What is Pelvic Health Physical Therapy? Going Beyond the Pelvic Floor.

Written by:
Activcore
November 14, 2019

As a pelvic health physical therapist, I often see people after they've visited countless other healthcare providers who have overlooked the muscular system. As they come in, I hear them say things like:

  • “I have no idea why I’m here.”
  • “I’m only here because my doctor told me to.”
  • “So what exactly is pelvic health PT?”
  • “Are we just going to do some Kegels?”

Pelvic health isn't a new type of physical therapy, however it is finally gaining some traction in the health and wellness industry. Physicians are now realizing that it’s not just for pregnant and postpartum moms. Pelvic health is for people of all genders, ages, and activity levels. Everyone has a pelvis, and therefore we all could benefit from better pelvic health. So let's discuss what pelvic health physical therapy actually is and how it can help you.

Pelvic health is an area of specialty within the field of physical therapy. It is typically not a significant part of a physical therapist’s education. Rather it is a specialization requiring much further study, training and practice following graduation from PT school. A pelvic health physical therapist holds both a degree in physical therapy as well as advanced credentials in the assessment and treatment of people with diagnoses that involve the pelvic floor musculature. Some pelvic health physical therapists take their education a step further by specializing in orthopedics, pediatrics, pregnancy and postpartum care, women’s health and/or men’s health. Having this additional knowledge gives them an even greater understanding of how to go beyond the pelvic floor to help you from head to toe.

The pelvic floor is made up of muscles and fascia that form a sling spanning across the bottom of your pelvis. It consists of 14 muscles in people with female genitalia, and 12 muscles in those with male genitalia. All of these muscles, in combination with your “core” muscles, must be functioning properly to ensure a healthy pelvis. Together they provide a foundation to the pelvic musculoskeletal structure for upright posture, support of your internal organs, and help regulating urinary and fecal continence as well as sexual function (erections, ejaculation, and orgasm).

Just like any other muscle in your body, the pelvic floor muscles can succumb to injury. And, similar to a torn ACL or a rotator cuff injury, the pelvic floor also responds very well to strength training or vice versa, to downtraining and relaxation.

Pelvic Floor Dysfunction is defined as an impaired ability to control (tighten and relax) your pelvic floor muscles. It can happen for a number of reasons, such as a sports injury, surgery, pregnancy, childbirth, inactivity, and cancer/radiation related dysfunction. Some common symptoms include:

  • Sudden urges to urinate
  • Leaking with exercise
  • Frequent or painful urination
  • Low back pain
  • Constipation
  • Painful sexual intercourse
  • Abdominal pain or weakness
  • Pelvic pressure and heaviness
  • Erectile dysfunction
  • Premature ejaculation

While these symptoms are common, they are absolutely not normal and could be a sign of Pelvic Floor Dysfunction. A physical therapist can help determine if you have this, based on your symptoms and the findings of a pelvic exam and movement screen.

Having a qualified physical therapist by your side who fully understands the relationship between your pelvic floor and how the body moves as a whole is key to attaining optimal pelvic health. Through a comprehensive assessment, I search for the underlying source of your musculoskeletal and movement limitations. I assess your symptoms and objective impairments to create a treatment plan personalized for you and your specific needs and goals. From there, each session is guided to ensure symptom reduction and goal-oriented success. I go beyond the symptoms and look at your whole body to help you recover from pain and injury, and safely return to a fulfilling life of sport, activity and wellness.

Each pelvic health treatment session is private and typically one hour long. They include a variety of skilled methods such as manual therapy, requiring internal and/or external techniques depending on your diagnosis. Some examples of manual therapy I employ include soft tissue and joint mobilizations, trigger point release, dry needling, and connective tissue manipulation. Treatments may also involve neuromuscular re-education and activation exercises with tools like Redcord suspension and Pilates, therapeutic exercise for general strengthening, breathing and relaxation techniques for downtraining, as well as education regarding anatomy, physiology, neural connections, and pain science. Your plan of care is established after the initial evaluation, and based on your diagnosis and complexity of symptoms.

Check out our Pelvic Health page to learn more about this topic.

Disclaimer:  The views expressed in this article are based on the opinion of the author, unless otherwise noted, and should not be taken as personal medical advice. The information provided is intended to help readers make their own informed health and wellness decisions.

