So what really is Pelvic PT? Is it Kegels? Do I have to leak urine to really benefit? There are so many questions and misconceptions on what Pelvic Physical Therapy actually entails. Here are a list of things that your Pelvic PT should be capable of doing with you:
Pelvic Exam - First and foremost, your therapist should be properly trained in pelvic exams that will target the muscles, bones, ligaments, and nerves of your pelvis. Not everyone is appropriate for internal pelvic treatment, but your PT should be able to do the job when necessary! If your "pelvic physical therapist" is not offering a pelvic exam or not explaining to you the justification for deferring, you should find another practice for care.
Comprehensive history on your bowel, bladder, and sexual health - It is very important to discuss your history in all of the organ systems within your pelvis. Believe it or not, they all compliment each other. Commonly, when one isn't working right, the others are involved as well. We will ask you information that you never thought you would discuss with anyone! What your poop looks like, sexual positions that cause you pain, what things cause you to leak.
Talk to you about your diet - We go in depth into what you eat, when you eat it, and how it makes you feel. This is an important subject to cover especially if you are having bowel concerns, urgency, or even pelvic pain!
Self-care Management - At Pittsburgh Pelvic Health, we are your guide through your journey. We provide you tools, exercises, and lifestyle modifications for you to work on in your everyday life. There is little need for multiple appointments per week in most cases. Bowel, bladder, and sexual health are systems that require time to improve - There is no quick fix! Not even that "Kegel Chair" can eliminate your leakage.
What not to expect of every Pelvic Physical Therapist:
High Tech Equipment - Biofeedback, E-Stim, Real-time ultrasound, just to name a few. These are excellent tools to have in clinic, but are certainly not a requirement to success. Some PTs are trained in these devices, others choose to only use them when necessary. There should also not be an expectation to put you on biofeedback in clinic and leave you in the room alone to do your own exercises.
Pregnancy/Postpartum Knowledge - Believe it or not, this is a subspecialty of Pelvic PT. Here at Pittsburgh Pelvic Health, your therapists have advanced training and knowledge to address your pregnancy and postpartum concerns. PPH is unique in that we provide assistance with intrapartum support (Labor & Delivery) and can work along with your birth team to ensure the best care for you!
Fancy Exercises - Many pelvic issues do not require planks, CrossFit moves, or standing on your head. So much of what we help you with is on lifestyle changes- pressure transfers, lifting mechanics, dietary alterations, and general education. There isn't necessarily therapeutic exercises for every issue. Kegels, a contraction of your pelvic floor, can be used in a number of ways to help with strengthening, down training (relaxation), and urgency control. Kegels should not be 100% of the answer though. Your therapist will have great options for your therapeutic exercises based on preference and comfort level.