Everything You Need To Know About Pelvic Floor Occupational Therapy

You visit different health practitioners for different reasons—like a massage therapist for your sore back or a podiatrist for issues with your feet.

Have you ever visited an occupational therapist? Did you know that an occupational therapist can support your pelvic health? 

Here’s how.

Why Your Pelvic Health is Important

What is pelvic health? You might think it encompasses healthy menstrual cycles, fertility, and perhaps avoiding urinary tract infections. Those are all examples of pelvic health, but it’s more than that.

Pelvic health is defined as the “best possible functioning and management of the bladder, bowel, and reproductive organs”¹—or bowel and bladder health, vaginal and uterine health, and sexual health. It also includes the muscles and structures in those areas.²

It’s not just the absence of disease or weakness. However, pelvic health disruptions include a problem with one of those organs—the bladder, parts of the bowel or intestine, and the reproductive organs of the uterus, ovaries, and vagina—and also the muscles, ligaments, and other tissues that hold everything together.¹

Also known as the pelvic floor, those muscles and tissues play a key role in pelvic health, and pelvic health plays an important role in your total well-being, including physical, mental, social, and sexual health. Unfortunately, it’s estimated that 1 in every 3 women in the United States suffer at some point with a pelvic health disorder.²

What is Your Pelvic Floor? 

To understand pelvic health, you need to understand the pelvic floor, and its importance to your overall health. We often take these connective tissues for granted until there is a problem.

The pelvic floor forms a structure like a hammock or a basket, holding those important organs in place, helping to stabilize your core, and assisting with essential bodily functions, like pooping, peeing and having sex.³

Your pelvic floor muscles and connective tissues also work in tandem with other key muscle groups in your torso to allow your body to absorb outside pressure, such as when you lift or cough, which in turn protects your spine and your organs. They also control bowel and bladder function, which when they are working properly is called continence.³

That’s because when those muscles squeeze or relax, you can move waste effectively out of your body. The muscles coordinate with your urethra—the tube that carries pee out of your body—and your anus, through which stools pass. As you know, squeezing your pelvic muscles holds it in, and relaxing the muscles lets it out.³

When you have healthy pelvic floor muscles, you can squeeze and relax automatically, and control them just like other muscles in your body.³

What Are Pelvic Floor Problems?

Unfortunately for many women, these muscles can weaken over time due to a number of issues:⁴

1. Having children: Being pregnant and having children, particularly vaginal deliveries, can impact the muscles. Some studies show the risk increases with the number of children a woman has delivered, and may be greater if forceps or a vacuum device is used during delivery. But women who have never been pregnant or who deliver by cesarean section can also have pelvic problems.

2. Consistent pressure on the pelvic floor: Factors that can impact the muscles include being overweight or obese, suffering from constipation or chronic straining to have a bowel movement, heavy lifting, and chronic coughing from smoking or health problems.

3. The natural process of aging: Getting older can lead to weaker muscles, as can the process of menopause.

4. Having weaker tissues: Some women genetically have different strengths in their bones, muscles, and connective tissues; some are born with conditions that affect the strength of their connective tissues, for instance, resulting in pelvic issues.

5. Surgery: Previous surgeries like a hysterectomy or one to correct prolapse are associated with higher risks of pelvic disorders. 

A weakening of the important pelvic floor muscles can lead to a number of pelvic floor conditions:⁵

• urinary disorders like incontinence or leakage of urine; overactive bladder, painful urination, bladder pain, recurring urinary tract infections and more.
• pelvic organ prolapse, which is when one of your organs—like your bladder—drops from its position in the pelvis.
• rectal disorders like leaking stool (fecal incontinence), rectal pain or constipation. 
• conditions that cause pelvic pain like painful bladder syndrome (interstitial cystitis), endometriosis, vaginal pain, or painful intercourse. 
• birth injury and trauma, like injuries to the vagina or rectum, or healing or pain issues after childbirth.