Need help? We're here for you. Contact us today to request an appointment. Also check out our Telehealth offerings to get help from the comfort of your home.

Activcore

Activcore is made up of physical therapists and Pilates instructors who are specially trained, fully equipped, and totally committed to bringing out the very best in you. They work together as an integrated team with a common mission to transform how you feel, move and perform. While they all have general orthopedic experience, each provider specializes in a particular area of study (e.g., pelvic health, TMJ disorders, men's health, scoliosis, etc.) so that you get the best care possible for your particular needs, lifestyle and goals.
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How Should I Recover After a Day on the Mountain? Guidance From Two Massage Therapists.

For all you ski enthusiasts out there, you know all too well what it feels like to wake up the next morning after a day on the slopes. Your whole body feels tired, your legs feel like lead, and even sitting down becomes a task. All this is to be expected due to the high physical demands of both skiing and snowboarding. With that being said, there are a few tips to help you recover and decrease soreness.

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Top 3 Tips for Preventing Low Back Pain on the Golf Course

It’s February, spring is right around the corner (or so Punxsutawney Phil says), and it’ll soon be time to hit the golf course. It’s tempting to just go straight to the driving range or first tee, because that’s the part of any sport that you love –– the playing part. Instead, consider first taking care of your body to set yourself up for a successful season. A body in pain can never perform at an optimal level, so what can you do to keep yourself injury-free this season?

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What Every Beginning Snowboarder Needs to Know. Q&A with Burton.

In addition to figuring out if your body is physically ready to hit the slopes, how do you know if you have the right equipment for optimal performance as a beginner snowboarder? I visited the Burton store here in the Rino District of downtown Denver to answer some of the most commonly asked questions that beginner snowboarders need answered. I was able to chat with the store’s Assistant Manager and avid snowboarder, Tom Ritter. ‍

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Mask Wearing Can Be a Pain in the Neck: 5 Movements to Alleviate Muscle Tension

After recently spending 3 days caretaking for my at-risk, elderly family members, I was humbled by the physical toll wearing a mask for 12 consecutive hours each day had on my body. As I was helping with household chores such as dishwashing, laundry and mail opening, about every 30 minutes I became aware of growing tension developing in the back of my neck. This was a result from looking down –– and over my mask –– for extended periods of time.

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Diastasis Recti Abdominis (DRA): Part 1, Diagnosis

Whether you’re new to motherhood or a seasoned Mom, I would like you to envision a scenario. You’ve just had your little one and you’re at home navigating through mommahood. As your baby is growing, your body is healing. You’re adjusting to a new life balance and trying to sleep whenever you get a free moment. And to top it off, there’s doming on your core every time you get out of bed. Does this sound familiar?

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New Study Uncovers the Truth About Lumbar Fusions

So here’s a very recent article about the use of lumbar fusion for chronic low back pain. The conclusion is very clear: “The present meta-analysis determined that fusion surgery was no better than nonoperative treatment in terms of the pain and disability outcomes either at short- or long-term follow-up.”

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Take Control of Your Personal Health: An Interview with the Founder of Align Health Coaching

In this interview, Dr. Elizabeth Dalrymple, lead physical therapist at Activcore, talks with Gail Turner-Cooper, the founder of Align Health coaching, about taking control of your personal health by making small, sustainable changes to your diet and lifestyle.

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Diastasis Recti Abdominis (DRA): Part 2, Evaluation

Now that we have a better understanding of what a Diastasis Recti Abdominis (DRA) is, let’s talk about what physical therapy can do for you. Physical therapy is a conservative treatment option, because there is no surgery involved and you allow the body to heal itself with specific exercises. Diastasis Recti are diagnosed measuring how many cm or mm of separation there is on the linea alba (i.e. the midline of your six-pack muscle).

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Chip it Close: An Interview with Golf Pro Heidi Mitchell

In this interview, I had the pleasure of chatting with Golf Pro Heidi Mitchell about her career path, her specialized training, and her top tips for golfers eager to improve their game. I met Heidi as a golf student myself. I sought out golf lessons not only to improve my swing, but also to enhance my understanding of the game to better help my physical therapy patients who are golfers. Heidi’s instruction is detailed, coming from years of experience on the golf course, creative, and (maybe most importantly) fun.

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How Should I Flatten My Abs During Exercise?

