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Pelvic Floor Physical Therapy: The Comprehensive Guide

Guest Post by Dr. Nicole Niu, PT, DPT, WCS, Pelvic Wellness Omaha

Pelvic floor physical therapy is a specialized branch of physical therapy that focuses on the muscles, ligaments, and connective tissues in the pelvic region. While commonly associated with women’s health, pelvic floor physical therapy is beneficial for both men and women experiencing various types of pelvic floor dysfunction. In this comprehensive guide, we will answer key questions surrounding pelvic floor physical therapy to help you make an informed decision.

Frequently Asked Questions about Pelvic Physical Therapy

1.     What is pelvic health physical therapy?

2.     Who is pelvic floor PT for?

3.     What diagnoses are treated in pelvic floor physical therapy?

4.     What does a typical pelvic health physical therapy evaluation look like?

5.     How long is the treatment for pelvic floor dysfunction?

6.     How to know if a physical therapist is a pelvic floor physical therapist?

7.     How to find a well-trained pelvic floor physical therapist near you.

8.     What does pelvic floor PT cost?

9.     More about Pelvic Wellness Physical Therapy

What is pelvic health physical therapy?

The pelvic floor is a group of muscles that form a hammock-like structure at the base of the pelvis. Its primary functions include supporting the pelvic organs (bladder, uterus, and rectum), maintaining continence, stabilizing the spine and pelvis, and enhancing sexual function. When the pelvic floor muscles become weakened, tight, or imbalanced, it can lead to a range of issues such as urinary or fecal incontinence, pelvic pain, sexual dysfunction, and even musculoskeletal problems.

Pelvic health physical therapy aims to address these issues by restoring the strength, flexibility, and coordination of the pelvic floor muscles. Through a combination of manual therapy techniques, exercises, and lifestyle modifications, a pelvic floor physical therapist can help individuals regain optimal pelvic floor function. By working with a qualified professional, you can develop a tailored treatment plan to address your specific needs and goals.

Who is pelvic floor PT for?

Pelvic floor physical therapy is not limited to a particular gender or age group. It can benefit both men and women experiencing a variety of conditions. Pediatrics and teens can also benefit from pelvic floor physical therapy.

Depending on the pelvic floor physical therapist, some do not treat men, some do not treat women, and some do not treat kids. You can utilize the directories provided for you later in this post to help find a pelvic floor PT qualified to treat you in or near your area of the United States.

Pelvic floor therapy is not JUST for those who have symptoms, but individuals can benefit from pelvic floor PT to prevent symptoms down the road. Pelvic floor therapy can help with athletic performance, help to prevent pain during pregnancy and the postpartum period, and assist with prevention of postpartum symptoms like pelvic organ prolapse, urinary incontinence, and sustained diastasis recti, just to name a few.

What diagnoses are treated in pelvic floor physical therapy?

Pelvic floor physical therapy can benefit both men and women experiencing a variety of conditions due to the vital role these muscles play for so many functions. Pelvic floor PT can help with the following diagnoses, but this list is by no means extensive. Here are some of the common conditions we treat at Pelvic Wellness Omaha.

  1. Urinary control: Urinary incontinence, urinary frequency, urinary urgency

    Pelvic floor physical therapy can help with symptoms of urine leakage in both men and women. Leaking during exercise is very common, however it is not normal. This is something than can be treated and eliminated.

    Pelvic floor therapy can also help with other urinary symptoms such as frequency and urgency. You should be able to hold urine for at least a little bit after getting the urge. It is normal to empty your bladder every 2-3 hours. If you have difficulty with either of these, you may benefit from pelvic floor PT.

  2. Bowel control: Constipation, fecal incontinence, gas incontinence, fecal urgency, pain with bowel movements, fecal smearing.

    The pelvic floor helps to control bowel movements including keeping them in when we are not ready to go and letting them happy when we do want to go.

  3. Pelvic pain: Pelvic pain encompasses a wide range of symptoms spanning anywhere between the belly button and the knees. At Pelvic Wellness we treat patients for all types of pelvic pain including pain during intercourse, pain during exercise such as running or lifting, pain during menstruation, male pelvic pain, and pain during pregnancy or postpartum.

    This pain is oftentimes described as achey, sharp, shooting, pulsating, radiating, or deep. We frequently find what may seem like typical hip or back pain, is related to the pelvic floor muscles. This is why we often see patients for these issues AFTER they have seen a typical orthopedic physical therapy without resolution of symptoms. Some common medical diagnoses with subsequent pelvic floor dysfunction contributing to pain can include:
    – Endometriosis
    – Irritable bowel syndrome
    – Interstitial cystitis
    – Painful bladder syndrome
    – Fibromyalgia
    – Infertility issues
    – Ehlers Danlos Syndrome

  4. Pelvic organ prolapse: Pelvic organ prolapse is a common diagnosis treated in pelvic floor PT. If you have prolapse you may have a feeling of heaviness or “falling out” in the vagina. Sometimes this is worse after long periods of standing or after lifting, running, or exercise. You may also have a feeling of pressure in the pelvis, along with urinary symptoms or bowel symptoms.

