Top 5 Questions About Pelvic Floor Physical Therapy

Although pelvic floor conditions are extremely common, they are widely under-studied and rarely talked about. Some healthcare providers aren’t properly trained to recognize and diagnose them, which means that many people who have pelvic floor dysfunction don’t even know it. Unfortunately, many people have to visit several providers to receive a diagnosis, and even after being diagnosed with a pelvic floor condition, it can be difficult to determine next steps or how to get relief from symptoms.

The good news is, however, that public awareness of pelvic floor conditions–and the options to treat them–is growing. In addition to support garments, pessaries, and other treatments, more people are turning to pelvic floor physical therapy to help manage their pelvic floor conditions.

Today, in the hopes of spreading awareness about a treatment and management option that can be incredibly beneficial, we’re taking a closer look at 5 of the most common questions about pelvic floor physical therapy.

1. What is pelvic floor physical therapy?

If you’ve never heard of pelvic floor physical therapy (PFPT), you’re not alone! A recent study showed that there’s a significant lack of awareness about PFPT, even among people who are already receiving physical therapy or experiencing symptoms. In short, a pelvic floor physical therapist is a medical professional who has received specialized training in diagnosing pelvic floor conditions and improving their patients’ symptoms. They provide individualized care plans for their patients that often include education, exercises, and resources.

Pelvic floor physical therapists are credentialed healthcare providers, so you should see some initials following their name, such as “PT” (“Physical Therapist”) and “DPT” (“Doctor of Physical Therapy”, a more advanced degree). To practice as a physical therapist in the US, providers must have a doctor of physical therapy degree from an accredited education program and pass a licensure exam.

2. What are the benefits of seeing a pelvic floor physical therapist?

Pelvic floor PTs understand that prolapse and other pelvic floor conditions can be life-altering, so these providers can offer support, help mitigate symptoms, and normalize common conditions that can feel so isolating. According to the National Association for Continence, they can help diagnose issues that are causing a range of pelvic floor symptoms, including lower back pain, abdominal pain, or pain with intercourse.

Because of their specialized training, they are sometimes able to diagnose pelvic floor conditions with more accuracy than a primary healthcare provider. In addition, they can help you learn “how to strengthen or relax parts of your body to ensure that everything is in alignment and functioning well.” It is important to remember that you can see a pelvic floor physical therapist as part of your ongoing well care. You do not have to have a problem in order to seek out a PFPT. 

Pelvic floor physical therapy can significantly improve your quality of life, and there are many physical and emotional benefits. “Pelvic floor physical therapy has been shown to reduce prolapse by 1 grade and can make a huge impact on symptoms. Though physical therapy may only change your grade by 1, it can help to significantly reduce and in many cases entirely eliminate symptoms associated with prolapse,” says Jessica Chastka, PT, DPT at Lady Bird Physical Therapy in Austin, TX.

Visiting a pelvic floor PT can help with Pelvic Organ Prolapse, but it’s also great for people with other concerns related to the pelvic floor. PFPTs can help with a range of issues, including incontinence, constipation, and endometriosis. They may further specialize in one area of PFPT, and they often focus on preventing injury. The mission of Lady Bird PT, for example, is to “help guide [its patients] through managing pregnancy pains, birth preparation, and postpartum recovery while helping reduce [the] risk of injury from the very beginning.”

3. Where can I find a pelvic floor PT near me?

Pelvic Floor PT is an emerging field, so finding a clinic may be a bit of a challenge. However, there are resources out there, and the number of providers is growing! Here are a few ways to begin your search:

• APTA's PT Locator - The Academy of Pelvic Health Physical Therapy (APTA) is a 501 (c) (6) non-profit professional association of more than 3,700 physical therapists, physical therapist assistants, and student physical therapists. Their PT Locator Service can help you find a pelvic floor physical therapist in your area.
• Ask your primary healthcare provider, OBGYN, or Urogynecologist for recommendations. 
• Use Google! Once you find a PT in your area, take a look at their website (“the face of their practice,” as Yuka, a certified health educator, reminds us) or call the clinic to learn more about them. A good pelvic floor PT will want you to feel comfortable and safe every time you interact with them, so don’t be afraid to ask questions about what to expect on your first visit.

4. What happens during my first visit with a pelvic floor PT?

Going to your first appointment can feel daunting and scary, and that’s completely understandable and normal! Having an awareness of what to expect can help calm your nerves. 

While each provider is different, in general, you can expect to talk to them about your medical history, your symptoms, and your goals. Your provider may ask you about your bladder, bowels, and sexual functions, since all of these are affected by the pelvic floor.

You may also have an external and/or internal physical exam, and your provider may discuss treatment options and/or things you can do at home to help alleviate your symptoms. It is extremely important that you feel safe and in control throughout your entire appointment, and a good pelvic floor PT will always wait for your consent before examining sensitive areas.

Looking for a more in-depth explanation of what an initial appointment with a pelvic floor PT looks like?  Check out this video, which provides a great overview of what you might be able to expect. 

5. Are pelvic floor PTs covered by insurance, and do I need a referral?

Whether your pelvic floor PT is covered by insurance will depend on your policy and the state you live in. You may need your doctor to submit a referral for you to see a pelvic floor physical therapist, and referral requirements vary by state. 

Researchers have found that a lack of provider referrals can be a significant barrier to receiving PFPT services, so it’s possible you may need to start the conversation with your doctor versus expecting them to recommend you see a PFPT. You can bring up the discussion with a simple question, such as: “I’ve heard about pelvic floor physical therapy and I’m curious about it. Can you tell me more about it?” Let your provider know you are interested in pelvic floor physical therapy as part of your overall care. You can express that you would like for them to send a referral to a physical therapist they recommend or that you have already set up an appointment with.