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The Forgotten Muscles

Physical therapists are well known for working with muscles - things like the hamstrings, biceps, or muscles of the back. Most people are surprised to learn that PTs also work on muscles inside the pelvis. These are muscles which most people do not think of, or even know about, but they can still cause problems - typically incontinence, or pain.

Types of pelvic floor problems

Pelvic floor impairments can lead to multiple issues such as:

Incontinence is the involuntary leakage of urine. There are several different types of incontinence and usually they are due to different issues in the pelvic floor. Stress, urge, overflow, functional, mixed, and bedwetting incontinence are several of the types of urinary incontinence. More than 13 million people in the United States have this issue. Unfortunately, it is advertised as normal in women, especially following having children. But in fact, a pelvic floor physical therapist can help. 

Pelvic pain is any pain that occurs either internally or externally in the pelvic or genital area. Both men and women can be affected, but it's more common in women.

What causes Incontinence?

Most incontinence is caused by issues with the pelvic muscles - either the muscles are too weak, or they are too tight. Other contributing factors may be spasms that cause bladder contractions, or conditions like anxiety that also increase the urge to empty the bladder.

What causes Pelvic Pain?

Pelvic pain is also usually attributed to either tightness or weakness of the muscles of the pelvic floor. The pelvis is made up of three bones, forming three joints where they meet. These joints need force from the pelvic muscles to stabilize them. If the muscles are too tight, the joints will have an excessive amount of compression on them. Too loose, and the joints of the pelvis can experience shear forces. Both conditions result in pelvic pain.

How can a Physical Therapist Help with these Issues?

Physical therapists are the experts in motion. We know how to lengthen and strengthen a muscle so that it can perform optimally. Because incontinence and pelvic pain are usually musculoskeletal conditions, physical therapy can offer various effective treatments. PTs might use exercise to strengthen or stretch the pelvic muscles to help correct imbalances, improve pelvic stability and reduce pain.

Types of Treatments Physical Therapists Use

There are other interesting treatments physical therapists can use to treat the pelvic muscles as well. Often, it is hard to get a mind body connection to these muscles since we do not usually see them activated. One of the things physical therapists can use to help with the mind body connection is biofeedback. Biofeedback uses sensors placed on the body while doing exercise to help the patient identify which muscle groups are working and bring awareness to areas of tightness or weakness. Education can help people learn to self-manage their symptoms and hands on techniques like joint mobilizations, trigger point release, soft tissue massage, or myofascial release can help improve mobility of the pelvic joints, decrease tone in spastic muscles, and reduce pain.

So, when you think of a PT working to help correct problems in muscles or tendons, remember that they can treat every muscle in the body, not just the obvious ones.


If you have been experiencing pelvic pain or incontinence, do not hesitate to reach out with any questions or concerns and schedule an appointment with us at Advantage Physical Therapy if you are in the Falls Church or Arlington region in Virginia.



About The Private Practice Section of the American Physical Therapy Association
Founded in 1956, the Private Practice Section of the American Physical Therapy Association champions the success of physical therapist-owned businesses. Our members are leaders and innovators in the healthcare system. The American Physical Therapy Association (APTA) represents more than 85,000 physical therapists, physical therapist assistants and students of physical therapy nationwide. For more information, please visit
Alana Hamilton Alana Hamilton is a physical therapist at Advantage Physical Therapy in Falls Church, Virginia. She is a proud Hokie from Virginia Tech with a major in Biology and a minor in psychology and sociology. Following graduation, she immediately got her doctorate in Physical Therapy from Radford University. She is an avid fan of Pilates, running, and hiking. On the weekends, she can be found hanging out with her family and baby as well as doing Spartan races with her old physical therapy classmates and friends. She is a big believer that during rehabilitation, "Motion is the Lotion" and that staying active is key to remaining healthy.

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