Why should all physical therapists should have knowledge of the pelvic floor?
When most people think of orthopedic physical therapy, they picture injuries like ACL tears, shoulder impingements, or chronic back pain. What often goes unnoticed is the role that the pelvic floor can play in many of these issues. This is actually why I started taking several continuing education courses in pelvic floor health as I was seeing a lot of overlap as an orthopedic PT. For orthopedic physical therapists, having a foundational understanding of the pelvic floor is not just beneficial—it’s essential. Here’s why:
1. The Pelvic Floor Is Central to Core Stability
The pelvic floor is a crucial component of the body’s core. Alongside the diaphragm, transverse abdominis, and multifidus, the pelvic floor forms a pressure-management system that stabilizes the spine and pelvis. Core dysfunction can manifest as low back pain, pelvic girdle pain, or even hip instability—all conditions orthopedic therapists encounter regularly. Without addressing the pelvic floor, treatment plans can miss a key piece of the puzzle.
This image illustrates what happens during inhalation: as the diaphragm descends, it increases pressure on the pelvic floor. If your pelvic floor is strong and can manage this pressure, you won’t experience any symptoms. However, if the pelvic floor has been weakened over time—due to factors like pregnancy—this pressure can be poorly managed, potentially leading to issues such as leakage, prolapse, and other pelvic floor dysfunctions."
2. Pelvic Floor Dysfunction Often Presents as Orthopedic Pain
Pelvic floor dysfunction doesn’t always appear as classic pelvic symptoms like incontinence or prolapse. Instead, it can present as:
Hip pain
SI joint discomfort
Persistent low back pain
Groin or adductor strain-like symptoms
If an orthopedic therapist lacks awareness of the pelvic floor’s role, they might treat these symptoms without addressing the root cause, leading to prolonged recovery or recurrent issues.
3. Orthopedic and Pelvic Health Are Deeply Interconnected
Life events like pregnancy, childbirth, and menopause impact not only the pelvic floor but also the entire musculoskeletal system. Postpartum clients, for example, often experience diastasis recti, hip pain, or mid-back discomfort—all of which are intertwined with pelvic floor health. Understanding these connections enables orthopedic therapists to provide comprehensive care for clients at all stages of life.
4. Athletes Are Not Exempt
Athletes often push their bodies to the limit, and the pelvic floor is no exception. High-impact activities like running, weightlifting, or gymnastics place significant stress on the pelvic floor. Symptoms like leaking during exercise (stress urinary incontinence) or pelvic pain can hinder performance. Orthopedic therapists who can identify and address pelvic floor dysfunction in athletes will set their clients up for better outcomes and longevity in their sport.
5. Collaborative Care Is the Future
As healthcare becomes more integrative, the lines between specialties are blurring. Orthopedic therapists who can collaborate effectively with pelvic floor specialists—or even address pelvic health concerns themselves—offer a higher standard of care. This holistic approach not only improves patient outcomes but also builds trust and rapport.
6. It’s About Seeing the Whole Picture
Physical therapists are movement specialists. To fully understand how the body functions, it’s necessary to consider every system, including the often-overlooked pelvic floor. Without this knowledge, therapists risk missing key drivers of dysfunction.
Built to Move is specialized in orthopedic and pelvic floor PT
What makes us different? Well, I’ve got the best of both worlds—education and experience in both orthopedics and pelvic health! This means if I spot any overlap in what you're dealing with, I can treat it all in one place, no need to send you to another clinic. Super convenient for you (and me)! I’ve also set up my office to handle everything from orthopedic issues to pelvic floor care, with a private, comfy space and all the right equipment to get you feeling your best.
Book your private session now or reach out with any questions!
