Pelvic floor physical therapy in Carmel, Indiana

A pelvic health therapist treats problems where the pelvic floor muscles are too weak, too tense or poorly coordinated, in women and in men. The most common are bladder leaks, a frequent or urgent need to pass urine, pelvic and tailbone pain, pain with intercourse, constipation linked to straining, and recovery after childbirth or prostate surgery.

Leaking with a cough, sneeze or jump is called stress urinary incontinence, and a sudden, strong urge that is hard to hold is urge incontinence. Both are covered on the urinary incontinence page. Recovery after birth, including abdominal separation and a return to running, is on the postpartum physical therapy page, and pain over the coccyx is covered under tailbone pain.

• Leaking with coughing, laughing, lifting or running
• Urgency, frequency or getting up at night to pass urine
• Pelvic, vulvar, perineal or tailbone pain
• Pain with intercourse or with pelvic exams
• Heaviness or bulging that may suggest prolapse, after a physician’s assessment
• Leaks or pelvic pain after prostate surgery

Pelvic floor therapy is matched to what the muscles need, and that is not always strengthening. For stress leaks, supervised pelvic floor muscle training is the usual first step: the NHS describes a program of at least eight contractions at least three times a day for at least three months, with technique checked by a specialist. For pain, tight or overactive muscles usually need to learn to relax first, and squeezing harder can make things worse.

Sessions often also include breathing and coordination drills, timing a pelvic floor contraction with lifting or coughing, bladder training to stretch the time between bathroom trips, and graded strengthening of the hips and trunk. Later stages can use the rack and weights in the suite to rehearse lifting children, groceries or a barbell without leaking, which links closely to pregnancy back pain and to returning to the gym.

Runners are a good example of why the plan has to fit the person. Leaking that appears only after a few miles on the Monon Trail, or on the downhill stretches of a race, is often about fatigue and impact rather than a weak squeeze at rest. A pelvic health therapist may build endurance in the pelvic floor and hips, adjust breathing and stride, and add hopping and impact drills in stages so a spring race such as the Indy Mini stays realistic.

• Pelvic floor muscle training, progressed in hold time, speed and position
• Down-training and relaxation for tense, painful muscles
• Breathing and pressure management during lifting and exercise
• Bladder training and habit changes for urgency and frequency
• Return to running, lifting or sport with symptom checkpoints

See a physician before pelvic floor therapy if you have blood in your urine, a fever or burning that suggests an infection, new loss of bladder or bowel control with back pain or numbness in the saddle area (an emergency), unexplained bleeding, or a bulge you can see or feel. A physician should also review sudden changes in bowel habits.

When you are ready, choose the closest area on the questionnaire and mention pelvic health in your notes. The matching team checks whether a pelvic health trained therapist is practising in the network at the time, and if not, tells you so and suggests you look for a CAPP-Pelvic or board-certified therapist elsewhere. For questions about therapy during pregnancy, read can I do physical therapy while pregnant.