To keep the abs flat, you need core coordination. Your pelvic floor, transverse abdominus and thoracic diaphragm need to work together to keep the abdominals flat during exercise. Abdominal coning is when the abdomen bulges upward during an exercise. This points to a difficulty recruiting the deep abdominal muscles. We need the deep abdominal muscles to stabilize the spine and the pelvis.‍ If they are not firing at the right time, it can result in pain, movement dysfunction, and postural changes down the line.

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2 Minutes of Diaphragmatic Breathing as an Immunity Boost

"Inhale into the low belly, then exhale"... We hear about diaphragmatic (or belly) breathing in yoga, fitness, relaxation techniques, and improvement in lymphatic flow. But why? There are several anatomically related reasons why, here are two...

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Is Dry Needling Like Acupuncture?

Acupuncture and dry needling can use the same, thin filiform needle. However, the mechanism for what each is used for differs. In this blog article, we will explore the differences between trigger point dry needling (TPDN) and acupuncture.‍ Have you ever felt a knot-like band in a muscle? Perhaps an aching pain coming from a particular spot on a muscle that is reproduced when pressure is applied? This may be known as a trigger point defined as a “focal area of hyperirritability that is sensitive to pressure and can refer symptoms to other areas of the body.”

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Get to Know Your PT: Dr. Sara Kiyani

I joined the Activcore team in Atlanta, GA in October 2021. I am a Doctor of Physical Therapy (DPT) who specializes in pelvic health, women's health, running analysis and general orthopedics. I help women address their pain, weakness, and dysfunction in their pelvic floor muscles so that they can engage in all activities they love to do without pain, urinary leakage, or any pelvic discomfort. I became interested in specializing in the burgeoning field of pelvic health...

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Physical Therapy for Concussions

We've helped countless people recover from concussions. Here are some of the most common questions that we get on this topic.‍ When should I start physical therapy after sustaining a concussion? What can a physical therapist do to help me recover from a concussion? It’s been a long time since my concussion, can physical therapy still help?

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As a New Mom, When is the Ideal Time to Start Running Again?

Although many articles commonly warn new moms that running too early postpartum can cause various complications and is not advised, this does not apply to every woman across the board. Every woman’s body is different and each will not only have a different recovery process, but also variations in their previous baseline of running prior to giving birth.

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Relieving Chronic Pelvic Pain with Yoga

Chronic Pelvic Pain (CPP) is a multifaceted condition affecting 20% of women in the United States. Treatment includes pharmacological interventions, physical therapy, and lifestyle modifications. Studies have shown that yoga is an effective intervention to help both improve pain and quality of life in women with CPP. ‍Many times those suffering with chronic pelvic pain experience high levels of both anxiety and stress.

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Vestibular Rehabilitation Therapy (VRT): What Is It & How It Can Help You

Dizziness, nausea, headache, feeling off-balanced, or a hard to describe “off” sensation are common symptoms associated with vestibular disorders. If you’re experiencing one, two, or all of these symptoms, you know that going to work, exercising, and socializing can become difficult or even impossible. If you are experiencing a vestibular disorder, you’re not alone. It is estimated that 35% of adults in the United States aged 40 and above have experienced symptoms related to a vestibular disorder.

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Suspect a Concussion? Know the FAQs

Over the last several years concussions have been gaining more attention in the sports realm and media. While there is a lot of new information out in the ether about how to treat a concussion; unfortunately, there is also a lot of out-dated advice available. If you think you’ve sustained a concussion from a sports injury, car accident, fall around your home or some other way, you will benefit from physical therapy to address your injury and any concussion symptoms you may be experiencing.

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Why Kegels Don’t Always Fix Stress Incontinence

Stress incontinence is when urine leaks while performing an action or activity. This can happen for many different reasons and here’s a hint: it’s not always weakness! There are three main factors that can be happening at the pelvic floor to cause stress incontinence: weakness, increased tone, or lack of coordination. Weakness can result after any injury or trauma to the pelvic floor, or just over time from dysfunctional movement patterns. If there is a lack of strength at the pelvic floor, that means there is not enough tension to combat pressures...

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Why Do I Feel Dizzy? The Vestibular System Explained.

