Pelvic Health vs. “Regular” Physical Therapy: Who Should I See?

I recently had a patient tell me that they had received “pelvic rehab” after having their first baby. When I inquired about their experience, they mentioned that they still had severe tailbone pain. It was not addressed by their physical therapist (“PT”) and their OBGYN told them that it would go away in time. This was heartbreaking for me to hear as a pelvic health specialist because I know that assessment and treatment of the tailbone is standard during pelvic health physical therapy. What’s more is that any trained and qualified pelvic health physical therapist would know this as well. Sadly, it’s far too common among patients and even referring healthcare professionals to seek treatment from PTs who lack the training and experience to adequately help their patients recover from pelvic health conditions.

Orthopedic Physical Therapy vs. Pelvic Health Physical Therapy

When seeking pelvic health physical therapy, many people don’t know that you should be adamant that you see a provider who is trained and qualified in Pelvic Health Physical Therapy and/or has received their certification in pelvic health from a credentialed training organization. Pelvic rehab practitioners have their degree in physical therapy AND have gone on to accumulate thousands of hours in the specialty of pelvic rehab, studied and passed a board exam, and specialize in treating this specified portion of your body.

You wouldn’t go see an orthopedic surgeon for heart disease – you would seek out the best and most qualified cardiologist. The same goes for pelvic health.

The inter-workings of pelvic health rehab involve a complex set of systems that require advanced knowledge and a specific skill set. This is not something that is taught in the doctorate program in PT school. It is certainly not a one-size-fits-all specialty where anyone with knowledge of the musculoskeletal system can decide to treat it on a whim. Just as physicians have specialties, so do PTs. You wouldn’t go see an orthopedic surgeon for heart disease – you would seek out the best and most qualified cardiologist. The same goes for pelvic health.

Orthopedic PTs are amazing professionals and resources for individuals suffering from a wide range of musculoskeletal issues, but it’s important to recognize the scope of their expertise. I certainly wouldn’t feel comfortable with someone who primarily treats knees and ankles to be rooting around in my pelvic region (did I mention pelvic health is extremely personal?) trying to diagnose and treat a condition for which they are not trained. If the entire system is not properly evaluated and assessed, chances are that your recovery will be incomplete. You will not return to optimal levels of functioning or achieve your desired outcomes. Those of us who specialize in this area have spent countless hours studying, educating and treating this very complex system and we are here to offer you the specialized treatment that you need in a private environment that’s suited for pelvic health treatment. Our number one goal is to listen and learn how we can improve your quality of life.

So, what is Pelvic Health Physical Therapy?

Pelvic Health Physical Therapy has been around for decades, yet we still struggle as specialists to spread the word about the services that we provide and what exactly our specialty treats. For anyone who is uncertain, I would love to help clarify. Pelvic Health Physical Therapy specializes in treating everything connected to your core pressure system. This system can be divided into 4 parts (top, bottom, front and back) including your:

• Diaphragm muscle (the muscle you use to breathe)
• ‍Abdominal muscles (your front core stabilizers)‍
• Pelvic floor (multiple layers of muscles that act as a supportive hammock for your bladder, rectum, uterus, etc.)
• ‍Low back muscles (your back core stabilizers)

Additionally, any bony structures connected to this core system such as your pelvis, tailbone, back, hips, and ribs.

These four components need to work in tandem for your body to function properly. If one of those components is injured, weak, tight or in pain, the rest of the system must compensate to keep the core stable. When that happens, the entire system is thrown off, resulting in many of the symptoms associated with pelvic floor dysfunction. We work to restore the harmony of the system by assessing and addressing all four components of your core. Believe it or not, pelvic health rehab isn’t just about peeing your pants or fixing your vagina after having a baby (not that it needs fixing!).

Take control of your health care

The good news is that you’re in the driver’s seat when it comes to your health care. In the state of Oregon, we have a ruling called “Direct Access” that allows you to seek treatment from a PT without a physician’s referral. That means that you get to choose your provider and seek care when you deem necessary. I’m here to remind you to choose your provider carefully and do the research. Be certain that you find a specialist who is certified and qualified. Ask questions about your provider, their education and experience. And remember that you should have complete confidence that you are receiving the best possible care before beginning treatment.

I understand that pelvic health can be a sensitive area and I want to reassure you that when you see a specialized and certified pelvic health physical therapist, your treatment will be personal, comfortable, compassionate and comprehensive. You will end your treatment feeling knowledgeable and empowered. We are here for you and want to be a beacon of light in your pelvic health journey.