Terapia de ejercicio para tu piso pélvico: cómo funciona, qué esperar y consejos de Hinge Health

Estornudas - y goteas. También ocurre cuando toses y te ríes. O tu loca carrera hacia el baño no te lleva a tiempo. (Estamos hablando para el nº 1 y el nº 2.) O tal vez para ti no se trate tanto de problemas para hacer pis y caca como de dolor y presión en la zona pélvica que no desaparecen.

¿Adivina qué? Hay fisioterapeuta para eso: terapia de ejercicio para tus problemas de piso pélvico.

Cuando oyes hablar de terapia de ejercicio, es posible que pienses directamente en distensiones musculares y esguinces, o en la recuperación tras una lesión articular o muscular. Pues bien, escucha esto: el dolor, los problemas urinarios, la dificultad para defecar, el dolor durante las relaciones sexuales y otras cosas pueden ser signos de problemas en los músculos y tejidos piso pélvico. La terapia de ejercicio para el piso pélvico puede tratar estos problemas.

Los problemas de salud pélvica suelen ser problemas musculoesqueléticos (MSK). Al igual que la terapia de ejercicio puede ayudarte a controlar el dolor de hombro o a tratar una lesión de rodilla, la terapia de ejercicio del piso pélvico puede ayudarte a tratar el dolor pélvico y otros síntomas de trastornos del piso pélvico. Es PT para tus partes privadas. 

La terapia de ejercicio es "el tratamiento proporcionado por un fisioterapeuta o un asistente de fisioterapeuta que ayuda a las personas a mejorar su movimiento y función física, a controlar el dolor y otras condiciones crónicas, y a recuperarse de lesiones y enfermedades crónicas y prevenirlas", según la Asociación Americana de terapia de ejercicio. La terapia de ejercicio del piso pélvico se centra en los músculos y tejidos del piso pélvico y las zonas circundantes para ayudar a reducir o eliminar los síntomas pélvicos.

Hinge Health ofrece acceso a terapia de ejercicio -incluida terapia de ejercicio del piso pélvico- y mucho más. Es una clínica musculoesquelética digital que ayuda a las personas a tomar el control de su salud pélvica proporcionándoles fisioterapia, terapia de ejercicios, educación y asesoramiento sanitario, entre otras ofertas. 

Aquí te explicaremos cómo se utiliza la terapia de ejercicio para tratar los problemas del piso pélvico y cómo Hinge Health puede ofrecerte acceso a terapia de ejercicio y mucho más. (Para saber si puedes acogerte al programa de Hinge Health, confirma aquí la cobertura gratuita a través de tu empleador).

Pelvic Floor Function, Explained

Your pelvic floor is a group of muscles and connective tissues that stretch like a hammock from the pubic bone in the front to your tailbone in the back. Like the foundation of a house, it helps support the organs above it (such as your bladder and rectum), and plays a role in bladder and bowel control and sexual response. 

Pelvic floor issues can stem from problems with your pelvic floor muscles. If pelvic floor muscles are too tight (or hypertonic), for example, you may feel pain or discomfort with urination or bowel movements. Pelvic floor muscles and tissues can also become weak, injured, or inflamed. When pelvic floor muscles stop working as they should, it can lead to pelvic pain, painful sex, urinary incontinence, fecal incontinence, and other pelvic floor disorders.

How Can Physical Therapy Help Pelvic Floor Symptoms?

Like any muscle, your pelvic floor muscles can become weak or tight, leading to symptoms like pain, urinary or bowel issues, and more. Targeted exercises that help strengthen, relax, or improve flexibility and control can improve or eliminate pelvic symptoms. 

Pelvic floor physical therapy is a comprehensive treatment that may include exercise, relaxation techniques, behavioral training, lifestyle modifications, biofeedback training, and more.

You can see a pelvic floor physical therapist in person or use a program like Hinge Health to access a PT who specializes in pelvic health via telehealth/video visit.

