Pelvic Floor Physical Therapy

What is the pelvic floor?

The pelvic floor is a group of muscles that go between your sit bones, pubic, bone, and coccyx. 

physical therapy involves assessing and treating muscle tone, muscle coordination, and strength to improve your overall function and quality of life.

What does an evaluation look like?

Your therapist will ask you a lot of questions to understand your situation and learn about the driving factors. Once a history has been taken, an observation of movement will be performed.  There may be assessment of areas above or below the pelvic floor, as these can influence pelvic floor function.  

You and your therapist will decide together how to specifically assess the pelvic floor muscles. This assessment can be done externally over clothing, or through an internal pelvic muscle exam, vaginally or rectally. We will typically test your pelvic floor muscles for resting tone or tension, muscle strength, endurance, and determine the total excursion of movement within the pelvic floor. Your comfort throughout this process is very important.

What if I don't wish to have an internal exam?

Consent is ongoing.  If at any point, you feel uncomfortable or have questions, tell your therapist.  Your therapist will meet you where you are.  Doing an internal pelvic floor exam is the best way to determine a specific treatment approach, but it is not required and you do not need it in order to receive physical therapy. Your therapist can perform external palpation, or have you perform external palpation on yourself.  They can also guide and instruct you on how to coordinate the core, pelvic floor, and deep core verbally.  There is plenty of education on habit modifications, positioning strategies, and exercise modifications that can help most pelvic floor conditions as well. 

How many treatment sessions should I expect?

Each therapy session is designed to be longer than most in-network rehab centers.  Longer sessions usually mean fewer and less frequent overall visits.  Most pelvic floor patients come in 1 time for the first few weeks and then taper care to every other week and then once per month.  Understand that total visits depend on the severity, acuity, and chronicity of the condition you are receiving care for. If you are seeking care simultaneously for other body regions beyond the pelvis/spine/and hip, you may opt for more frequent sessions.

What resources will I be given?

You will be provided with educational hand-outs, written instructions, and personalized videos of your exercises. Depending on your needs, you will receive handouts that instruct on posture modifications, toileting mechanics, techniques for urge suppression, bowel and bladder habit retraining, coordination exercises for the pelvic floor and deep core, instructions on how to perform a kegel, or how to down train or calm the central nervous system. You will receive evidence based information on your condition as well.  In a world full of misinformation, your therapist will ensure that all questions are answered, and will provide research if you are interested in learning more.

What if I don't have a physican’s referral?

We do not need a referral to start treatment.  New York is a direct access state.  This means that with a doctorate in physical therapy, your therapist is allowed to assess anyone to determine their need for care and treat your for 30 calendar days prior to getting a referral on file.