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Pelvic floor physical therapy (PFPT) is a specialty area within physical therapy focusing on the rehabilitation of muscles in the pelvic floor after injury or dysfunction. It can be used to address issues such as muscle weakness or tightness post childbirth, dyspareunia, vaginismus, vulvodynia, constipation, fecal or urinary incontinence, pelvic organ prolapse, and sexual dysfunction.
Kegel exercise, also known as pelvic floor exercise, involves repeatedly contracting and relaxing the muscles that form part of the pelvic floor, now sometimes colloquially referred to as the "Kegel muscles". The exercise can be performed many times a day, for several minutes at a time but takes one to three months to begin to have an effect.
Mechanistically, the causes of pelvic floor dysfunction are two-fold: widening of the pelvic floor hiatus and descent of pelvic floor below the pubococcygeal line, with specific organ prolapse, graded relative to the hiatus. [10] People with an inherited deficiency in their collagen type may be more likely to develop pelvic floor dysfunction.
The pelvic floor is a "broad sling of muscles, ligaments and sheet-like tissues that stretch from your pubic bone at the front of your body, to the base of your spine at the back". [4] The pelvic floor is resistant to stretch and weight as it bounces back. However, after carrying weight for long periods of time, it can become stretched. [4]
The pelvic floor or pelvic diaphragm is an anatomical location in the human body, [1] which has an important role in urinary and anal continence, sexual function and support of the pelvic organs. [2] The pelvic floor includes muscles, both skeletal and smooth, ligaments and fascia.
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The major muscles involved in core stability include the pelvic floor muscles, transversus abdominis, multifidus, internal and external obliques, rectus abdominis, erector spinae (sacrospinalis) especially the longissimus thoracis, and the diaphragm.
The vagina is attached to the pelvic walls by endopelvic fascia. The peritoneum is the external layer of skin that covers the fascia. This tissue provides additional support to the pelvic floor. The endopelvic fascia is one continuous sheet of tissue and varies in thickness. It permits some shifting of the pelvic structures.