Pelvic Prime's Anatomy Academy Series
Pelvic Floor Therapy for Neurodivergent Individuals
Pelvic floor physical therapy can be highly beneficial for neurodivergent individuals, such as those with ADHD, autism, OCD, and sensory processing challenges, especially when approached with a whole-body, holistic focus. By integrating sensory, motor, and emotional regulation strategies, pelvic floor physical therapists can provide targeted support that goes beyond just addressing the pelvic floor. Here are specific examples of how pelvic floor physical therapy can help neurodivergent individuals with a whole-body treatment approach:
Addressing Sensory Processing Issues
Many neurodivergent individuals, especially those with autism or ADHD, experience sensory processing difficulties. These issues can make it challenging to perceive and interpret sensory input accurately, including sensations from the pelvic area. Pelvic floor physical therapy can help by:
Sensory Integration Techniques: Therapists can use sensory-based interventions to improve how the body responds to different sensations in the pelvic region. For example, using textured materials, body awareness exercises, or weighted blankets during therapy can help the individual tolerate sensory input more effectively.
Proprioception Training: Neurodivergent individuals may struggle with proprioception, or the ability to sense body position. Pelvic floor therapy can include exercises that enhance body awareness, helping individuals better recognize and control their pelvic floor muscles. This can improve motor coordination and reduce sensations of discomfort or disconnection from the pelvic area.
Deep Pressure and Calming Strategies: Many neurodivergent individuals respond well to deep pressure, which can be calming and grounding. Therapists might incorporate techniques like deep tissue massage or weighted therapies to provide a sense of security during treatment, which can help reduce anxiety and make pelvic floor exercises more tolerable.
Improving Motor Coordination and Control
Neurodivergent individuals, particularly those with ADHD or autism, may have challenges with motor coordination, which can affect the ability to properly engage the pelvic floor muscles. Pelvic floor physical therapy addresses these issues through:
Motor Planning and Sequencing: Therapists use exercises to help neurodivergent individuals practice motor planning, or the ability to think through and execute movements. For example, a therapist might guide an individual through the steps of contracting and relaxing the pelvic floor muscles in a structured, repetitive way to improve control.
Using Visual and Verbal Cues: Neurodivergent individuals often benefit from clear, structured instructions, including visual or auditory cues. Pelvic floor physical therapists can use diagrams, videos, or verbal prompts to help individuals understand how to engage their pelvic floor muscles, making exercises easier to follow and complete.
Dynamic Movement Integration: Pelvic floor therapy might include dynamic movements that integrate the entire body, such as squats or yoga-based movements, which help neurodivergent individuals engage their core and pelvic floor simultaneously. This can improve overall coordination and functional movement patterns in daily activities
Emotional and Behavioral Regulation through Movement
For neurodivergent individuals, regulating emotions and behaviors can be a challenge. Pelvic floor physical therapy, with its focus on whole-body treatment, can help neurodivergent individuals develop emotional and behavioral regulation strategies through movement and body awareness:
Breathing Techniques for Emotional Regulation: Therapists often teach diaphragmatic breathing and other breathing techniques that engage the pelvic floor and core muscles. For neurodivergent individuals, these breathing exercises can help reduce anxiety, manage stress, and regulate emotions. Practicing controlled breathing helps establish a mind-body connection and promotes calmness.
Body-Based Calming Strategies: Neurodivergent individuals who experience anxiety or repetitive behaviors (such as in OCD) can benefit from body-based calming techniques, such as grounding exercises, that encourage relaxation and reduce tension in the pelvic floor. This approach helps individuals become more aware of their bodies and reduces the likelihood of physical symptoms related to anxiety or compulsions.
Mindfulness and Body Awareness: Pelvic floor therapy can include mindfulness exercises that focus on improving body awareness. By focusing attention on the pelvic region and learning to recognize physical sensations, neurodivergent individuals can develop better control over their physical and emotional responses. This is especially beneficial for individuals who may disconnect from or overlook bodily signals due to sensory processing issues.
Managing Incontinence and Bladder Control
Incontinence and bladder control issues can be prevalent in neurodivergent individuals, particularly those with ADHD or autism, due to difficulties with sensory awareness, motor planning, or impulsivity. Pelvic floor physical therapy can help manage these challenges through:
Bladder Retraining: Therapists can help neurodivergent individuals learn to manage bladder urgency and frequency by developing a bladder retraining program. This may involve setting specific bathroom schedules, practicing relaxation techniques to reduce urgency, and learning to engage the pelvic floor muscles appropriately when needed.
Pelvic Floor Muscle Strengthening: By strengthening the pelvic floor muscles, therapists can help neurodivergent individuals improve bladder and bowel control. Kegel exercises or similar pelvic floor strengthening routines are adapted to each individual’s needs, helping them gain confidence in managing incontinence.
Addressing Sensory Urgency: For some neurodivergent individuals, sensory processing issues may cause exaggerated sensations of bladder fullness or urgency. Therapists work on helping individuals recalibrate their responses to these sensations, teaching them how to distinguish between true bladder fullness and false urgency.