  5. Tailbone pain: This includes pain directly on or in the region of the tailbone. This can sometimes result from a fall or difficult childbirth. The pelvic floor muscles are often a contributing factor to this pain.

  6. Pregnancy and postpartum: Pelvic floor physical therapy can play a significant role in supporting women during the perinatal period, which includes pregnancy, childbirth, and the postpartum period. Here are some ways pelvic floor physical therapy can help during this time:
    – Preparing for labor and delivery
    – Managing pregnancy-related pain and discomfort
    – Addressing urinary and fecal incontinence
    – Recovering from vaginal or cesarean birth
    – Managing pelvic organ prolapse
    – Treatment of diastasis recti abdominis
    – Prevention and treatment of postpartum pelvic floor related symptoms

  7. Core stability and performance: The pelvic floor plays an important role in athletic performance including support, stability, and pressure management. Whether an athlete is a heavy lifter or endurance runner, pelvic floor therapy can help to improve core stability which can improve athletic performance. 

What does a typical pelvic health physical therapy evaluation look like?

A pelvic floor physical therapy evaluation typically involves a combination of assessment, education, manual therapy techniques, and exercises tailored to your specific needs. Here’s a breakdown of what you can expect during a first visit with a pelvic floor PT in Omaha:

  1. Initial Assessment: At the beginning of your first session, the pelvic floor physical therapist will conduct a comprehensive assessment to gather information about your medical history, symptoms, and concerns. They may ask you questions about your pelvic health, previous treatments, and lifestyle factors. This assessment helps the therapist understand your condition and develop an appropriate treatment plan.
  2. Physical Examination: Depending on your specific concerns, the therapist may perform a physical examination of the pelvic region. This examination may involve external and internal assessments, including palpation of muscles and tissues, to assess muscle strength, tone, flexibility, and any areas of tenderness or tightness. The therapist will explain the examination process and ensure your comfort and consent throughout. The therapist will also examine the areas adjacent to the pelvic region such as the low back or hips. They will evaluate your posture and watch you perform functional movements that may be related to your symptoms. This will all help them to determine the ROOT CAUSE of your symptoms.
  3. Education and Treatment Plan: Following the assessment, the therapist will provide you with personalized education about your condition and the role of pelvic floor physical therapy in your treatment. They will explain how the pelvic floor muscles function, any dysfunction identified during the assessment, and how therapy can help address your symptoms. They will discuss your treatment goals and develop a customized plan tailored to your needs.
  4. Manual Therapy Techniques: Pelvic floor physical therapists often utilize various manual therapy techniques to address muscle imbalances, tension, or weakness in the pelvic floor. These techniques may include internal or external trigger point release, myofascial release, soft tissue mobilization, or joint mobilization. The therapist will use their hands to apply gentle pressure and movements to specific areas to help relax and restore optimal muscle function.
  5. Therapeutic Exercises: Exercise plays a significant role in pelvic floor physical therapy. The therapist will guide you through specific exercises designed to strengthen, stretch, or relax the pelvic floor muscles. These exercises may include kegel exercises, core strengthening exercises, breathing techniques, and postural exercises. The therapist will provide clear instructions on proper technique and ensure you are performing the exercises correctly.
  6. Home Program and Self-Care: To complement the in-clinic sessions, the therapist will typically provide you with a home program consisting of exercises and self-care techniques. They may recommend specific exercises, stretches, or relaxation techniques to be performed at home between sessions. Following the therapist’s guidance and consistently practicing your home program will enhance the effectiveness of the therapy and contribute to your progress.

Remember, each pelvic floor physical therapy session is personalized to address your unique concerns. The number of sessions and the frequency of visits will depend on your condition and treatment goals. Building a trusting relationship with your therapist and maintaining open communication about your progress and any concerns will help optimize your therapy experience. We provide a resource of typical pelvic floor physical therapy questions on our website to avoid any confusion.

How long is the treatment for pelvic floor dysfunction?

At Pelvic Wellness, you can expect every visit to be 60 minutes, 1 on 1 with a Doctor of Physical Therapy. The duration of pelvic floor physical therapy treatment can vary depending on several factors, including the individual’s condition, severity of symptoms, response to treatment, and adherence to the home exercise program. In general, the treatment duration for pelvic floor physical therapy can range from a few weeks to several months. It may involve an initial phase of more frequent sessions, followed by a maintenance phase with reduced frequency as symptoms improve.