Pelvic Floor Symptoms and Physical Therapy

Working with a pelvic floor physical therapist is one of the first treatments providers recommend for many pelvic floor issues. Pelvic floor problems are treatable. Many people significantly improve their symptoms with a combination of lifestyle changes and nonsurgical treatments, especially exercise.

Pelvic floor physical therapy can help you manage a lot of different pelvic symptoms, including: 

• Pelvic, low back, or hip pain

• Pain with penetration, during sex or gynecological exams, or while inserting or wearing tampons

• Leaking pee occasionally, constantly, or with certain activities (coughing, sneezing, laughing, or exercising)

• Urinary urgency and frequency, or feeling like you “gotta go” all the time

• Difficulty peeing (trouble starting or completely emptying, weak urine stream, or feeling the need to push or strain)

• Difficulty pooping (frequent constipation, hemorrhoids, fissures, trouble finishing a bowel movement, or leaking feces or staining your underwear)

• Pelvic pressure, bulging, or a feeling of heaviness in your vagina

• Weak or separated abdominal muscles, especially after childbirth

Pelvic Floor Conditions and Physical Therapy

Pelvic floor issues can be caused by a number of different conditions that your physical therapist may be able to work with you to improve. These include: 

• Pelvic pain

• Stress urinary incontinence

• Fecal incontinence

• Overactive bladder, or urinary urgency and frequency

• Chronic constipation

• Diastasis recti, or separated abdominal muscles

• Dyspareunia, or painful sex

• Pelvic organ prolapse

• Genitourinary syndrome of menopause

• Vaginismus

• Interstitial cystitis, or bladder pain syndrome

• Levator ani syndrome

• Coccydynia, or tailbone pain

• Vulvodynia, or pain in the vulvar area

• Pelvic floor muscle dysfunction

Whether your symptoms are primarily due to one of these conditions or something else, physical therapy can offer a lot of benefits for pelvic symptoms. 

Goals of Physical Therapy for Pelvic Health

• Relieving pain. A primary goal of physical therapy for pelvic pain is to reduce aches, stiffness, and discomfort. Physical therapists provide guidance on how to do exercises that are tailored for your exact needs and goals. 

• Reducing symptoms. Pelvic symptoms like pain, bladder and bowel issues, and painful sex can have a major impact on your quality of life. Studies show that lifestyle modifications and a specialized physical therapy exercise program can significantly improve pelvic symptoms and function. 

• Improving mobility. It’s hard to want to move if you hurt or leak urine during activity, but physical therapy can help you manage symptoms and safely push through a bit of that pain to get you back to doing the things you love — or even just being able to accomplish the daily stuff you need to do with more ease. 

• Strengthening and stabilizing. Muscles in your core, hips, back, and legs that have lost strength can contribute to pelvic pain and symptoms. Physical therapists prescribe specific strengthening exercises to target the muscles that support your pelvic floor to reduce strain on your pelvic floor muscles and improve overall function. 

• Providing education and self-management techniques. Physical therapists play a vital role in educating patients about their symptoms and conditions, providing self-management strategies and lifestyle changes, and empowering them to take an active role in their recovery. Physical therapists can help you make lifestyle modifications as needed and teach you how you can manage pain on your own (especially with movement and exercise) so you can keep making progress toward your goals. 

• Sharing prevention tips. Physical therapy isn’t just about managing current pain or symptoms. It’s also about equipping you with tools and knowledge to prevent future issues and maintain your pelvic and overall health. Physical therapists may provide guidance on ongoing exercises, self-care strategies, and lifestyle modifications to minimize the risk of pain or symptom flares and promote long-term health.

The goals and treatment approaches used in pelvic floor physical therapy will vary depending on your specific condition and needs. A thorough assessment by a qualified pelvic floor physical therapist will help determine the most appropriate treatment plan tailored to your unique situation.

Using a Pelvic Trainer in Your Physical Therapy

A pelvic trainer is a tool that helps you practice Kegel exercises. Kegels — or pelvic floor muscle contractions — can be an important part of your exercise program. Strengthening your pelvic floor muscles with Kegels can help you improve bladder and bowel control, speed up postpartum recovery, improve your sexual response, and help improve prolapse symptoms. But Kegels can be tricky to master.

