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When I first started graduate school for physical therapy I had absolutely no idea that pelvic health physical therapy even existed. I didn’t even understand how physical therapy could help treat symptoms like pelvic pain or perineal tearing postpartum. My roommate/PT-school-sidekick-support-system at the time had experience working with a pelvic PT prior to school. She explained to me that a pelvic PT can work with women postpartum, women who experience pain with sex, anyone experiencing pelvic pain, amongst many other conditions. Easy to say, I was instantly intrigued. With a little bit of luck amidst the final semesters of my training, the stars aligned, and I was placed in an intensive four-month clinical rotation to learn the skills of a pelvic health physical therapist. During my training, I was exposed to a world of treatment modalities and techniques for the pelvis, most of which were never even talked about during PT school. I was also shocked to see how many patients tiredly dragged their painful bodies into the clinic after years of dismissal from gynecologists, urologists, and/or other health care providers. Many of these women, and men, were just like me and had only heard about pelvic PT through a friend or family member. Most (not all) were never even referred to PT by their primary care provider! With this being said, medical doctors are extremely essential to treating pelvic floor and pelvic health related conditions, however I have observed a global lack of proper referrals of women to pelvic health physical therapy. My observations come from my time as a student in Chicago and my work as a pelvic PT here in Israel.
Pelvic PT is so important. I feel passionate about this work because the world truly needs more women helping women heal. So, tell your friends, family, loved ones, and even your doctors that despite the inaccurate taboo of treating the pelvic floor, there are trained health care providers just like myself who do just that!! And I have seen and experienced with my own eyes women and men walking out of pelvic rehab with a stronger understanding of their own anatomy and most importantly an improved quality of life with less pain and more confidence.
Here are some of the top 5 reasons to visit a pelvic health physical therapist:
1. You just had a baby. Yes, it was a big deal. Your body either just pushed out a small cantaloupe sized baby head via the vaginal canal and pelvic floor muscles or you underwent a cesarean section which cuts through about 6 layers of tissue from your skin into your abdominal muscles. In both scenarios, pelvic physical therapy can help. First, often times vaginal deliveries result in perineal tearing which can reduce the function of the pelvic floor muscles or later result in perineal pain. In physical therapy, you will learn how to retrain to pelvic floor muscles to regain function and decrease pain as well as techniques to treat perineal scar tissue. Also, post c-section rehabilitation includes scar management to prevent a decrease in skin pliability and abdominal strengthening exercises to rebuild healthy abdominal muscle tissue. I like to tell my patients that having a baby is in fact a sporting event. And sometimes after the event, body needs a little bit of help to get back to a functional pain-free place.
2. Pain with sex. You read it right, pelvic health physical therapy can help women experience sex pain free. A recent statistic from the American College of Obstetricians and Gynecologists in 2018 found that 75% of women will experience pain during sex at some point. There are many reasons as to why a woman might be experiencing pain, however the most common one is a non-relaxing pelvic floor. In pelvic PT you will learn therapeutic exercise techniques, with the help of a consensual pelvic exam, how to relax the pelvic floor muscles to promote pain free sexual intercourse.
3. Urinary or fecal incontinence. This is a big one. A report from the Mayo Clinic in 2018 found that 1 in 4 women complain of urinary incontinence. Pelvic PT can help retrain the pelvic floor muscles to improve their strength, coordination, and endurance to reduce symptoms of urinary incontinence. Read more on my previous blog post about urge urinary incontinence.
4. Pelvic pain. Pelvic pain is a very general term for any pain experienced in the pelvic bowel. This includes, but is not limited to, endometriosis, vaginismus, abdominal pain, chronic pelvic pain, interstitial cystitis etc. During a treatment session, your therapist will combine manual therapy skills with appropriate therapeutic exercises to help reduce pain. You will also discover at home self-treatments you can do on yourself during a pain flare up. Pelvic pain can often be silent on the outside, and extremely loud and chaotic on the inside. If you’re experiencing pelvic pain in any degree reach out to a local pelvic health physical therapy for help.
5. Prevention and education. Have any more questions about the pelvis or pelvic floor? Maybe you plan to have a baby soon and you would like to know ways to prevent perineal tearing or postpartum complications? Or maybe you simply want to learn more about your own pelvic floor anatomy and function? Pelvic PT is a great place to discover more about your body and prevent future complications or pain.
Pelvic PT should be a regular and accessible option for women and men who are struggling with any problems in and around the pelvis. If you have more questions let me know, and I’ll try to help in the best way that I can.
Don’t forget to check out my other blog posts on yoga and physical therapy.
Feel well and stay healthy,
Dana