When it comes to breaking the cycle of UTIs or UTI-like symptoms, Hill says pelvic floor therapy usually focuses on relaxing the pelvic floor.
What to Expect
Pelvic floor physical therapy for recurrent UTIs will likely begin with an examination. Your healthcare provider may assess your hips, legs and feet, and spine; press on your abdomen, groin area, and inner thighs; and ask you to do some simple exercises to detect any muscle weakness or imbalance that could contribute to pelvic floor dysfunction.
They may also perform an internal exam, in which they insert gloved fingers into the vagina or rectum to understand how your organs are structured and identify areas that are particularly tight or painful. The external and internal exams will help your therapist create an individualized treatment plan that may include one or more of the following:
Pelvic Floor Manual Therapy Hands-on treatments can help relax the pelvic floor by applying gentle pressure or massaging tense muscles internally or externally. Myofascial release is a manual therapy technique where trigger points are stimulated to release tension.
Pelvic Floor Retraining Your pelvic floor physical therapist may be able to teach you exercises to help you release your pelvic floor if the muscles are tight. “We can coach people through pelvic floor relaxation, so almost like the opposite of a Kegel or contraction,” says Hill.
Biofeedback This mind-body technique uses sensors to track muscle activity. “Biofeedback is an electrical modality, so when you contract and relax, you can actually see it on a screen, which can help with retraining,” says Hill.
Lifestyle Changes and Addressing Contributing Factors Your physical therapist will likely suggest lifestyle changes that could improve symptoms, such as “having plenty of water and avoiding bladder irritants like caffeine, carbonated beverages, alcohol, or acidic things,” says Hill.
In addition, you may work together to identify and address other factors that may be causing recurrent UTI symptoms, such as chronic constipation or menopause-related changes.
Hormonal changes can affect some of the protective properties of the vagina, making women in perimenopause or menopause more prone to UTIs. Vaginal estrogen cream is a generally safe and effective treatment, says Dr. Gleicher.
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