Written by Megan Williams, OT Student
With guidance from Audra Killingsworth, OTR/L
Pelvic floor therapy fits seamlessly into all things occupational therapy. This niche area of practice addresses the fundamental aspects of daily living, particularly toileting, sexual function and intimacy, and addressing overall quality of life. According to the Occupational Therapy Practice Framework (OTPF-4), activities like sexual intimacy and toileting are considered Activities of Daily Living (ADLs). While occupational therapists are already addressing and engaging in areas like toilet transfers, lower body dressing, and hygiene; pelvic floor dysfunction such as urinary and fecal incontinence, constipation, urgency, pelvic floor pain, etc. often remains under-addressed for an occupational therapy standpoint, despite its undeniable direct impact on daily life.
Occupational therapists are experts in helping individuals achieve optimal occupational performance and engagement, which includes addressing the physical, social, emotional, and behavioral factors that make up and impact one’s well being. Pelvic floor therapy goes beyond just addressing the physical mechanics of pelvic health; it involves supporting clients mental, emotional, and nervous system health as well. For instance, studies show that anxiety and depression can significantly increase the risk of urinary incontinence, which in turn contributes to a wide range of social and emotional challenges such as social isolation, stigma, and lower self-esteem. All of these factors can negatively impact social participation, leisure participation, and sexual activity, directly affecting overall quality of life and optimum occupational performance.
By integrating OT into pelvic floor therapy, we are not only helping clients to better manage the physical aspect and symptoms but also taking a holistic approach to improving their emotional and psychological health. Specific approaches can include behavioral modifications, coping strategies, stress management, sensory integration, nervous system manipulation, and creating client centered home exercise and activity programs that meet the client where they are with accounts into not only their daily routine but their overall context.
By recognizing pelvic floor therapy as a critical area in which OT’s play a significant role in, we can empower clients to lead healthier, more fulfilling lives. As AOTA president emphasized, “If our pelvic floor is not healthy, there is no occupation we can perform”. This highlights the profound impact that occupational therapists have in addressing pelvic health in our clients at all stages of life.
Occupational therapists addressing pelvic floor therapy goes beyond treating a dysfunction; it is a holistic approach aimed in helping clients to regain control of their lives and interact in fulfilling occupations. Incorporating occupational therapy’s distinct perspective into pelvic floor therapy will not only deepen our understanding of pelvic floor dysfunction but will also improve our client’s outcomes and overall quality of life – ultimately is this not the primary goal in all rehabilitation professions?
References
American Occupational Therapy Association. (2020). Occupational therapy practice framework; Domain and process (4th ed.).
Mishra, G. D., Barker, M. S., Herber-Gast, G. C., & Hillard, T. (2015). Depression and the incidence of urinary incontinence symptoms among young women: Results from a prospective cohort study. Maturitas, 81, 456–461. https://doi.org/10.1016/j.maturitas.2015.05.006