This is a specialized form of physical therapy that focuses on the pelvic floor muscles, abdominal muscles, lower body muscles, joints, and nerves. If muscles are too weak, then they are strengthened. If muscles are too tight, then they are relaxed. If the nerves of the pelvis are over stimulated, then we can help them calm down. If the joints hurt, then we can get them moving better.

Your pelvis is a group of bones that form a circle, going from the pubic bone to the tail bone and across to both hip bones. There are muscles all around and inside of these bones. There are many nerves that go into the pelvis and the pelvic floor muscles (PFM). There are blood vessels here as well. Inside the pelvis there are organs like the bladder, uterus, prostate, and rectum. On the outside of the pelvis, are the vulva, vagina, penis, scrotum, testicles, and the anus. Your low back, abdomen, and hips are also very involved in the function of the pelvic floor. All of this is considered the “pelvic floor.”

Pelvic floor symptoms develop when the muscles, nerves, and joints of the pelvic area are not resting or moving as they should. This could be because they are too tight, too weak, or too sensitive to any stimulus.

During the initial appointment, your therapist will ask you a lot of questions to understand what is going on for your specific issue. They may ask about bladder, bowel, pain, sexual function issues, diet, exercise routine, work, and past medical history. At that appointment the therapist will educate you on anatomy and function of the pelvis and pelvic floor. They will give you exercises which you can do at home to help manage your symptoms.

During any appointment, a physical assessment may be necessary. This can include testing the muscles of the abdomen, hips, back, and/or pelvic floor. PFM testing can be completed externally and/or internally. If you are uncomfortable with ANY of the assessment or treatment options suggested by your therapist, just tell them and they will suggest something else!

All of these questions and assessments help determine the cause of the symptoms. The goal is to figure out how to decrease the intensity and frequency of the symptoms, and hopefully make them go away all together.

The internal pelvic floor assessment is done with primarily comfort in mind. The point of an internal pelvic floor assessment is to see how well the PFM relax and contract to test for muscle strength, endurance, coordination, and tension or hypersensitivity.

If your therapist suggests an internal PFM assessment, with your consent, the therapist will very gently place a gloved and lubricated finger into the vagina or rectum. The PFM around the vagina and rectum are all PFM, just the front or back (needs rewording – not sur what you were trying to say here). The therapist may put pressure on specific muscles to test for muscle tightness or nerve sensitivity. If there are no muscle tension issues, this pressure should feel like exactly that – pressure, not pain. If there is pain, it may mean that the muscles are too tight or sensitive.

Your therapist may test muscle strength, coordination, and endurance by asking you to do a Pelvic Floor Contraction or a Kegel. If you don’t know how to do a Kegel, your therapist will teach you!

Sometimes it is not necessary to do an internal assessment. If you are uncomfortable with ANY of assessment or treatment options suggested by your therapist, just tell them and they will suggest something else!

Bethany Davidson PT, DPT, PRPC is a pelvic health physical therapist and Director of Physical Therapy at UCNT. She received her clinical Doctorate of Physical Therapy from the University of the Incarnate Word in San Antonio, TX. After working as a pelvic health physical therapist for 2 years, she earned her Pelvic Rehabilitation Practitioner Certification (PRPC), which distinguishes her as an expert in the field of pelvic rehabilitation. She has been a pelvic health physical therapist with UCNT since January 2021. Prior to that, she worked at Memorial Hermann Hospital in Houston, TX.

Abi Offringa, PT, DPT is a Physical Therapist at Urology Clinics of North Texas. She received her clinical Doctorate of Physical Therapy from Hardin-Simmons University in Abilene. She completed months of clinical rotations with the main focus on sports medicine at the beginning of her career. She is now focusing on pelvic floor issues after being recruited to be a part of the UCNT pelvic floor physical therapy team.

Each appointment costs $150 out of pocket which will be collected at the time of the appointment. Your therapist will give you a superbill, which is like an itemized receipt which you can use to ask for reimbursement from your insurance company. Some insurance companies cover all of the cost of pelvic health physical therapy, others cover some or none of the cost.

When your doctor refers you to pelvic health physical therapy, your physical therapist will call you to answer any questions you have regarding treatment or payment.

Dallas:
10501 N Central Expressway
Suite 200
Dallas, TX 75231

Frisco:
4401 Coit Rd
Suite 309
Frisco, TX 75035

Flower Mound:
4370 Medical Arts Dr
Suite 270
Flower Mound, TX 75028