Treatment Strategies for the Pelvic Girdle and Pelvic Floor

1. Pelvic Rehabilitation Pathways

This chapter will provide an overview of pelvic floor rehabilitation and how it uses principles and techniques common to other rehab specialties. The importance of determining the state of the pelvic floor musculature in choosing the optimal treatment pathway will be emphasized.

2. Overactive Bladder and Bladder Retraining

This chapter will help the participant select appropriate patient education strategies to help manage symptoms of overactive bladder, such as urgency, frequency, nocturia, and leakage. Techniques to restore healthy bladder capacity, reestablish control of urinary frequency, and improve suppression of urgency will be presented.

3. Stress Incontinence and the “Knack”

This chapter will focus on how to integrate pelvic floor muscle activation into core stabilization exercises to minimize incontinence episodes during functional tasks. While a strong pelvic floor is important, its optimal function occurs during timely contractions during local core stability. Strategies on sequencing pelvic floor contractions (the “Knack”) with functional tasks will be presented.

4. Pelvic Floor Muscle Education

This chapter will touch upon the challenges that exist in teaching exercises for the pelvic floor due to its location. Utilization of a multimodal neuromuscular reeducation approach will give the best results. How to provide verbal, tactile, and visual cues for neuromuscular reeducation will be presented.

5. Pelvic Pain Relief Techniques

This chapter will assist the participant in understanding the importance of toileting posture in constipation management. Optimal posture while on the toilet can minimize symptoms of obstructed constipation, which is common in pelvic pain syndromes. Other strategies, such as targeted stretching and muscle relaxation techniques, will be presented.