By Carrie Pagliano, PT, DPT, OCS, WCS
There can be a sense of mystery behind pelvic physical therapy, not only from the point of view of the patient, but from professional colleagues in the medical community. Perhaps this has to do with the fact that pelvic Physical Therapists (PT) are often tucked away in physical therapy clinics behind a closed door. But let’s be honest; most of the mystery comes down to the internal (vaginal or rectal) muscle examination as a potential component of examination and treatment. That said, simplifying pelvic physical therapy down to an internal assessment or a vagina therapist is akin to saying the late Stephen Hawkings studied donut holes. There is so much more to pelvic PT and the conditions we treat.
The beauty of practicing in pelvic physical therapy lies in the culmination of so many areas of expertise. It requires an integrative understanding of the human body, finding the right clinical hypothesis and treatment direction in an area of practice where research is still evolving. Pelvic physical therapy has the unique privilege of being truly wholistic. Our patients have issues ranging from pelvic organ prolapse, chronic pelvic pain, pain from oncologic or dermatologic issues, urinary and fecal incontinence, issues related to pregnancy or surgery, pain or difficulty with orgasm or intercourse, and the list goes on. Our patients are female, male, intersex, and transgender. Our patients are adults and children. Our patients are referred to physical therapy from ObGyn, Urology, Colorectal, Neurology, Orthopaedics, Pediatrics, Psychology and Dermatology. Our patient’s problems range from simple to complex. Our examination includes the entire person, from a comprehensive subjective examination, where the patient can share their story, to a thorough objective assessment which includes the spine, pelvis, hips, etc. The smallest part of the exam focuses on the internal assessment; either vaginal, rectal, both, or not at all. For many patients, this portion of the examination is the first time which a medical provider identifies their pain or problem after seeking advice from multiple practitioners. Pelvic PT’s are often the first provider who has listened to their story for more than a few moments and acknowledged that as a patient, they are not broken, and there is hope.Read More