Typically, individuals attend pelvic floor physical therapy sessions once or twice a week initially. As progress is made, the frequency may be reduced to once every two weeks or even less, depending on the therapist’s assessment and the individual’s needs. The exact duration of treatment will be determined by your therapist based on your condition, progress, and treatment goals.

It is important to remember that pelvic floor physical therapy is a comprehensive approach that aims to address the underlying causes of pelvic floor dysfunction. It involves not only in-clinic sessions but also a home exercise program to support the progress achieved during therapy. Consistency and active participation in both in-clinic sessions and home exercises play a significant role in achieving the best results from pelvic floor physical therapy.

How to know if a physical therapist is a pelvic floor physical therapist?

To determine if a physical therapist specializes in pelvic floor physical therapy, you can consider the following methods:

1.     Research their credentials: Start by researching the physical therapist’s background, education, and certifications. Look for indications that they have received specialized training in pelvic floor rehabilitation or women’s health. Relevant certifications may include the Board Certification by the American Physical Therapy Association (APTA) called the Women’s Health Certified Specialist (WCS) or other certifications focused on pelvic health.

2.     Review their areas of expertise: Check the physical therapist’s website or professional profile to see if they specifically mention pelvic floor physical therapy or women’s health as areas of expertise. Look for information about the conditions they treat, such as urinary incontinence, pelvic pain, or postpartum recovery, which are commonly associated with pelvic floor issues. You can see the training of our physical therapists at Pelvic Wellness here.

3.     Seek recommendations: Ask your healthcare provider, such as your primary care physician, gynecologist, or urologist, if they can recommend a qualified pelvic floor physical therapist. These professionals sometimes have knowledge of therapists with expertise in this specialized field and can provide valuable referrals.

4.     Contact the clinic or therapist directly: If you have identified a physical therapist or a clinic, you can reach out to them directly and inquire about their experience and expertise in pelvic floor physical therapy. Ask specific questions about their training, certifications, and the percentage of their practice dedicated to pelvic floor rehabilitation.

5.     Verify during the initial consultation: When you schedule an initial consultation or assessment, clarify with the physical therapist if they have experience and expertise in pelvic floor physical therapy. Use this opportunity to ask questions about their training, the conditions they treat, and their treatment approach to ensure they are well-suited to address your specific needs.

It is important to note that not all physical therapists may specialize in pelvic floor physical therapy. By following these steps, you can increase your chances of finding a physical therapist with the necessary training and expertise in pelvic floor rehabilitation.

How to find a well-trained pelvic floor physical therapist near you.

If you’re looking for a pelvic PT in your area (and you are not local Omaha, Nebraska where Pelvic Wellness is located), then we suggest checking out the following directories to find a pelvic therapist:

If you are in Omaha, NE or the surrounding areas, call us at Pelvic Wellness Omaha as we have specialized training in treating all types of pelvic floor dysfunction.

What does Pelvic Floor PT cost?

Depending on where you go to pelvic PT, you may be able to utilize your insurance benefits. At Pelvic Wellness, we are out of network with insurance companies, because insurance companies limit the level of care we can provide to our patients and therefore sacrificing quality of care for patients. Often, pelvic PT is not covered by insurance benefits because it is not medically necessary, per the insurance company. Pelvic floor therapy is also often focused on prevention of symptoms such as during pregnancy or postpartum, which unfortunately is not covered by insurance companies.

Pelvic Wellness is also out of network because we do not like hidden costs. You will always know the exact cost of your sessions. If you would like to submit for out-of-network reimbursement from your insurance company, we will provide you with the paperwork necessary to do so.

Learn more about Pelvic Wellness Omaha pricing and policies at our website.

About Pelvic Wellness Physical Therapy

Pelvic Wellness Physical Therapy is a pelvic health specialty physical therapy clinic in Omaha, NE that focuses on individualized treatment of pelvic floor conditions to determine the root cause of the symptoms. Our goal is to evaluate every patient in a holistic manner to determine the best treatment methods to help return patients to what they love.

At Pelvic Wellness, the therapists have specialized training in the treatment of pelvic floor dysfunction for both men and women. The therapists have advanced training in treatment of perinatal issues, urinary dysfunction, bowel dysfunction, pediatric pelvic floor PT, and pelvic floor PT for men.

Pelvic floor symptoms can be embarrassing and lonely. When pee, poop and sex are not functioning the way we expect, our life is significantly impacted. Pelvic Wellness is here to listen and be your guide in eliminating these symptoms and regaining your life back.

If you are dealing with pelvic floor dysfunction or are wondering if you might be a good fit for an evaluation, call Pelvic Wellness Physical Therapy at (402)-625-0313 to set up a free 15-minute discovery call or contact us via our online contact form.

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