Have you ever experienced dizziness, nausea, headache, difficulty with balance, or that hard-to-explain feeling of being "off"? If you have, then you've had experience with your vestibular system whether you’ve heard of it or not. If you’ve experienced any of these symptoms, you know that doing regular everyday tasks like getting ready in the morning, driving, working, and socializing can become difficult or even impossible. But what even is your vestibular system? How does it work?‍

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Is Your Physical Therapist the Right Fit for You? 5 Questions You Should Be Asking.

There are now over 300,000 physical therapists (PTs) in the United States. If you’re looking for one in any major metropolitan area like Denver, CO, it might feel like most of them are located near you! With so many, it may be overwhelming when looking for the right fit for you. All physical therapists have similar backgrounds when it comes to the basics. We are all required to graduate from an accredited school, pass the national boards, and hold an active license in each state we practice in.

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Should I Get Worse Before I Get Better? Understanding Vestibular Rehabilitation Therapy

If you are experiencing vertigo, dizziness, or headaches and have been diagnosed with anything from BPPV to a concussion, you are not alone! It is estimated that 35% of adults in the United States ages 40+ have experienced symptoms related to a vestibular disorder. [1] If you are looking to address your condition, your doctor may refer you to Vestibular Rehabilitation Therapy (VRT). But what is VRT and why did they make it sound like it’d be awful?!

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Prenatal Prep Workshop on March 10th in Denver!

Has anyone taught you how to push your baby out during delivery? Are you experiencing any urinary incontinence, low back pain, pelvic/pubic pain, constipation, etc. and you're pregnant? Come learn the mechanics on how your pelvic floor works, exercises you can be doing during your pregnancy, exercises you can do before your 6 week postpartum check up, and a few other topics you don't want to miss.

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Do I Have Pelvic Floor Dysfunction? How to Screen For This.

I am a physical therapist who specializes in the pelvic floor. I can assess, diagnose, prevent and prescribe treatment of pelvic floor related conditions. These dysfunctions include urinary incontinence, bladder and bowel dysfunctions, sensory issues and pain around pelvis, pain with sex and other sexual related dysfunctions, pelvic organ prolapse, pregnancy and postpartum recovery and more.

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5 Signs of Concussion

Did you know that a concussion is classified as a mild traumatic brain injury? Concussions can be the result of a direct hit to the head, a fall, sports accident, car accident, bicycle accident, or work-related injury. It can also occur from forceful neck motion such as whiplash.

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So You Had a Concussion, Now What? Learn the Do’s and Don’ts

If you suspect that you’ve sustained a concussion, fast track your recovery by following these general guidelines. You may not even realize you have signs and symptoms of a concussion until you try normal everyday activities. Early intervention is essential to safely recover. A concussion trained physical therapist can help you.

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Is Dry Needling The Same As Acupuncture? Can It Get Rid Of My Pain?

You may have heard friends or family talk about being “needled” as a part of their physical therapy regimen. Some of them may have even described it as a magical cure for getting rid of pain! But what exactly is dry needling? Is it like acupuncture? And could it be helpful for you?

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3 Tips For Managing Diastasis Recti During Pregnancy

A diastasis recti (DR) occurs when the rectus abdominis, your 6-pack muscles, separate in the front of the body. This commonly occurs during pregnancy but can also be found in persons with stomach obesity. As the abdomen increases in size, it stretches the front abdominal wall leaving the linea alba (connective tissue between your abdominal muscles) vulnerable to separation.

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Get to Know Dr. Sarah Pucillo from Women’s Health Care Associates

I recently started offering pelvic health physical therapy services at our latest Activcore studio in Littleton, Colorado. It is located within a popular OB/GYN practice called Women’s Health Care Associates. This new venture has given me an opportunity to learn more about this amazing group of medical providers in the Denver area.

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Physical Therapist's Role in Osteoporosis Management

Bone density peaks for women around age 18 and in the early 20s for men. Women begin to rapidly lose bone density during menopause. After menopause, bone density losses taper. It is during this time that women are at risk for developing osteoporosis. New guidelines have been released by the American Physical Therapy Association (APTA) on physical therapist's management of osteoporosis...

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Finding Your Pelvic Floor Muscles

Have you been hearing about the pelvic floor or pelvic health physical therapy, but aren’t sure exactly what the pelvic floor actually is? In this week’s video, Dr. Krystal guides you through a step-by-step process of identifying this group of muscles with visual aid and verbal cues.

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