What is pelvic physical therapy?

Megan Pratt, PT, DPT

What is pelvic physical therapy? Pelvic physical therapy is just like regular physical therapy that you would go to after you tore your ACL or got a hip replacement; those same basic physical therapy skills are tailored to treat musculoskeletal dysfunction of the pelvis. This can be a foreign concept to most people, but it is a robustly growing specialty within the medical community. Even your doctor, gynecologist, or urologist may not be aware of what pelvic physical therapy is. Allow me to elaborate a bit further.

            Pelvic physical therapy is a type of physical therapy that specializes in treating issues specific to the low back, abdomen, and pelvis. Both men and women can experience dysfunction within the pelvic or abdominal region; this can include but is not limited to urinary problems like incontinence (urine leakage) or over active bladder (peeing too often, lots of urgency, and even urinating at night), bowel problems like chronic constipation or fecal incontinence (stool leakage), and any sort of pelvic pain like dyspareunia (painful intercourse) or pelvic girdle pain during pregnancy and postpartum. Most people know about physical therapy from their own or a friend’s rehab experience with treating a torn ACL tear or rotator cuff. You go to an out patient clinic, get massaged, stretched, do exercises, and eventually heal from that issue. I would love if pelvic physical therapy was just as popular! The most common phrase my patients say is, “I wish I would have known about this sooner!” Pelvic physical therapy is seen as a conservative type of treatment for many of these issues, but in my personal and professional experience, it is very powerful and effective. 

            I’ve listed just a few examples of common impairments, and I’ll include a more comprehensive list at the end of this short blog. If you are experiencing any of these symptoms or conditions, you could first consult your primary care provider, a gynecologist/obstetrician, or a urologist to ask for possible treatment options. But you can also go directly to a pelvic physical therapist in your area. They can do a very thorough evaluation of your symptoms, and if these symptoms are related to musculoskeletal or behavioral habits, a pelvic physical therapist could be what you need! A lot of these issues/conditions are treatable, and medication or a procedure or surgery is not the answer. If you have any other questions, please leave a message in the discussion board or click ‘ask a question’!

• Pregnancy and Postpartum: low back pain, SI joint dysfunction, pubic symphysis dysfunction, sciatica, diastasis rectus abdominis (DRA), generalized core weakness/instability, safe exercising after delivery, C-sections/episiotomy scar pain
• Urinary Dysfunction: Incontinence (urinary leakage), over active bladder/incomplete emptying, Painful Bladder Syndrome/Interstitial Cystitis
• Bowel Dysfunction: chronic constipation, fecal incontinence, rectal prolapse, painful defecation
• Sexual Dysfunction: dyspareunia (painful intercourse), premature ejaculation, erectile dysfunction, hard flaccid syndrome
• Pelvic Pain: dyspareunia (painful intercourse), vaginismus, vulvodynia, coccydynia, levator ani syndrome, endometriosis, pudendal neuralgia, chronic prostatitis
• Pre and Post Surgical Conditions: hysterectomy, cesarean section, episiotomy, sling procedure, prolapse repair, radiation (current and post oncology)
• Pelvic Floor Dysfunction: pelvic organ prolapse, bowel/bladder dysfunction (increased frequency, urgency, incomplete emptying), pelvic pain
• Perimenopausal/Menopasual Concerns: urinary leakage, prolapse, dyspareunia