Posture and Core Stability to Support Pelvic Floor
Many neurodivergent individuals, particularly those with autism or ADHD, may have poor posture, core instability, or muscle imbalances that affect pelvic floor function. Pelvic floor physical therapists focus on the entire body to improve posture and stability, which in turn supports the pelvic floor:
Core Strengthening Exercises: Therapists use core-strengthening exercises to improve stability in the trunk and pelvic area. This not only helps with pelvic floor function but also improves posture and overall body control, which can be particularly beneficial for individuals who struggle with maintaining proper body alignment.
Functional Movement Training: Neurodivergent individuals may have difficulty with tasks that require coordination of multiple muscle groups, such as sitting down, standing up, or walking with correct posture. Pelvic floor physical therapists can incorporate functional movement training that improves these abilities, ensuring that pelvic floor muscles are properly engaged and supported during daily activities.
Postural Realignment: For individuals with poor posture or scoliosis (which is common in certain neurodivergent populations), pelvic floor physical therapists may incorporate postural realignment techniques to ensure that the pelvis and spine are in proper alignment. This reduces strain on the pelvic floor muscles and helps improve their function over time.
Promoting Independence and Confidence in Daily Activities
A whole-body approach in pelvic floor physical therapy helps neurodivergent individuals build the confidence and skills needed to engage in daily activities independently. The therapeutic process emphasizes improving physical function, which leads to greater self-sufficiency:
Personalized Home Exercise Programs: Therapists often provide tailored home exercise programs that neurodivergent individuals can easily follow. These programs help individuals practice their skills at home, improving their confidence in managing pelvic floor function and applying the skills they learn in therapy to real-life situations.
Building Physical and Mental Resilience: Physical therapy promotes resilience by teaching individuals how to manage their pelvic floor symptoms and how to cope with sensory or motor challenges they may face. This leads to greater independence and self-assurance, reducing anxiety about body function.
Social Engagement through Movement: Group therapy sessions or social movement activities, such as yoga or Pilates-based therapy, can promote social interaction and communication for neurodivergent individuals. These activities help individuals connect with others while building physical strength and emotional resilience.
Neurodivergent People Often Need Extended Physical Therapy and Accountability Programs
People with ADHD, OCD, or autism may need longer physical therapy care or accountability programs due to the unique challenges they face in relation to learning, processing, and maintaining consistent routines.
Here are some reasons why extended or ongoing physical therapy and accountability programs might be necessary for neurodivergent individuals:
Difficulty with Routine and Consistency (ADHD, Autism)
Many neurodivergent individuals, especially those with ADHD or autism, may find it challenging to maintain a regular routine, which is essential for achieving successful outcomes in physical therapy. For these individuals, longer or more structured therapy programs can offer significant benefits.
One of the key challenges for individuals with ADHD is inconsistent follow-through. Executive functioning difficulties, common in ADHD, can make it hard to consistently perform at-home exercises or attend therapy sessions regularly. Longer-term therapy programs can reinforce habits, helping to ensure that these individuals get the practice they need.
For people with autism, having a structured and predictable routine is often crucial. Extended therapy programs give therapists the opportunity to gradually introduce new movements or exercises in a systematic and controlled way. This structured approach can make it easier for individuals with autism to adjust to changes over time.
Additionally, external accountability can play a vital role in supporting neurodivergent individuals. Programs that offer regular check-ins or support help those who may struggle with self-motivation or organizational skills. This is particularly beneficial for those with ADHD, who may need reminders, coaching, and feedback to stay on track with their therapy goals.
Slower Progress Due to Sensory and Motor Challenges (Autism, ADHD)
Neurodivergent individuals often face unique challenges such as sensory processing difficulties, motor delays, or coordination issues, which can extend the time needed to achieve physical therapy goals. These factors can make it harder to meet typical therapy milestones and require more tailored, long-term approaches.
For individuals with autism or ADHD, sensory processing issues can pose a significant barrier to participating in physical therapy. Some may experience sensory overload, while others may be under-responsive, making it difficult to engage in certain exercises. Therapists may need additional time to adjust the exercises to suit the individual’s sensory preferences. This process often requires extended care to ensure steady progress.
Motor skill development is another area where many neurodivergent individuals may face delays. Gross or fine motor skills might be underdeveloped, which can impact coordination, balance, and motor planning. Physical therapy in these cases may take longer, as therapists work through repeated practice and increased guidance to help develop the necessary muscle memory. Compared to neurotypical individuals, progress may be slower, but consistent work can yield improvements over time.
Adaptation and modification of therapy techniques are crucial when working with individuals who have autism or ADHD. Therapists often need to adjust exercises to meet the specific needs of the individual, which requires time to experiment with different methods. Finding the right strategies for each person can be a trial-and-error process, making longer-term therapy essential for success.
