PT Assessment of the Pelvic Floor-PT Assessment of the Pelvic Floor

Video Transcription

Video Summary

The speaker, a physical therapist, reviewed pelvic floor anatomy, functions, assessment, and common dysfunctions. She explained pelvic floor roles using the “five S’s”: sphincteric control of bowel and bladder, support of pelvic organs, sexual function, spinal/lumbopelvic stability, and “sump pump” lymphatic fluid movement. She described two main dysfunction patterns: underactive/low-tone muscles, which can cause incontinence, prolapse, weakness, and difficulty with orgasm; and overactive/high-tone muscles, which can cause pain, dyspareunia, constipation, bladder pain, and lumbopelvic/SI dysfunction.<br /><br />She outlined pelvic floor muscle layers and palpation landmarks, including superficial muscles, the sphincter complex, levator ani muscles, coccygeus, and obturator internus. Assessment includes visual inspection, skin and sensation checks, sacral nerve testing when indicated, observing contraction patterns, external and internal palpation, strength/endurance testing, and coordination with breathing and core muscles. She emphasized that the diaphragm, abdominals, back muscles, and pelvic floor should work together as a coordinated “core.”<br /><br />Practical advice included using very light palpation, avoiding painful exams, and recognizing that pelvic floor therapy may need to stay external in patients with tissue pain or postmenopausal changes. She also discussed referral guidance, noting that pelvic floor therapy is typically used when symptoms show a muscular component and that specialized pelvic PTs can be found through professional directories and credentials.

Keywords

pelvic floor anatomy

pelvic floor dysfunction

incontinence

dyspareunia

levator ani

pelvic floor assessment

core coordination

pelvic physical therapy