Many women suffer in silence with their pelvic condition. For instance, those with incontinence may limit activity to avoid embarrassment. Some women believe these issues are a normal part of aging—which they are not! Some studies show that women who have a pelvic floor dysfunction have a worse perceived quality of life, in particular their emotional well-being.⁶ 

There’s good news!

Treatment including specific exercises can help pelvic floor disorders. For instance, research has shown that performing pelvic floor exercises commonly known as Kegels will help keep your pelvic floor muscles “fit.” These exercises can be done to prevent issues, or as part of a treatment plan for women already suffering with a pelvic disorder.

Pelvic floor muscles can be trained using the INNOVO Urinary Incontinence Kit. This product includes a pair of shorts and a controller that help you perform Kegel exercises properly, in short 30-minute sessions. Subscribe to the INNOVO newsletter to receive a $20 discount code for your purchase!

Otherwise, how do you know you’re doing your Kegels properly? What else can you do for your pelvic health? That’s where pelvic floor occupational therapy comes in.

Pelvic Floor Occupational Therapy

The American Occupational Therapy Association states that occupational therapy, as a profession, “promotes health, well-being, and participation.” This therapy uses everyday life activities, or occupations, to promote health, well-being, and your ability to better participate. 

Occupational therapy services typically include a personal evaluation, an intervention plan to improve your ability to perform daily activities and reach your goals, and an outcomes evaluation.⁷

An occupational therapist can support your pelvic health treatment plan. Depending on the specific pelvic dysfunction, a therapist can work with you to strengthen the muscles. A therapist can train you to do Kegels properly, for instance, and also use diaphragmatic breathing, biofeedback, and possible devices like vaginal weights or electrical stimulation. 

On the flipside, if you have overactive or tight pelvic floor muscles, an OT will support the relaxation approach with diaphragmatic breathing, biofeedback, relaxation and guided imagery techniques, to name a few.⁸

Therapy may be supplemented with environmental strategies like adjusting your toilet height or other bathroom modifications, or recommending adaptive clothing. Behavioral strategies may be suggested like pain management, mindfulness, managing medication, and planning schedules for using the bathroom. 

Therapists can even support you with education on lifestyle changes, hygiene practices and nutritional considerations.⁹

In short, pelvic floor occupational therapy can help. 

One study provided a qualitative case series to provide a description of the experience of women who received OT for pelvic floor health conditions. 

There were 3 themes that emerged from the data. Occupation-based therapy provided the following results:

1. It changed the course of women’s ongoing journey with pelvic health. 
2. Women experienced relief.
3. Women were empowered to be the experts of their own bodies.

There were clinically significant changes for participants, with a  decrease in pelvic floor disorder symptoms and an improvement of quality of life. Researchers concluded that occupational therapy interventions “may play an important role in positively impacting women’s life” when they have pelvic floor dysfunction. 

Women understood their bodies better, were able to return to occupations they enjoyed, and their symptoms were reduced. The research supported and advocated for the role of occupational therapists in women’s health and pelvic floor health.¹⁰

Pelvic Floor Occupational Therapy in Action

It’s not just about exercise, either. Here’s an example of areas an occupational therapist can supplement physical treatment:

Urinary incontinence is when you leak urine by accident. There are different forms of incontinence, and patients don’t always have to resort to surgery to find improvement of symptoms.

Treatment by an occupational therapist should encompass physical as well as behavioral and even environmental factors. When it comes to your environment, for instance: do you rush to the bathroom a lot at night? Are the pathways clear? Is there adequate lighting? Can you manage your clothing? If you have arthritis or coordination issues, are you wearing the proper garments? 

An occupational therapist will consider these questions in creating modifications to your environment.¹¹

In practice, occupational therapists have a role to play in treating pelvic floor disorders. Occupational therapists can offer a holistic perspective to address functional deficits caused by pelvic conditions, help patients to decrease social, physical, psychological, and sexual stressors, and improve their self-esteem and quality of life.¹²

Ask Your Doctor 

If you’re suffering from a pelvic floor disorder, use our Physician Finder to find a doctor near you with expertise in women’s health. Your treatment plan may include working with an occupational therapist who can support physical, environmental, and behavioral factors in your rehabilitation.