Pelvic Floor Therapy

Pelvic Floor Physical Therapy in Central Massachusetts and Beyond

Pelvic pain, urinary incontinence and other types of pelvic floor disorders are sensitive concerns. People sometimes feel embarrassed or hesitate to get treatment. But you don’t have to live with pelvic issues. Pelvic floor therapists at UMass Memorial Health offer gentle, supportive care to help adults and adolescents feel their best.

What Is Pelvic Floor Dysfunction?

Your pelvic floor is a group of muscles and other soft tissues at the bottom of your pelvis that help support your bladder, rectum and reproductive organs. Sometimes, these muscles weaken or get too tight, which can lead to pain, urinary or bowel problems or discomfort during sex.

Pelvic floor dysfunction can affect women and men. It can be the result of aging, pregnancy and childbirth, or medical treatments such as surgery or radiation therapy. Regardless of the cause, we offer effective, personalized treatment for pelvic floor disorders so you can feel your best.

Pelvic Floor Disorders We Treat

At UMass Memorial, we treat all types of pelvic floor conditions, including: 

• Bladder and bowel incontinence (involuntary leakage)
• Pain during sex
• Pelvic organ prolapse
• Pelvic pain
• Postoperative issues following gynecologic or urologic surgery
• Postpartum issues, including diastasis recti (separated abdominal muscles) and scarring from a cesarean birth 
• Urinary urgency and frequent urination 
• Vaginismus (tight vaginal muscles), which can make it difficult to insert tampons or have a pelvic exam

We offer specialized care for male pelvic floor dysfunction at UMass Memorial Health – Milford Regional. We treat incontinence and chronic pelvic pain in men and address post-prostatectomy complications, such as erectile dysfunction and urinary retention (difficulty emptying your bladder).

Your First Visit: What to Expect

At your first appointment, you meet with an experienced pelvic floor therapist for one hour. Your evaluation and any treatment you need take place in private therapy rooms. You see the same therapist at all of your appointments, so you can feel comfortable with a familiar provider you trust. Most people have weekly treatment sessions, typically lasting between four and eight weeks depending on your needs.

At your first visit, you can expect: 

• Health history: Your therapist reviews your medical and reproductive history. Tell them about any conditions, injuries or surgeries you’ve had. Give a detailed account of your symptoms, such as pelvic pain or urine leakage. 
• Daily habits: Your therapist asks you questions about your diet, fluid intake (water, caffeine and alcohol), activity level and bathroom habits. They also learn about your work, stress level and sleep patterns to get a full picture of your health. 
• Pelvic floor education: You learn how your pelvic anatomy supports bladder and bowel control, sexual function and core stability. This information can help you feel more informed and confident during treatment. 
• External exam: Your therapist assesses your posture and spine as well as the range of motion in your hips. They may palpate (gently press) on your abdomen, pelvic region and groin to evaluate muscle tone and identify pain triggers. 
• Internal exam (optional): We may recommend an internal exam that involves examining the inside of your vagina or rectum with a gloved, lubricated finger (no speculum or stirrups). An internal exam is completely optional. 
• Bladder diary: You go home with a bladder diary to track your urination (leaks and retention) and fluid intake over several days. This log helps your therapist identify patterns and personalize your treatment plan.

Our Treatments for Pelvic Floor Dysfunction

You and your therapist work together to design an individualized physical therapy plan. Our evidence-based pelvic floor treatments include:

• Lifestyle modifications: If you have bladder issues, we may recommend adjusting your hydration habits. For example, drink water instead of soda or front-load water intake (drink more water earlier in the day). Consuming more fiber and cutting back on processed foods can also help with bowel issues.
• Pelvic floor exercises: These exercises help strengthen or relax pelvic floor muscles, depending on your needs. People with incontinence or pelvic organ prolapse may benefit from Kegel exercises (contractions to engage and strengthen the pelvic floor muscles).
• Manual therapies: Our therapists do hands-on soft tissue mobilization to release tightness and ease pain around your belly, back, groin and anus. We also do perineal and C-section scar massage to break up adhesions (internal scar tissue).
• Biofeedback: Surface electromyography (EMG) is a noninvasive tool that measures how well your pelvic floor muscles are working. We place painless electrodes near your anus that record electrical activity as you contract and release your muscles. This helps ensure you’re doing the exercises correctly and effectively and allows you to track your progress.
• Pelvic wands and vaginal dilators: You can use therapeutic, internal tools at home as part of your treatment plan. A pelvic wand can help relax tight pelvic floor muscles. A vaginal dilator gradually stretches vaginal muscles so that sex, tampon insertion and pelvic exams are less painful.
• Vacuum erectile devices (VEDs): Also called penis pumps, VEDs support penile rehabilitation after prostate surgery. The device draws blood into the penis to create an erection, which can help prevent penis atrophy (shrinkage) and erectile dysfunction (ED).