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pelvic floor physical therapy

Physical Therapy & Pelvic Floor Care

Pelvic physical therapy is more than just kegels!

How pelvic physical therapy works


While pelvic floor muscle exercises are very important, they are only one very small piece of the care provided by pelvic physical therapists. Other treatments utilize neuroscience, knowledge and adjustment of posture and body alignment, behavior retraining, down-training techniques, relaxation and breathing techniques, manual therapy including myofascial release, scar tissue/adhesion mobilization and release, bowel and bladder retraining, and much more. A physical therapist also provides education in visits, so that clients understand what is going on within their body and how the exercises and treatments are designed to help. Each treatment plan is based on a client’s presentation and symptoms, so is fully individualized, and then integrated into the plan of care from their OB physician, midwife, primary care provider, or colorectal, urology, urogynecology, or gastroenterology specialist.

If you can answer YES to any of the following questions, you might benefit from seeing a pelvic physical therapist:

  • Do you leak urine?

  • Do you have strong urges to urinate that you can’t control?

  • Do you get out of bed to urinate more than once per night?

  • Do you urinate more than every two hours during the day?

  • Do you have pain with urination or bowel movements?

  • Do you have difficulty initiating a urine stream?

  • Do you have to strain for bowel movements?

  • Do you have fewer than 3 bowel movements per week?

  • Do you have abdominal or genital pain during or after sexual activity?

  • Do you have abdominal or genital pain that prevents you from participating in your regular home, work, social, or recreational activities?

  • Do you often hold your breath?

  • Do you have recurrent or unresolved low back, hip, or pelvic pain?

  • Do your abs bulge with exercise of lifting?

  • Do you have pressure or bulging in your perineum?

Pelvic pain can have many causes

Pelvic pain conditions are occasionally undiagnosed due to their complex nature. Thus, it is often up to a person to search and locate the specialist who will correctly identify the roots of their pelvic pain. It can sometimes be hard to tell musculoskeletal pain from pain originating within a pelvic organ, so a women’s health Nurse Practitioner can screen for, and rule out some causes of pelvic pain, such as an infection, cysts, polyps, fibroids, malignant neoplasms, and endometriosis, to name a few, and then make a referral to the pelvic Physical Therapist for evaluation and treatment for some of the following issues that cause pelvic pain:

  • Pelvic floor muscle tension

  • Levator Ani Syndrome

  • Dyspareunia

  • Interstitial cystitis/painful bladder syndrome

  • Vaginismus

  • Vulvodynia

  • Pudendal neuralgia

  • Pelvic organ prolapse


For men, a pelvic Physical Therapist can help with a variety of conditions that cause pelvic pain, after they have been evaluated by their physician, PA, or APRN, and referred to pelvic PT.

Sexual problems affecting women

You don’t have to keep quiet about it!


Statistics suggest that approximately 21% of women ages 18-29 experience painful vaginal intercourse, with these symptoms occurring throughout the lifespan. Painful sex can also be associated with difficulty using tampons or having a gynecological exam. Some women have experienced it their whole lives, while others began having pain after a surgery, infection, traumatic experience, or an unknown cause. Many women experience painful intercourse after birth (whether vaginal or cesarean).

Many couples seek fertility treatment because they are unable to have vaginal intercourse. Others may already be pregnant and realizing that their history of painful intercourse may affect their birth experience. The pelvic floor dysfunction associated with vaginismus increases the risk of musculoskeletal injury during birth, so we strongly recommend pelvic physical therapy for women with these symptoms who are hoping to become pregnant or who already are.

Our team of women’s health Nurse Practitioners and Pelvic Physical Therapist can help identify the cause of your pain, and help alleviate it. As a women’s health team of multi-disciplinary, holistic care providers, we can address all possible aspects of sexual issues, some within our office, like the gynecological and musculoskeletal components, and via referral to an experienced sex therapist, for the psychological components.

Sexual issues affecting men

A pelvic physical therapist may be able to help with issues of painful ejaculation, premature ejaculation, and some cases of erectile dysfunction. Men can experience issues with pelvic function including urinary incontinence, bowel incontinence, chronic constipation, erectile dysfunction (ED), and pain. Melissa receives referrals from local urology practices because she provides therapy for post-proctatectomy rehabilitation, to help you regain your independence after surgery. Pelvic physical therapy can help you regain your sexual functioning, reduce and eliminate incontinence, reduce pain, and help you return to the quality of life you desire.

Urinary isues

Incontinence is not a normal consequence of birth or aging.


Because many symptoms of urinary incontinence are caused by pelvic floor muscle weakness and dysfunction, a specially trained pelvic physical therapist is a provider to help you gain control over your symptoms.

Pelvic physical therapy can help with the following conditions:

  • Urinary incontinence – stress, urge, or overactive bladder

  • Urinary frequency/urgency/retention

  • Voiding difficulties

  • Pelvic organ prolapse

Bowel issues

Physical therapy can be successful in identifying and treating musculoskeletal dysfunctions such as tightness or weakness in the abdomen, low back or pelvic floor musculature caused by IBS. Trigger point release in the abdomen, back, gluteals, and pelvic floor, and neuromuscular re-education of these muscle groups can be very successful in minimizing and/or eliminating symptoms.

Pelvic physical therapy can help with conditions such as:

  • Fecal or gas incontinence

  • Constipation

  • Irritable Bowel Syndrome (IBS)

  • Hemorrhoids/Fissures

  • Pelvic Organ Prolapse


Your physical therapist will coordinate care with your colorectal surgeon, gastroenterologist, naturopathic doctor and dietician/nutritionist to address all aspects of bowel dysfunction.

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