FAQ

Pelvic health physical therapy focuses on musculoskeletal dysfunctions within the pelvis, hips, abdomen, and the adjacent joints. The goal of pelvic physical therapy is to restore the length, function, and activation of these muscles to a more optimal state. This allows for more unrestricted participation in all of life’s activities – including jumping on trampolines.

Pelvic floor physical therapy treatments might also include:

• Working to restore posture
• General strengthening of core and hips
• Relaxation and down-training techniques
• Manual therapies to the external and internal pelvic floor muscles,
• including myofascial release
• Scar tissue mobilization
• Visceral mobilization

Your first visit is 90 minutes long so we can spend time getting to know you and your medical history, do a physical exam, and collaborate on your treatment plan.

First, we’ll take a deep dive into your medical history. We’ll review your general medical history; birth history, if applicable; bowel, bladder, and sexual function; orthopedic issues; and anything else that could influence your function and return to activities.

We’ll then complete a respectful, patient-centric physical exam. The physical exam helps us adequately identify contributing factors to your symptoms. If you need an internal pelvic floor exam, we’ll use a single gloved finger without a speculum to assess what’s happening at each layer of the pelvic floor muscles.

From here, we collaborate with you to develop your personalized treatment plan. We craft it to address the root cause of your symptoms, your body, and your ultimate goal for physical therapy. We also connect and collaborate with other providers, caretakers, and professionals as needed to assist in your healing journeys.

We’ll kick off treatment right away with exercises, hands-on manual therapy, or suggestions for lifestyle changes.

Visits start with your provider getting a full picture of your medical history from your. Our physical therapists then use a physical exam to assess the root cause of your symptoms. This can include an internal physical exam – something our physical therapists are specially trained to conduct. Internal exams are always done with respect and to your comfort level, with open communication throughout the process. Our physical therapists don’t use a speculum, just one gloved finger to get an idea of what’s happening in each layer of the pelvic floor muscles.

With your medical history and physical exam complete, you and your physical therapist coordinate on a personalized plan of care. It’s customized to the root cause of your symptoms, your body, and your goals. We also connect and collaborate with other providers, caretakers, and professionals as needed to assist in your healing journeys.

The pelvic floor muscles don’t work in insolation, so we take a holistic, full-body approach to your treatment plan. As much as you’d like, we can incorporate lifestyle factors into your care. We pull from a variety of treatment techniques to build our patient care plans: neural manipulation, visceral manipulation, manual therapy, Pilates movements, and dry needling, to name a few.
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We find that most patients do well with one visit each week or every other week for a month or two. They’re often able to decrease to one appointment every few weeks as they feel better. This cadence gives you enough time to work through your personalized home program of exercises, practice new strategies we’ve discussed, and be ready for the next progression of exercises.

If you’re experiencing significant orthopedic aches and pains, it can be worthwhile to be seen twice a week until we get things better managed. As you improve, we schedule you less frequently, until you decide you have all the tools you need to succeed and feel better overall.

Patients frequently tell us that they’ve done Kegels in the past and they haven’t worked. In truth, most people either do Kegels incorrectly or don’t do nearly enough of them! Current research suggests 90 Kegels a day help to make measurable strength gains over the course of a six- to eight-week period. Other factors affect Kegels as well, such as managing intra-abdominal pressure, posture, general strength, and breath patterns.

However, it’s a common misconception that pelvic physical therapy is only about Kegel exercises! Exercising the pelvic floor muscles is important, but there is much more to optimizing function. We take a holistic, full-body approach to your treatment to help you reach your goals.

Finally, it is important to be assessed by a therapist to determine if Kegels are even appropriate for you. If you’re experiencing pain or have muscles that are already tight, strengthening the pelvic floor muscles with Kegels might be counterproductive or cause more issues.

You conquered both pregnancy and delivery! High five, friend!
Wouldn’t it be nice to say that after delivery and a good six weeks of recovery, our bodies bounced back to normal? Unfortunately, the truth is there is a “new normal.” It takes time for the muscles of the entire body to come back to their new normal resting position.

Many people can return to physical activity after pregnancy without issues, but the orthopedic issues that may have occurred during pregnancy don’t always resolve after delivery. Sometimes, you have more aches after delivering than you did during pregnancy from the new stress of carrying and feeding baby in poor postures, adding stress to the shoulders, neck, and back. Often, some gentle stretches and exercises can resolve most of your discomfort. Pelvic health therapy after pregnancy isn’t just for the pelvis. It’s for the whole body, and its goal is to restore alignment and efficient movements to each person, so they can return to their normal activities.

