In simple terms, what is pelvic floor physical therapy and what does a pelvic health physical therapist do?

Pelvic health physical therapy is a non-surgical way of treating pelvic dysfunction and supporting muscles, also called the “pelvic floor.” Pelvic floor physical therapists work with women—and sometimes men. There are many reasons for working with a pelvic floor physical therapist. Diagnoses include incontinence, pelvic/vaginal pain, prenatal and postpartum musculoskeletal pain, separation of the abdominal muscles (especially after pregnancy), bowel, bladder and sexual function, osteoporosis, rehabilitation after breast surgery, lower back pain, lymphedema, conditions specific to the female athlete, fibromyalgia, and other abdominal and pelvic concerns.

Pelvic floor physical therapists are musculoskeletal experts who focus specifically on the areas mentioned above. Pelvic floor physical therapists complete extensive, post-doctoral specialty courses focused on pelvic anatomy and physiology—and are trained in assessing and examining all areas associated with the pelvis.

Tell us a little bit about yourself. What’s your background? What are your passions/interests hobbies?

I grew up in Chicago, but came over to Stamford Health from Phoenix. It was in Phoenix where I earned my Doctorate of Physical Therapy and found my love for pelvic health. I have known I wanted to be a physical therapist since I was about 17, when I was in and out of physical therapy for injuries I sustained as an athlete. I originally thought I wanted to be a pediatric physical therapist, but once I found pelvic floor physical therapy, I saw how important this specialty area is for both men and women. I also have been a yoga instructor for the last 8 years and I love incorporating yoga and breath work into my healing plans with patients.

What drew you to this field? Did you wake up one day and say, “I want to be a pelvic floor physical therapist?

As mentioned above, I did not know that pelvic floor physical therapy was a specialty niche when I entered my PT program. During my stint in grad school, students are strongly encouraged to research specialty niches and perform four 8-10 week clinicals in multiple areas of practice. Completing a pelvic health rotation was not on my radar until I fell and injured my right hip and tailbone and needed to have my own course of treatment. I was treated by a great orthopedic physical therapist for the hip and tailbone injury, but I started to notice some pelvic pain and sacroiliac joint issues after my hip course treatment wrapped up. I decided to study and work with a pelvic floor physical therapist for my own course of treatment.

My pelvic floor physical therapist changed my whole outlook on life and my career, she was able to educate and empower me to manage my symptoms and improve my function; as well as introduce me to entire new skills that we are not taught in physical therapy school which include the pelvic muscle assessment techniques as well as visceral manipulation techniques. This experience gives me a unique perspective on what the patient goes through during their healing journey. The week after I was discharged from physical therapy, I enrolled in pelvic floor and visceral manipulation foundational courses. I was so eager to learn I finished both series in a year to specialize in this niche. Seeing patients succeed and meet their goals keeps me motivated and constantly wanting to be up to date on the most recent research and techniques to implement!

What’s the most rewarding part of your job? The most challenging?

At this time, many people don’t even know I exist! When it comes to the phrase “pelvic floor,” most think “Kegel exercises” but it’s so much more involved than that. With education and exposure, more people will come to understand what pelvic floor therapy means.

There’s also a stigma that needs to be broken when it comes to addressing pelvic floor issues such as urinary incontinence and sexual dysfunction. It can be a sensitive topic to discuss with a new healthcare provider; however, leaking with a cough, sneeze, laugh, or jump is not normal function (and can be helped!).

My job is so rewarding, it is very difficult to choose just one part! Seeing individuals come into the office stating their diagnosis is “the way it has always been” or stating “this is a part of aging” and by the end of their course of treatment they are pain-free, leak-free, and their mobility and strength is the best it has ever been. With these new improvements, they are able to return to the activities they love; riding their bike, running, playing with their children or grandchildren on the floor without difficulty, or (insert your functional goal of choice here); that’s when the true feeling of “reward” comes into play.

What have your patients taught you over the years?

I’m a “go-go-go” person and I’ve come to realize the body does not heal on a timeline. Being gentle with yourself is important. Everybody- and every “body”—as well as every nervous system, is different.

Explain a little bit about how pelvic floor therapy has evolved over the years.

Pelvic floor physical therapy is a relatively new specialty compared to the profession as a whole. Physical therapy began as “rehabilitation aides” for the civil war and our professional organization incorporated in 1921. The institutions who educate providers on women’s health and care in the physical therapy realm include the Herman and Wallace Institute and the Academy of Pelvic Health Physical Therapy, formerly known as the Section on Women’s Health. These two institutions began to emerge in the late 1970’s. At that time, pelvic floor therapy focused on mainly pregnancy and educating other physical therapists on how to treat a woman who was pregnant. Since then, the specialty market has exponentially grown. In the last 5 years alone, there has been so much exposure; You see it everywhere in the media. Individuals also have been diligent about creating healthcare teams for themselves, asking for continued care after delivery and being their best advocate during life transitions that bring physical and functional changes.

How can we as a community empower patients to seek the care and treatment they need when it comes to pelvic floor health?

The key is to encourage exposure and collaboration. Patients have been great advocating for their health, and as providers we must collaborate. As a pelvic floor physical therapist, I see myself as an extension of the care they are receiving from their doctor if that is where the referral was generated. Physical Therapists do have direct access in the state of Connecticut, so we can be a direct entry point in to the healthcare system. With this responsibility also comes big opportunity to create a positive experience and strengthen their healthcare team right from the initial evaluation.

What is one piece of advice you’d give to those who are struggling with pelvic floor dysfunction?

Be your own advocate and find your allies—your doctors and other providers are your allies. Ask questions, and come from a place of sheer curiosity. When in doubt, Breathe. Take the extra five seconds to take some deep belly breaths to ground yourself and calm your nervous system before you take on the rest of the day. And remember, we are here to help.