That’s where a pelvic trainer can help. Inserted into your vagina, pelvic trainers have sensors that provide real time biofeedback to monitor your pelvic floor contractions. Your physical therapist might suggest using one during in-person office visits to help you gauge the strength of your contractions and gain confidence in your Kegel form. But there are also pelvic training devices for at-home use — like those available as part of a Hinge Health program. Combining pelvic floor exercise with a pelvic trainer can help treat certain types of pelvic pain, urinary incontinence, and urinary urgency and frequency.

But a pelvic trainer isn’t for everyone. Some pelvic floor problems are due to muscles that are tense or too tight, which can make relaxing your pelvic floor muscles more important than strengthening. Your health care provider or PT can evaluate your symptoms and discuss if a pelvic trainer is right for you.   

Physical Therapy, Exercise Therapy, and Hinge Health 

Physical therapy means you are getting treatment from a licensed physical therapist or physical therapy assistant. At Hinge Health, our members can see their own licensed physical therapist who personalizes and oversees their care plan. Hinge Health pelvic floor physical therapists focus on what we call exercise therapy, or therapeutic exercises.

Exercise therapy means following a treatment plan of different types of exercises to help relieve pelvic pain and manage pelvic issues like bladder and bowel incontinence and pelvic prolapse. Many people associate “exercise” only with getting fit or losing weight. We at Hinge Health love the phrase exercise therapy because it speaks to one of our main treatment philosophies: Movement is medicine.

Exercise therapy and physical therapy are not interchangeable. Our physical therapists prescribe exercise therapy to our members. Following your own personalized exercise therapy routine is one of the best ways to heal your hip pain and prevent it from recurring. 

Pelvic Floor Symptom Recovery with Hinge Health

If you’re experiencing pelvic pain or other symptoms, you can get relief with Hinge Health. A digital clinic for joint and muscle care, Hinge Health provides members with access to their own pelvic floor physical therapist, in addition to other program offerings (guided exercise therapy, personalized health coaching, education, and more). 

It can be very challenging to stay consistent in doing exercise therapy, but research shows that consistency is the best way to build a habit and maximize your results. Our physical therapists, health coaches, doctors, and other care team members all share a common goal of helping our members make exercise therapy a habit so they can get back to doing what they love.

Hinge Health physical therapists can give you an assessment and provide you with personalized recommendations to help you achieve your goals. Our physical therapists are trained to rule out any serious causes of your pain or symptoms, modify your activities, empower you with tools to help, and provide you with a personalized program to strengthen your body and help you reduce your pelvic symptoms.

Meeting with a Hinge Health Physical Therapist

Unlike many traditional physical therapy visits, you can meet with a Hinge Health pelvic floor physical therapist via video visit. That means, from the comfort of your own home, you can discuss your symptoms and goals with a physical therapist. They can conduct a movement assessment, observing how you move through different ranges of motion — and then create a personalized plan for you based on their findings. They can show you how to perform certain exercises and make sure you feel confident performing those movements on your own.

In addition to looking at your movement patterns and showing you how to do certain exercises, your video visit with a physical therapist provides you the opportunity to ask questions about your pain or symptoms, function, and progress in the Hinge Health program. Your physical therapist can also make modifications to the exercises in your Hinge Health program to help you along the way to healing. 

Hinge Health's Proven Results and Effectiveness

Hinge Health members have access to a library of therapeutic exercises designed to help you overcome your pelvic pain or symptoms. This can involve a combination of strengthening and stretching exercises. Your physical therapist can then tailor those exercises even further to better suit your needs and help you achieve your specific goals. 

Many studies show that a specialized physical therapy exercise program (like your Hinge Health exercises) and lifestyle modifications can significantly improve pelvic floor symptoms, including urinary issues like frequent and urgent trips to the bathroom. Results from our Hinge Health pelvic health program members show, on average, a 67% reduction in pelvic pain and a 54% reduction in non-pain-related pelvic symptoms by week 12. Beating pain and symptoms has other benefits, too. Members with mental health symptoms experienced a reduction in depression and anxiety over that same period.

