercises,” simple moves and stretches I could do at home.
It’s all about the process
But like all physical therapies, results don’t just happen overnight. While it’s a process that typically lasts weeks, the long-term results are worth it.
“I sometimes explain it to patients with urinary leakage by asking them would they rather have a couple of weeks of physical therapy or wear adult diapers for the rest of their life,” Benoit said. “It’s frustrating to see that conditions like urinary leakage are being framed as something to accept, when it’s something that we can help with.”
Good pelvic health is important as it can affect a patient much more than they realize.
"The core and pelvic floor are the place from which all other movement stems – this not only includes movement of our limbs but also movement of our internal organs,” Benoit said. “When our core and pelvic floor aren’t working well, that can lead to not only other orthopedic issues, but it can lead to digestion issues, chronic pain or reproductive issues.”
Thankfully, I found relief before I had any other major issues. And I went from skeptic to believer after five years of chronic pain came to a halt.
Patients don’t need a referral to see a pelvic physical therapist. And many insurances cover the sessions. Be sure to ask upfront.
If you think this might improve your quality of life, have a conversation with your doctor about pelvic physical therapy as a potential solution.