Pelvic Physical Therapy Services

 

Sexual Pain and Dysfunction

Pain with intercourse can be caused by tight pelvic floor, inner thigh, and/or abdominal muscles causing discomfort and difficulty achieving orgasm.  Sexual pain can be a symptom of pelvic organ prolapse, sensitive scar tissue, and connective tissue restrictions.  The discomfort could be during or after intercourse, or both. Like we mentioned before, your body is a system, and we work to find the source of your symptoms which will direct us to the best treatment options for your unique body.

  • Recommendations for pain-free intercourse positions depending on location and type of discomfort

  • Recommendations for proper lubrication and which ones to avoid

  • Pre/Post coital pain management strategies until pain has resolved

  • Pelvic muscle assessment to determine if strengthening or flexibility is needed

  • Dilator exercises, if needed

  • Treatment for internal adhesions (restrictions) from previous surgeries or endometriosis, for example

 

Persistent Pelvic Pain

Pelvic pain can be classified as any discomfort felt in the lower abdomen, pubic area, sacroiliac joints, pelvic floor, tail bone/coccyx, or around the hips and is considered persistent if it lasts more than 6 months.  The discomfort may feel sharp, burning, stabbing, aching or numbness in the pelvis or legs.  There are many causes and treatment requires an individualized approach based on your history.  Injuries may occur during a vaginal delivery, a fall on the hip or tail bone, an abdominal surgery or a pelvic surgery.  Some conditions worsen if your job requires you to sit or drive for long periods of time. Injuries to the back, pelvis, or even legs that may make walking difficult can worsen pelvic pain.  Pelvic floor and abdominal wall muscle dysfunction can occur in common conditions such as endometriosis, irritable bowel syndrome, interstitial cystitis, benign prostatitis, and vulvodynia.  Assessment and treatment will include evaluation of the spine and posture, abdominal wall and breathing patterns, pelvic floor flexibility and strength, body mechanics during daily activities, stress management, nutritional assessment, and most of all education.  It is important to learn about your anatomy and underlying causes of your pain in order to begin the healing process and provide tools so you can begin and continue to manage symptoms on your own, when able.

  • Guidance on safe exercise

  • Stress management

  • Nutritional suggestions

  • Avoidance of certain postures

  • Improving flexibility and strength

  • Constipation management strategies

  • Exercises for nerve health

  • Releasing soft tissue tender points

  • Proper breathing

Prenatal Health

There are many changes that occur during pregnancy, including posture. As the baby grows, the abdominal wall stretches and becomes weakened. For women who reach full term, 100% will develop a diastasis during pregnancy, but research shows us that one third will not resolve spontaneously in the postpartum. The role of PT will be to reduce the extent of the separation, maintain strength of the deep core and pelvic floor, improving your body’s ability to heal and promote full restoration of the abdominal wall separation in the postpartum period. Another main goal during prenatal PT is to keep you as mobile as possible. Exercise is healthy for you and your baby’s development. If you are in a significant amount of pain and are having difficult tolerating walking or standing, this is a problem that can be helped. Maintaining correct alignment and learning ways to move safely to avoid excessive pressure on the abdomen and pelvic floor during your daily activities is also very important during your pregnancy.

  • Guidance for safe continuation of exercise

  • Maintaining core strength

  • Breathing strategies

  • Body mechanics (lifting, sitting, work-related activities, home-related activities)

  • Posture and Alignment during daily tasks

  • Decreasing or Eliminating Pain

 

Preparation for Labor & Delivery

Having good alignment and flexible pelvic floor muscles improves the birthing process and reduces the risk of perineal tears during delivery.  Knowledge of proper breathing patters, avoiding breath holding, and awareness of normal birthing reflexes will also reduce risk of injury to the pelvic floor.  We may discuss techniques to reduce discomfort and positions you can safely use during your labor.  Maintaining good abdominal wall strength and coordination will improve the recovery process in the post-partum. 

  • Breathing and Pelvic Floor Coordination

  • Pelvic Floor Muscle Flexibility

  • Optimal Hip, Back, and Tail Bone Flexibility

  • Exploration of Comfortable Birth Positions

 

Postpartum Health

Physical Therapy after giving birth, regardless of the method you delivered, will help you to start feeling like yourself again.  Many women expect their bodies to return to normal within 6 weeks and may try to do too much too soon.  We can guide you during this recovery process and make sure you are doing what’s best for your body.  Even nursing impacts recovery time.  We will retrain your pelvic floor and your core, prevent leaking and prolapse, resolve any pains you may be having, resolve urinary/fecal incontinence, and improve sexual health.  Another primary goal of postpartum PT is ensuring that any scar tissue, whether in the abdomen or the pelvic floor, is flexible and painless to touch.  Cesarean birth scarring can cause abdominal adhesions, tight pelvic floor muscles, abdominal wall spasms, problems with fertility, and back pain.  Manual therapies, guided safe exercises, and stretching effectively reduce the side effects of this type of birth.  We will also help you address the emotional difficulties during this delicate time. We have many resources to other healthcare providers in the community, including counselors and lactation consultants if needed.  