Challenges with Emotional Regulation and Compulsions (OCD, Autism)
For individuals with OCD or autism, challenges related to emotional regulation and repetitive behaviors can significantly impact the physical therapy process. These factors often require more time and attention from therapists to ensure progress is made in a way that respects the individual’s needs.
In the case of individuals with OCD, compulsive behaviors and anxiety can interfere with therapy. Some may engage in repetitive behaviors, such as checking or focusing excessively on certain body movements, which can slow down their ability to engage in exercises. Longer treatment may be necessary to help them develop coping mechanisms and relaxation techniques. Additionally, anxiety about body sensations, movements, or the fear of injury may cause hesitation in therapy, requiring a more gradual approach to help them feel comfortable and confident.
For individuals with autism, emotional regulation can be a major challenge. Therapy may become overwhelming, leading to meltdowns or frustration. As a result, therapy programs often need to proceed at a slower pace, allowing time to build trust and emotional resilience. Therapists may also focus on helping individuals develop self-regulation skills, ensuring that they can engage in therapy without becoming emotionally overwhelmed.
Need for Repetition and Reinforcement (ADHD, Autism)
Neurodivergent individuals often need additional repetition and reinforcement to effectively learn and retain new motor skills or body awareness techniques. These challenges can make physical therapy a longer process, requiring patience and consistent practice.
For individuals with ADHD, executive functioning challenges such as difficulties with memory, attention, and task completion can impact their ability to master physical therapy exercises. They may need more repetition and reinforcement to fully grasp and retain the skills they are learning. Regular reminders and structured guidance help ensure that what is learned during therapy carries over into their daily activities.
Similarly, individuals with autism may experience motor learning delays. Their brains might process and integrate motor skills differently, meaning they often require more time to build muscle memory for new movements. Extended therapy, regular practice, and ongoing feedback are essential to help these individuals develop automatic responses to the exercises they are working on. The repetition allows them to progress at a pace suited to their unique needs.
Behavioral and Sensory Adaptations (All Conditions)
Physical therapy for neurodivergent individuals often takes longer to address their unique sensory or behavioral needs. Therapists must adjust the pace and approach to ensure that each person's experience is comfortable and productive.
For individuals with sensory sensitivities, which are common in both ADHD and autism, new sensations, movements, or environments can be overwhelming. Gradual exposure to these elements is essential to avoid triggering sensory overload. Therapists need to introduce exercises slowly and carefully build up tolerance, which can extend the length of therapy as progress is made at a pace that suits the individual’s needs.
Behavioral support and motivation are also critical factors in the therapy process. Therapists may use strategies like positive reinforcement or visual schedules to keep neurodivergent individuals engaged, especially children with ADHD or autism. Accountability programs that involve regular check-ins and clear goal-setting are important to help maintain motivation and ensure long-term success in therapy.
Individualized Pace of Therapy
Neurodivergent individuals often progress at their own pace, which can differ significantly from the typical timelines set for physical therapy. Extended therapy durations provide the necessary flexibility to meet individuals where they are and address their unique needs.
Building trust and rapport can take longer for neurodivergent individuals, particularly for those with autism, who may need more time to adjust to new people or environments. A longer therapy program allows therapists to establish a strong therapeutic relationship, which is crucial for making progress. Trust is essential in creating a supportive and comfortable environment for the individual to engage fully in therapy.
Additionally, adjusting to the individual's learning style is critical in physical therapy for neurodivergent individuals. Therapists often need to tailor their approach, whether by incorporating more visual aids, hands-on guidance, or verbal prompts, depending on what works best for the individual. This personalized approach takes time, as therapists must explore and refine the most effective methods for teaching new skills and promoting growth.
Neurodivergent individuals, including those with ADHD, OCD, or autism, frequently benefit from longer physical therapy care and accountability programs due to challenges related to routine, sensory processing, motor skill development, emotional regulation, and behavior. With a structured, individualized, and flexible approach, extended physical therapy programs help these individuals make steady progress, retain their gains, and ultimately improve their quality of life.
"Physical Therapy for Neurodivergent Individuals" – American Physical Therapy Association (APTA): https://www.apta.org/
"Motor Skills Development in Children with Autism Spectrum Disorder" – Developmental Medicine & Child Neurology:. DOI: 10.1111/dmcn.14400
"Occupational Therapy and Physical Therapy for Autism" – Autism Speaks:. https://www.autismspeaks.org/
"The Role of Physical Activity and Motor Coordination in ADHD Treatment" – Journal of Attention Disorders: . DOI: 10.1177/1087054716672337
"Sensory Integration and the Neurodivergent Brain" – Sensory Processing Disorder Foundation: https://www.spdstar.org/
"The Benefits of Exercise in the Treatment of OCD" – Journal of Anxiety Disorders: DOI: 10.1016/j.janxdis.2016.07.004
"Physical Therapy for ADHD: Motor and Executive Functioning" – Child: Care, Health, and Development: DOI: 10.1111/cch.12756
"Motor Difficulties in Children with Neurodevelopmental Disorders" – Neuropsychology Review: DOI: 10.1007/s11065-017-9353-3