The role of manual therapy in the treatment of pelvic floor dysfunction

Abstract Pelvic floor massage has been used for many years to treat the symptoms of pelvic floor dysfunction. The literature dealing with palpation of the pelvic floor has endeavoured to demonstrate either the reliability of various techniques or a correlation with pain scores in cases of dysfunction. Manual therapy research has generally reported good results with regard to symptomatic relief for patients. However, what clinicians do and how they report it varies, leading to difficulties when comparing studies. The existing literature on the use of manual therapy techniques has tended to focus on chronic pelvic pain disorders such as interstitial cystitis, but clinically, pelvic floor musculoskeletal dysfunction seems to extend across the spectrum of all urogynaecological disorders. This paper attempts to label the techniques that can be applied to the pelvic floor myofascial system, and provide a brief overview of the application of these approaches to a population with pelvic organ prolapse (POP). The background to a research study evaluating the effect of manual therapy on the levator plate in women with POP is provided, although the main findings are not reported in this paper.