Physical Therapy to Treat Bladder & Bowel Leaks

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Your pelvic floor is one of those body parts you probably take for granted — until embarrassing problems arise. Urine leaks when you laugh, or your bowels fail at the worst possible time. These are signs that the pelvic floor muscles, which help support the pelvic organs (bladder, bowel, and uterus), may be weakening. Pelvic physical therapy can help.

At UVA Health, we offer a variety of non-surgical treatment options for pelvic floor disorders. One of these treatments is pelvic floor physical therapy.

How Can Pelvic Floor Physical Therapy Help Me?

Pelvic floor physical therapy is a specialized branch of physical therapy that focuses on treatment to help restore function to the muscles of the pelvic floor.

You may benefit from pelvic floor physical therapy if you have:

  • Urinary incontinence, urgency, frequency
  • Overactive bladder
  • Constipation, bowel incontinence, painful bowel movements
  • Pelvic organ prolapse
  • Endometriosis
  • Painful bladder syndrome
  • Chronic pelvic pain
  • Vaginismus or vaginal muscle spasm during penetration
  • Vulvodynia or chronic pain at the vaginal entrance
  • Pain during sex
  • Pregnancy or delivery-related pelvic pain or injury
  • Incontinence after prostate or other abdominal/pelvic surgeries or treatment

Pelvic floor physical therapy can help anyone who has a pelvic floor disorder. This includes men and women of all ages, and the transgender population.

What to Expect During Pelvic Physical Therapy

A physical therapist specially trained in pelvic health will do an initial evaluation to get your complete medical history. They will discuss your treatment goals and assess your bladder and bowel habits, as well as any pain you may be experiencing.

The therapist will do an external exam to:

  • Examine your posture, joint alignment, range of motion, strength, flexibility, and movement patterns
  • Evaluate your trunk and pelvic soft tissue (muscles, ligaments, etc.)

A pelvic exam, either vaginal and/or rectal, may be necessary to evaluate your pelvic floor muscles. With this exam, the therapist will be able to identify fascial restrictions and determine the pelvic floor muscles’:

  • Strength
  • Coordination
  • Endurance
  • Restrictions
  • Tone
  • Mobility
  • Pain points

Treatment Options for a Weak Pelvic Floor

Learning About Your Pelvic Floor

Your physical therapist help you better understand the many factors that can impact your pelvic floor muscles:

  • Diet
  • Behavioral patterns
  • Posture
  • How you move

You’ll work together to plan what changes you can make during and after therapy to improve your pelvic health.

Kegels & Other Exercises

The most common exercise associated with the pelvic floor is the Kegel. This is an exercise that involves tightening and releasing the pelvic floor muscles. Kegels can strengthen and improve endurance and coordination of the pelvic floor muscles, which helps with bowel and bladder control.

Your physical therapist may recommend other exercises and techniques to help:

  • Relax the pelvic floor muscles
  • Strengthen and stabilize the core using the pelvic floor, abdominals, back, and diaphragm
  • Retrain your bladder

Pelvic Floor Devices

In some cases, a physical therapist may use or recommend tools to bolster your progress.


This treatment uses sensors to measure the electrical activity of the pelvic floor muscles as you tighten and release them. The results help you and your therapist determine changes you can make to strengthen these muscles and evaluate your progress over time.

Electrical stimulation/TENS (Transcutaneous Electrical Nerve Stimulation)

This device uses electrodes to stimulate the nerves of the pelvic floor with small pulses of low-grade electrical current. A therapist may recommend this for people with extremely weak pelvic floor muscles.

Vaginal and Rectal Dilators

These devices can be used vaginally or rectally to improve tissue elasticity, relieve tension, and retrain the muscles to relax and contract as appropriate.

How Long Does Pelvic PT Take?

How long you will need pelvic floor physical therapy varies depending on your diagnosis and treatment goals.

Some patients may require only a few sessions, but others may benefit from several months of therapy. Typically, you will need to see a therapist 1 to 2 times per week when you begin treatment. You may be required to continue some exercises and other treatment approaches at home after therapy ends to maintain pelvic floor health.

What Strong Pelvic Muscles Can Do

Pelvic floor physical therapy can help:

  • Improve your quality of life
  • Lessen social anxiety due to bowel and bladder leakage
  • Ease pelvic pain
  • Improve sexual health
  • Increase strength and coordination of the muscles of the spine and hips
  • Speed recovery after pregnancy and delivery or abdominal/pelvic surgery