  • Pain free return to intercourse

  • Restoring the core and treatment of Diastasis Recti Abdominis

  • Scar management

  • Safe return to exercise using an individualized approach

  • Collaboration with other professionals (personal trainers, yoga/pilates instructors, crossfit trainers, etc)

  • Restoring normal pelvic alignment

  • Resolve any urinary incontinence (leakage) or fecal incontinence (stool or gas)

  • Cesarean scar treatment

 

Adjunctive Fertility Treatment

If you are having difficulty conceiving, manual physical therapy has been shown to have many positive outcomes. Manual therapies can decrease elevated FSH levels and improve pregnancy rates by almost 50%. Bodywork can reverse female infertility in cases such as occluded fallopian tubes, endometriosis, hormone dysregulation, and PCOS. The research also shows that if IUI or IVF is needed, a woman’s success rate increases when physical therapy is part of the collaborative treatment. 

  • Management of external scars and internal abdominal/pelvic adhesions

  • Improving circulation to the reproductive organs

  • Improving hormonal function

  • Recommendations for pain free intercourse


Appointment Options

60 or 90 Minute Initial Evaluation

30, 60, or 90 Minute Follow up Sessions

In-home Postpartum Wellness Visit within the first 2 weeks after delivery

4 Visit Package (10% off)

6 Visit Package (15% off)

10 Visit Package (20% off)

Now offering recurring payment plan options!

 

 


 

Physical Therapy Services also offered for these conditions:

  • Coccyx Pain

  • Pre/Post Abdominal or Pelvic Surgery

  • Pudendal Neuralgia

  • Genital Pain

  • Pelvic Girdle Pain

  • Concerns with Arousal/Desire

  • Erectile Dysfunction

  • Adjunctive Fertility Treatment

  • Blocked Fallopian Tubes

  • Abdominal or Pelvic Adhesions

  • Urinary or Fecal Incontinence

  • Abdominal Pain and Dysfunction

  • Pelvic Organ Prolapse

  • Pelvic Organ Cancer Rehabilitation

  • Endometriosis

  • Constipation

  • Scar Management

  • Pelvic/Back/Breast Pain Management

  • Cervical Scarring or Inflammation

  • Sacroiliac Pain


 

What Others Say:

Urinary Lekaage - Only Four Appointments

“After my initial visit , you made me feel totally comfortable with your knowledge and professionalism.  Everything we talked about including pelvic exercises, and also the physical exercises you demonstrated to me to work on at home have been very helpful.  After only four appointments with you, I can definitely tell a difference and feel so encouraged that my problems can continue to improve with your therapy and advice.  Thank you for being so understanding and helping me work through my difficulties.”

— E.W., 64 y.o. 

Scar & Sexual Pain after Cesarean Birth

“I was about three months postpartum with my son when I began receiving care from Tina. I was having significant discomfort in my incision area from my cesarean, sharp pains during intercourse, as well as problems with inconsistency with my bladder (peeing when I sneezed).

As a Physical Therapist, Tina is highly-skilled, incredibly kind, and an excellent listener. She is very adept at diagnosing the cause of my pain and used a series of hands on therapies and stretches to effectively treat my pelvic pain. Pelvic pain, and the symptoms associated with it, are not easy for anyone to deal with. Tina's positive, solution-oriented approach is very reassuring. She helps patients explore the physical, environmental, and emotional causes and triggers of pelvic pain. Throughout the sessions, she also offers a series of thorough explanations, visualizations, and diagrams that allow me to understand how parts of my anatomy and musculature are inter-connected and related to the pain. The physical therapy homework she assigns is very helpful and allows my symptoms to keep improving between sessions. She is always mindful to ensure the home exercises are helping with my progress. Tina is responsive to email and always follows up on my questions.

If you experience any pelvic discomfort or any of the common symptoms following the birth of a baby, I highly recommend Tina to help you heal and care for your body."

— S. R., 27 y.o.

Male Pelvic/Sexual Pain

“Tina, just a little note of thanks for helping me with my problem. I am very grateful that my general doctor was well read enough to suggest your services to remedy my very rare issue down below. What really amazes me is that TWO urologists with years of training had no clue of this problem occurring in the male anatomy. It took the knowledge of a general practitioner and a very wonderful physical therapist to remedy what was a very painful and frustrating issue.

What made my experience with the therapy even more comfortable was your delicate method of explaining and talking about my problem. Your gentle touch and professional demeanor made my experience with physical therapy so much better. Not every woman could do what you did for me, as a member of the opposite sex, and not make it painful or embarrassing.

I am still doing the exercises you taught me daily and have worked them into my daily stretching regimen. 

Thank you again for finding the answer to what could have been a lifelong problem. The pain is gone in that area and life is good."

— S.D., 48 y.o.