What is women’s health physical therapy?

Women’s health physical therapy is a specialized form of therapy that encompasses exercise, manual therapy, and education to treat problems unique to the pelvic floor for people across the lifespan. These include, but are not limited to the following:

  • Incontinence (stress, urge, or mixed)
  • Bowel or bladder dysfunction
  • Sexual dysfunction
  • Pelvic pain
  • Prenatal and postpartum PT
  • Pelvic organ prolapse

 

Who can benefit from women’s health physical therapy?

Patients who present with the following symptoms and those who have been cleared of alternative diagnoses may benefit from a pelvic floor evaluation:

  • Urine, gas, or feces leakage with coughing, sneezing, laughing, bending, lifting, running, squatting, etc.
  • Inability to control urges to urinate or have a bowel movement resulting in leakage with the sound of running water, cold weather, “key in the door”, etc.
  • Chronic hip or low back pain
  • Pelvic pain
  • Sexual dysfunction
  • Feelings of heaviness or “falling out”

 

How is a physical therapy pelvic exam different from a pelvic exam that I would receive at my gynecologist’s or primary care physician’s office?

Physical therapists specialize in disorders of the musculoskeletal system and movement disorders. Physical therapists who specialize in pelvic floor rehabilitation have special training to assess the pelvic floor, which is multiple layers of muscles that can affect your bowel, bladder, and sexual function. A physical therapist does not check pelvic organs or use a speculum.

 

What can patients expect with a physical therapy pelvic floor evaluation?

  • You will be asked to fill out a medical intake form to help your physical therapist determine the best treatment and plan of care for your current condition. Please come at least 20 minutes early to your scheduled appointment or have these forms filled out prior to your arrival.
  • You and your physical therapist will discuss your current symptoms, current and past medical history and goals that are important to you.
  • Your physical therapist will perform a postural examination, evaluation of movement in your low back, hips, and movements that are important to your goals.
  • With your permission, your physical therapist will perform both an external and internal pelvic floor exam, assessing how these muscles contract and relax.
  • Your physical therapist may ask you to fill out a bladder diary to obtain information more specifically about your symptoms.
  • A treatment plan will be set up for your symptoms, findings from your evaluation, and what works best in your day to day life.

 

My mom/aunt/grandmother used to tell me about how she leaked urine, gas, or feces, does this mean it will happen to me as well?

Family history does not necessarily increase your chances of having these symptoms.

 

Are you just going to tell me to do more Kegels?

No. Arnold Kegel helped to lay the foundation of pelvic floor training, but with a detailed history of your current symptoms, postural exam, hip, low back, and pelvic evaluation, an individualized plan of care will be developed that is tailored to your body, symptoms, and goals.

 

I do Kegels all of the time, but I still have pelvic pain, leaking, hip/low back pain, etc. Can you still help me?

There are multiple approaches to treatment of the pelvic floor, only one of these being the incorporation of Kegel exercises. As a physical therapist, we address the whole body and how your daily movements, activities, and posture can affect symptoms of the pelvic floor.

 

TRUE OR FALSE?

Bladder leaking is normal as you get older or after childbirth, there’s nothing you can do about it!

FALSE!
Although bladder leakage is more common with aging or following childbirth, there are many techniques that can be used to decrease and eliminate leaking.

 

I don’t have any problems with leaking, but I go to the bathroom one or more times every hour and this is normal.

FALSE!
Urinating 5-7 times per day is considered normal.

 

I want to talk to somebody about my symptoms, but don’t want to have an internal exam performed. There’s nothing I can do.

FALSE!
There are numerous approaches to pelvic floor rehabilitation that can be addressed prior to an internal exam. Behavior modification, a bladder diary, postural training, and strengthening/stretching of specific hip and low back musculature may play a significant role in your rehabilitation.

 

DO ANY OF THE FOLLOWING DESCRIBE YOU?

If you answer “yes” to any of the following, you may benefit from a pelvic floor evaluation.

  • I keep an extra pair of clothes in my car just in case I have an accident.
  • I know where every bathroom is in my weekly grocery shopping trip and feel apprehensive about going to a new location if I do not know where the bathroom is.
  • I am unable to have intercourse with my partner because of pain in my pelvic floor, hip, or low back.
  • I purposely spill a glass of water on myself when out with family or friends who make me laugh to cover up a bladder leak.
  • I leak urine, gas, or feces every time I make it home after work and am unlocking my door.
  • In order to go to the bathroom, I have to use my hand to move something out of the way in my vagina or rectum to urinate or have a bowel movement.
  • I feel like something is falling out “down there”.
  • I can’t use a tampon or have a pelvic exam from my gynecologist/primary care physician because it is painful.
  • I cannot/do not wear jeans because the fabric is irritating to my pelvic area.

 

I have been experiencing one or more of the above symptoms, what should I do?

Make an appointment with your primary care physician, gynecologist, or urologist to discuss your symptoms and if a physical therapy evaluation with a specialist in women’s health would be appropriate.
Your primary care physician, gynecologist, or urologist, if necessary, will perform a pelvic exam to determine your best treatment options.

OR

Call (541) 386-1211 to schedule a consult with Kristen Klesh, PT, DPT or Lauren Bryan, PT, DPT to determine if you could benefit from a pelvic floor evaluation.
kristenKristen Klesh, PT, DPT
Columbia Gorge Physical Therapy and Sports Medicine
Email: kristendillscgpt@gmail.com
Phone: (541) 386-1211

Lauren Bryan, PT, DPTLauren Bryan, PT, DPT
Columbia Gorge Physical Therapy and Sports Medicine
Email: laurenbryancgpt@gmail.com
Phone: (541) 386-1211