Dr. Susie Gronski


There's Therapy For That?!

In the spirit of Valentine's Day, I decided to treat me and my husband to a relaxing manicure and pedicure. While chatting up small talk with my manicurist, she asked me the million dollar question, "So, what do you do?" I smiled and told her I was a physical therapist, but not just any physical therapist, a pelvic floor specialist.

She stopped for a moment and looked at me with wide eyes, expressing a bit of confusion. I explained to her ‘in a nutshell’ that pelvic floor therapy helps with issues such as incontinence, constipation, pain with intercourse, pre- and post-natal care, post-surgical scarring, and so much more. She nodded and said, "Oh, I had no idea there was therapy for that?! My sister had some problems like that and she told her primary care doctor. He told her to squeeze her muscles. She stopped doing it though, because she said it made her feel bad. It felt weird."

All of my fellow pelvic floor therapists are probably shaking their heads right now. It's unfortunate that the woman's doctor didn't know to refer her to a pelvic floor therapist who could've helped her and maybe even changed her life. Odds are that she was probably having pain from doing what most doctors haphazardly tell their female patients to do when they come in complaining of incontinence or pain… "Just do some Kegels."

If it were only that simple. Pelvic floor muscles function just like any other muscle in the body. You wouldn't go strengthening your biceps if it was so tight that you couldn't even straighten out your elbow would you? The same goes for the pelvic floor. Sometimes Kegels aren't the answer.

You have to know the baseline measurement of strength for the muscle(s) you are trying to strengthen, whether that’s biceps or, er, somewhere else. Without a pelvic floor healthcare provider's assessment, you might be doing yourself more harm than good.

The pelvic floor muscles are hammock-like, extending from your tailbone to the front of your pubic bone. They have several important roles, which I like to describe like this:

The 5 ‘S'es


1. Sphincteric Control: The pelvic floor muscles clamp down on the tubes that empty your bladder and bowel to keep you continent. They relax when you urinate or defecate.

2. Support: They are the ‘foundation’ of your body. Their job is to support your abdominal and pelvic organs. They function in conjunction with your breathing muscles to harmonize your body's pressure system. For example, when you cough or sneeze, the pelvic floor muscles reflexively tighten to oppose the extra pressure coming down from your abdomen and pelvis.

3. Stability: Pelvic floor muscles work together to stabilize your back, pelvis, hips, and legs. They are constantly adjusting to activity and are working all the time.

4. Sexual Appreciation: Yes, you read that right. Your pelvic floor muscles help with having an orgasm.

5. Sump Pump: Having sex is healthy and oftentimes recommended for pelvic health. Having an orgasm helps release ‘feel good’ hormones, improves venolymphatic flow, decreases pelvic congestion, assists with sleep, flushes out toxins, and in women, can even help with improving memory!

These muscles get overlooked all the time, forgotten out of the equation in many common orthopedic diagnoses such as sacroiliac pain (commonly called SIJ pain), lower back pain, and hip pain.

It's way too often that women who have given birth suffer with painful intercourse for several months, even years, before even seeking help, not knowing that an episiotomy or C-section scar might be a contributing factor.

And how about that hockey player who suddenly develops pelvic pain and all the tests come back negative being told, "But there's nothing wrong with you”?

Menopause? You betcha! Pelvic floor therapy can help with that too!

My favorite, though, is constipation.

I'm sure you’ve heard of the ‘squatty potty’ or seen the rainbow-pooping unicorn that went viral on the web. I even shared the video here. But in all seriousness, do you actually know the proper way to sit on the toilet? You could be saving yourself a lot of trouble from those agonizing days of straining and pushing if you learned what your pelvic floor was doing.

These are just a few examples of how important it is to really know your pelvic health and to get to know this special group of healthcare providers called pelvic floor specialists.

Aside from the musculoskeletal rehab part of being a pelvic floor therapist, we are much much more! We are the support you need when you feel hopeless about living with pelvic pain, the shoulder you cry on when no-one cared to listen. We are the hope that you get when everyone else told you you'd ‘just have to live with it for the rest of your life’.

We are the gatekeepers of your health, always guiding you to the help you need to treat the whole you and not just your symptoms. We are a unique bunch, that truly care about making a difference in the world, one patient at a time.



The blog content on this website is not intended to substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a healthcare professional with any questions you may have regarding treatment, medications/supplements, or any medical diagnoses. This information is intended for educational purposes only and is in no way to substitute the advice of a licensed healthcare professional.