For the vast majority of women, there can be lasting consequences if you don’t retrain muscles to function in proper alignment and positions again. Worse yet, symptoms might only begin to arise much later in life. You need to focus on developing the correct recruitment and activation patterns so you don’t reinforce dysfunctional movement and stability patterns that your body slowly developed through the nine-month progression of postural changes — aka pregnancy.

Even people in the postpartum period who aren’t experiencing symptoms benefit from a couple sessions of pelvic health physical therapy. As we age, our muscle fibers decrease in quality as well as quantity. You might not have any symptoms at the moment, but as the muscles age, symptoms can begin to appear. Countries that offer pelvic health services as a standard of practice to postpartum women have a decreased rate of incontinence, prolapse, and many other pelvic floor issues throughout their citizens’ lifespan.

For women who have a planned or unplanned C-section, your pelvic floor muscles are still affected by pregnancy. These muscles are under greater stress while supporting more weight from the baby and uterus for nine months. Your posture is greatly changed through pregnancy, and your muscle recruitment pattern is altered by this change.

Unfortunately, our bodies don’t just “bounce back” to their normal function. We must relearn and retrain the muscles to function properly again. Without coordinated training, your body will continue to move using the abnormal strategy from pregnancy.

A cesarean section also means doctors had to cut through your abdominal wall to get baby out, and that can impact the strength and recruitment of your core muscles.

It is quite common for women to experience urinary leakage after delivery, but that doesn’t mean it’s normal or that you should live with incontinence after giving birth!

In fact, one in three women experience urinary leakage at some point in their life, even without having had kids.

Urinary leakage will often improve over time, but not fully resolve. It’s especially common with jumping, coughing, and sneezing. It’s very common for this to occur, but it’s not normal. Nor is it normal to leak gas. Pelvic health physical therapy helps to strengthen and address contributing factors to improve the control of the sphincters to the bowel and bladder.

Pelvic health therapy can address a wide variety of symptoms including, but not limited to, the following:

• Coccyx pain
• Constipation
• Diastasis recti abdominis
• Fecal incontinence
• Headaches
• Intercourse pain
• Irritable Bowel Syndrome (IBS)
• Nursing considerations
• Pain in the hips, low back, or shoulders
• Pelvic Organ Prolapse
• Pregnancy discomfort
• Postpartum weakness
• Urinary incontinence
• Urinary urgency or high frequency
• Vaginal pain or tightness

Yes! It truly doesn’t make a difference to our physical therapists; we typically tell women that as long as they’re comfortable with internal work, we can continue with it. There are also a lot of other aspects to treatment, such as visceral work on the abdomen, exercises, and manual therapy, that we can do instead to keep you on track with your goals.

Additionally, therapists can often provide relief from cramping, back pain, and other menstrual-related symptoms.

We’re now contracted with select insurance companies. Please reach out to us directly so we can confirm whether we’re contracted with your carrier.
For all patients, we check your benefits to give you a cost estimate for your appointments.

For out-of-network plans, we do our best to determine your potential for reimbursement. Any reimbursement from insurance would be made directly to you by your insurance company. If you’re submitting for reimbursement, we will provide and send in completing the necessary forms to receive reimbursement at no additional charge.

For all appointments, payment is due at the time of service. Payment plans are also available.

It’s never too late to start pelvic physical therapy — the sooner, the better. If you’re planning a pregnancy, getting surgery, or experiencing symptoms that might indicate a pelvic health issue, call 208-629-1030 or fill out our contact form to get scheduled.

We’ve worked with hundreds of people throughout the birth process. Therapists can help you prepare your body during preconception, address symptoms every trimester of pregnancy, and build strength during the postpartum period. If you have weakness in your core or pelvic floor, even years after giving birth, we can help you to strengthen and rebuild your body safely.

Pelvic physical therapy is an important — though often forgotten — part of post-operative care. If you’re getting orthopedic surgery, like a hip replacement, we can help with mobility, flexibility, strength, and scar tissue mobilization. If you’re getting surgery that affects your digestive or reproductive organs, we can help with organ motility through visceral manipulation and scar tissue mobilization. Book an appointment as soon as you have your surgery date.

After you give birth, we can work on strategies to optimize your healing from a vaginal or cesarean birth and give you techniques to improve common postpartum issues, like bowel or bladder function. If your joints make it hard to comfortably navigate through your new routine with baby, it’s helpful to start physical therapy as soon as possible to resolve any limitations.

We usually wait until you get the all-clear from your provider at your six-week checkup to start an internal pelvic floor assessment and treatment. When we know you’ve healed well, we can introduce internal therapies for issues like painful intercourse, difficult bowel movements, and urinary leakage.