Importance of Health Coaching 

Another facet of the Hinge Health program that sets it apart: personalized health coaching. In addition to having tailored exercises and access to a pelvic floor physical therapist, many Hinge Health members work with a health coach. Their job: to be your partner and support you on your Hinge Health journey.

Your coach can share information and guidance on the exercises and education concepts in your program, help you stay motivated and accountable, celebrate your progress and support you in working through obstacles, and help you explore meaningful goals and ways to reach them. 

Lo diremos otra vez. El ejercicio del piso pélvico es algo más que Kegels. Los ejercicios para todo el cuerpo son importantes porque el piso pélvico está conectado con el resto del cuerpo. La fuerza y la flexibilidad de los músculos en el centro (core), el pecho, las caderas, los muslos, las pantorrillas y otras zonas afectan a la función del piso pélvico. A continuación se indican ejercicios clave que pueden ayudar a mejorar el dolor del piso pélvico y otros síntomas.

La información contenida en estos vídeos está destinada exclusivamente a fines educativos y no constituye consejo médico ni tratamiento para ninguna afección específica. Hinge Health no es tu proveedor de atención médica y no es responsable de ninguna lesión sufrida o exacerbada por tu uso o participación en estos ejercicios. Consulta a tu proveedor de atención médica sobre cualquier pregunta que puedas tener sobre tu afección o tratamiento médico.

Este artículo y su contenido se proporcionan únicamente con fines educativos e informativos y no constituyen asesoramiento médico o servicios profesionales específicos para ti o tu afección médica.

Referencias

1. Bonis, M., Lormand, J. y Walsh, C. (2019). Cómo usar el Cuestionario de Impacto del Suelo Pélvico y modificaciones en el estilo de vida para mejorar los síntomas de la disfunción del suelo pélvico. American Journal of Biomedical Science & Research, 3(1), 23-26. biomedgrid.com/fulltext/volume3/utilizando-el-cuestionario-de-impacto-del-suelo-pélvico.000628.ph

2. Bradley, M. H., Rawlins, A., & Brinker, C. A. (2017). Physical Therapy Treatment of Pelvic Pain. Physical medicine and rehabilitation clinics of North America, 28(3), 589–601. doi:10.1016/j.pmr.2017.03.009 

3. da Mata, K. R. U., Costa, R. C. M., Carbone, É. dos S. M., Gimenez, M. M., Bortolini, M. A. T., Castro, R. A., & Fitz, F. F. (2020). Telesalud en la rehabilitación de la disfunción del suelo pélvico femenino: una revisión sistemática de la literatura. International urogynecology journal, 32(2), 249–259. doi:10.1007/s00192-020-04588-8

4. Faubion, S. S., Shuster, L. T. y Bharucha, A. E. (2012). Recognition and management of nonrelaxing pelvic floor dysfunction. Mayo Clinic proceedings, 87(2), 187–193. doi:10.1016/j.mayocp.2011.09.004

5. Grimes, W. R. y Stratton, M. (2021). Pelvic Floor Dysfunction. PubMed; publicación StatPearls. www.ncbi.nlm.nih.gov/books/NBK559246/

6. Huang, Y.-C., & Chang, K.-V. (2021). Kegel Exercises. PubMed; publicación StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK554546/

7. Trastornos del piso pélvico (TSP). (28 de enero de 2021). Https://Www.nichd.nih.gov/. www.nichd.nih.gov/health/topics/pelvicfloor

8. van Reijn-Baggen, D. A., Han-Geurts, I., Voorham-van der Zalm, P. J., Pelger, R., Hagenaars-van Miert, C., & Laan, E. (2022). Pelvic Floor Physical Therapy for Pelvic Floor Hypertonicity: A Systematic Review of Treatment Efficacy. Revisiones de Medicina Sexual, 10(2). doi:10.1016/j.sxmr.2021.03.002