Giusi giving a talk about pelvic health and exercise.


What should I expect?

This takes place in your home and a private area is recommended. A table will be provided as well as other necessary equipment. First session is your evaluation where the main assessment is conducted. Depending on the nature of the diagnosis, treatment may also be given on the same day. Otherwise, treatment will start the following session. The number of sessions will vary on patient compliance, level of dysfunction and types of goals. Once the discussed goals are met, you will be discharged from PT and will continue with a home exercise program. I will be available for questions during our time together as well as after your discharge.

What is pelvic rehab?

It usually involves an internal exam during the evaluation and sometimes during sessions for re-assessment. It mostly addresses any of the various pelvic floor dysfunctions which may also include the hip and lower back. I will assess your muscles, joints, movements, strength, etc. It varies depending on the issue being addressed.

Will I have to do internal work?

This depends on many factors including level of comfort. You will not be asked to do anything you are not comfortable doing. Please see the research page for benefits of internal manual therapy for pelvic floor dysfunctions.

Who is appropriate for pelvic rehab?

Everyone! Women and men. Pregnant women, women going through menopause, women who experience pain with sex, women who leak every time they cough, sneeze, laugh whether you are postpartum or have never had a child.

I’m pregnant, am I still appropriate for pelvic rehab?

Absolutely! You may need approval from your obgyn, but it has been proven to be safe and beneficial. Pregnant women experience many musculoskeletal changes and PT may help prevent some dysfunctions that occur postpartum.

Will I be able to do my exercises at home?

Yes! Your entire program can be done at home. No equipment needed.

How long and how often are the sessions?

It is one on one care for 55 minutes. Session frequency will range from 1-2x/week initially and then reduce to 1-2 times/month. It will depend on your needs and progress.

Does insurance cover pelvic rehab?

This is a cash based practice, however, if you have out of network benefits, I can provide you with a super bill that you can submit to your insurance for reimbursement.

How long before I see a difference?

This is a popular and loaded question. If you are compliant with your home exercise program, you should see progress within 2 weeks. The amount of work and time you dedicate really determines the answer to this question.

What is the success rate of physical therapy as treatment for pelvic floor dysfunction?

There is extensive research supporting PT for various dysfunctions associated with the pelvic floor. Please see the research section for specific studies.

Relevant Research Articles

In recent years, there has been an increase in published research on pelvic health. In physical therapy practice treatment is evidence based. Below are some of those articles addressing some common pelvic diagnoses. Each description has a link to the original publication for further review.

Pregnant woman holding stomach.
Benefits of Exercise during Pregnancy: This article discusses the importance and benefits of exercise while pregnant. Too few women actually exercise while pregnant. American College of Obstetrics and Gynecology recommends moderate exercise for 20 to 30 minutes most days of the week (as long as there are no complications or not at increased risk for complications).

Newton, E. R., & May, L. (2017). Adaptation of maternal-fetal physiology to exercise in pregnancy: the basis of guidelines for physical activity in pregnancy. Clinical Medicine Insights: Women’s Health, 10, 1179562X17693224.

Read full article here.

Structured exercise reduces the risk of developing gestational diabetes and slightly reduces the amount of weight gain during pregnancy.

Sanabria‐Martínez, G., García‐Hermoso, A., Poyatos‐León, R., Álvarez‐Bueno, C., Sánchez‐López, M., & Martínez‐Vizcaíno, V. (2015). Effectiveness of physical activity interventions on preventing gestational diabetes mellitus and excessive maternal weight gain: a meta‐analysis. BJOG: An International Journal of Obstetrics & Gynaecology, 122(9), 1167-1174.

Read full article here.

Pelvic floor muscle training is the first line of treatment for stress urinary incontinence in women. Pelvic floor muscle training consists of a variety of methods to work on endurance training, strengthening and control. This article summarizes multiple studies that have been conducted on stress urinary incontinence and use of pelvic floor muscle training as successful treatment.

Dumoulin, C., Glazener, C., & Jenkinson, D. (2011). Determining the optimal pelvic floor muscle training regimen for women with stress urinary incontinence. Neurourology and urodynamics, 30(5), 746-753.

Read full article here.

Physical therapy, specifically pelvic floor training is the primary treatment for urinary incontinence and pelvic organ prolapse. Women who participate in pelvic floor muscle training are 8 times more likely to be cured than women who have no treatment.

Bø, K. (2020). Physiotherapy management of urinary incontinence in females.

Read full article here.

Urinary incontinence after childbirth affects about half of new mothers. This article studies the effects of high and low impact exercises postpartum. Exercising during pregnancy reduces the chances of postpartum urinary incontinence. Exercising postpartum also cures urinary incontinence at a much faster rate than not exercising.

Szumilewicz, A., Kuchta, A., Kranich, M., Dornowski, M., & Jastrzębski, Z. (2020). Prenatal high-low impact exercise program supported by pelvic floor muscle education and training decreases the life impact of postnatal urinary incontinence: A quasiexperimental trial. Medicine, 99(6).

Read full article here.