FAQ about Pelvic Health Physical Therapy

By Alexis Eusterbrock

I have been working as a pelvic health physical therapist for nearly 13 years. Before training in pelvic health, even with my doctoral training in physical therapy, I really did not have a great understanding of what the care involved and who could be helped by pelvic health physical therapy services. So if I didn’t know, given my education, it is hard for the general public to know! I consistently have patients who have questions about what to expect from pelvic health physical therapy care. So, here are answers to some commonly asked questions.

What is pelvic health physical therapy? 

  • Pelvic health is a specialty area in physical therapy. It is not a focus of most Doctoral Physical Therapy programs, so training is achieved through multiple continuing education courses and clinical mentorship. Just like other physical therapy treatments, the goal of pelvic health physical therapy is to improve function. We address muscles, ligaments, tendons, fascia, and nerves in and around the pelvic bowl. Pelvic floor muscle activity impacts static and dynamic postural control and proper bladder, bowel, and sexual function. Improving the coordination, strength, endurance, and excursion of the pelvic floor muscles is critical for these normal life functions. The pelvic floor muscles interact with other body systems as well, so integrating these systems is also a focus of care.

What can I expect on my first visit? 

  • The most important part of your first session is hearing and understanding your story and concerns. We understand that working in the pelvis can be sensitive and can bring up past trauma and challenges. It is also hard sometimes to acknowledge and talk about issues with bowel, bladder, and sexual function. The primary goal of the first session is to listen, educate, and together decide on a care strategy that feels safe and realistic. 

I’ve heard that there might be an internal assessment, what does that mean?

  • The majority of pelvic health physical therapy providers have the ability to perform an intravaginal and/or intrarectal pelvic floor muscle assessment. This is a digital exam, meaning the provider will insert a gloved finger into the vagina or rectum to palpate the tissues and evaluate muscle activity. Performing this assessment can be a useful tool in determining the factors contributing to your individual symptoms. However, it is not something that is a mandatory part of addressing pelvic health concerns. Your provider will help to educate you regarding the potential benefits of this type of assessment for you. But, ultimately, it is your choice and if it doesn’t feel like the right tool for you, that is okay! This is not the only tool pelvic health physical therapists have to utilize.

How might pelvic health physical therapy benefit me? 

  •  If you are having any of the below concerns, pelvic health physical therapy care is likely appropriate for you! It is always good to have a conversation with your doctor about these concerns as collaborative care is best management. Most of these concerns apply to all genders, others are specific to those with male or female anatomy. 
    • Urinary, fecal, or gas incontinence 
    • Pelvic pain 
    • Abdominal pain 
    • Sexual dysfunction  
    • Pain with sexual activity 
    • Past abdominal or pelvic surgery 
    • Constipation, fissures, and/or bowel dysfunction 
    • Urinary dysfunction- slow stream, incomplete emptying, frequency, post void dribbling 
    • Urogenital symptoms of menopause 
    • Pelvic organ prolapse 
    • Pregnancy 
    • Postpartum 
    • Erectile dysfunction 
    • Post pelvic cancer treatment 
    • Hip, sacral, coccyx, or low back pain not responding to current treatment methods 

Are there specialties within pelvic health physical therapy? 

  • Every provider has different tools to offer clinically based on individual training. Some pelvic health physical therapists do not treat all genders or have very specific skill sets, so it is important to ask when scheduling an appointment to make sure you find a provider that is the best match for your concerns. If you have an appointment with a physical therapist that doesn’t feel like the right fit, then use your voice and ask this provider to help you find another clinician in the area. Most providers will be happy to assist in this process!

Who is a pelvic health provider at Stride Physio?

We are proud that we have been able to grow this program at Stride over the years. If you have any additional questions about our pelvic health services, please do not hesitate to reach out to our admin team at admin@strideseattle.com. They will direct your questions to one of our pelvic health physical therapists.