Many people suffer from pelvic issues in isolation because society has deemed the subject matter “TMI” and they do not realize help exists. But it does! Think you might need pelvic physical therapy but don’t know where to start? Many people have questions or feel intimidated at first. So, here are the answers you’ve searched for – all in one place – from an expert!
Contents (click to jump to a specific question about pelvic therapy)
Hi! I am Lacey, doctor of physical therapy and specialist in pelvic health. I spend my days treating people’s pelvises (pelvisi? *insert whatever the plural of pelvis is here*). I am also the proud owner of my own pelvic floor. I have been a provider. I have been a patient. I know how it feels to have pelvic dysfunction – I have struggled with a wide variety of pelvic issues myself:
- Low back pain
- Chronic constipation
- Years of infertility
- Urinary frequency
- Urinary incontinence (yes, I have peed my pants)
- Period pain (dysmennorhea)
- Pelvic pain
- Prolapse (after delivery of 1st baby)
- Tailbone pain (coccydynia)
Yes – this is MY LIST! I know. This list is long. The issues on this list propelled me to seek help, which unfortunately can be very hard to find. Not to mention the vast amount of effort it takes to research, find, schedule, and go see a new doctor to talk about *embarrassing* issues….And if they can’t help you then you must repeat, repeat, repeat.
My goal is to help YOU avoid living with these ailments. Continue reading to learn what I wish I would have known as a new patient. Trust me, this treatment can change your life forever!
1. Who should go to pelvic physical therapy?
Every person who has a pelvic floor can go to pelvic physical therapy. So, according to my calculations that includes every woman, child, and man! Here is a list of common reasons people seek pelvic physical therapy.
- Urinary incontinence, frequency, urgency
- Postpartum and pregnancy wellness
- Labor and delivery preparation
- Painful bladder syndrome (Interstitial cystitis/IC)
- Fecal incontinence
- Vulvodynia
- Childhood bedwetting (nocturnal enuresis)/daytime accidents
- Pain with intercourse
- Sexual dysfunction
- General pain in the pelvis, abdomen, vagina, rectum, testicles
- Endometriosis
- Prolapse
- Vaginismus
- Constipation
- Menopause symptoms
- Low back, hip, thigh, tailbone pain
- Painful periods (dysmenorrhea)
2. What should I expect at my pelvic physical therapy appointment?
Where will treatment take place?
Your treatment session will not occur in a typical physical therapy gym surrounded by other patients. It will happen in a private treatment room where you can feel comfortable, protected, and relaxed.
What will happen at my first appointment?
The first visit always focuses on learning your medical history, symptoms, and lifestyle. Sometimes people must go back to age 5 – you are encouraged to discuss anything that may be relevant to your current pelvic condition.
After this, an examination will follow of important body structures, movement, and testing to determine root cause of symptoms. It should always include your whole body because nothing works in isolation (yep, that’s right, you are not just a floating pelvis).
Then we will begin to develop a plan of care to achieve your goals. I’ll say that again, YOUR goals. Treatment looks very different for a person that wants to return to Olympic weightlifting versus a person that wants to be able to drive for a couple of hours without pain. Make sure to discuss what you would like to achieve with pelvic rehabilitation.
Do I have to have an internal examination?
For some conditions, an internal examination may provide useful information. This is not typically done at the first visit, and always depends on patient comfort level. Moreover, you are always welcome to bring a partner or friend to your appointments if this increases your comfort.
If you have had pain with a pelvic exam at the gynecologist, read here for helpful tips!
What are common treatment techniques that will be used?
Treatment may include (but is definitely not limited to):
- Education, education, education (on your anatomy, how your body works, tips, pelvic and general health)
- General massage, muscle releases, manual therapy
- Yoga poses
- Breathing techniques
- Relaxation exercises
- Biofeedback machine for improved awareness of your pelvic floor muscles
- Strength, endurance, and coordination exercises
- Program to complete at home
3. Is pelvic physical therapy going to hurt?
Listen up! This is NOT a “no pain, no gain” area of your body. Pelvic floor physical therapy should not hurt you. Often people have experienced significant trauma or negative experiences through their pelvic region. I am a firm believer that more pain will not heal your existing pain. This should be a positive experience where you are totally comfortable and totally in control.
That being said, sometimes people report discomfort through the assessment. This happens because your therapist must find your “trouble” areas. In addition, treatment can make some people a little sore the following day.
4. How should I prepare for my pelvic physical therapy appointment?
There is not a checklist. There is no homework. You are already so brave for scheduling the appointment and extending your trust to a new provider! Good job!
Nevertheless, the following are suggestions if you are an overachiever who wants to feel extra prepared. However, there is no pressure!
- If you have seen other doctors, it may be helpful to have their notes sent to your provider.
- Symptom log where you track when/where you are having pelvic issues.
- Write down any questions/fears/concerns you have so you don’t forget.
5. What should I wear to pelvic physical therapy?
What type of clothing makes you feel most comfortable? Wear that. If you want specifics, wear stretchy/loose fitting clothing that allows you to move. Examples:
- Sweat pants (or even pajama pats – no judgment here!)
- Workout clothes
- Yoga pants
- Athleisure (in my mind, this is always the appropriate attire no matter where I go…)
- Dress or skirt – this one may seem the weirdest but many people cannot tolerate waistbands.
If you are still considering pelvic physical therapy at this point, but continue to have some nerves – check out these stories from a patient’s perspective!
Finally, if you are tired of reading (whew!) but want to watch a patient’s full experience, click here (35-minute video but great detail).
Summary
As a result of my long, bumpy journey to healing, I try to be the provider that I struggled to find myself. In order to find my answers, I needed to receive a doctorate degree, specialize in pelvic health, and advocate for myself to countless doctors. It was ridiculous. I do NOT want you to have that experience.
Through reading this article, I hope some of your questions have been answered and your apprehensions eased. Because now you know more about:
1. Who should go to pelvic physical therapy?
Pretty much anyone could benefit from pelvic physical therapy.
2. What should I expect at my pelvic physical therapy appointment?
Comfort, being heard, creating custom treatment plan based upon your goals and values.
3. Is pelvic floor physical therapy going to hurt?
Short answer: nope!
4. How should I prepare for my pelvic physical therapy appointment?
You are already perfectly prepared.
5. What should I wear to pelvic physical therapy?
Whatever outfit helps you feel most comfortable.
Still have questions? Check out my FAQ page!
If you still don’t see an answer, comment below and ask!
Lastly, don’t forget to subscribe so you can continue to learn expert tips and save yourself time, money, and energy in your healing journey.
I am honored to be a part of your journey as you restore your health from the bottom up!
Dr. Lacey White PT, DPT
This material is presented for informational and educational purposes only. This information does not constitute medical advice and is not intended to be a substitute for professional medical advice. You should always seek the advice of a physician or other qualified healthcare provider before beginning any exercise program. If you experience any pain or difficulty with these exercises, stop and consult your healthcare provider. PELVIC REHAB MAKES NO WARRANTIES, EXPRESS OR IMPLIED, THAT THE INFORMATION CONTAINED IN THESE MATERIALS WILL MEET YOUR NEEDS.
Can I simply say what a relief to uncover someone who really understands what they are discussing on the internet. You certainly know how to bring an issue to light and make it important. More people ought to look at this and understand this side of the story. I cant believe you arent more popular since you certainly have the gift.
You should be a part of a contest for one of the highest quality sites on the web. Im going to recommend this website!