What is Pelvic Health?

What is Pelvic Physical Therapy and how can it benefit me? 


Have you ever had to cross your legs and stand still when you sneeze to avoid an embarrassing wet spot on your pants? Ever leaked a little with an unexpected cough? Have you experienced pain in your pelvic area? Is intercourse painful for you? Do you have to sit on the toilet forever and strain to get a bowel movement out? Do you have residual issues since prostate surgery? Have you experienced back pain since pregnancy, delivery or a c-section?

If you said yes to any of these questions, you could benefit from Pelvic physical therapy.


Were you even aware that Pelvic Physical Therapy is a thing? You may be wondering what it even is. Not all physical therapists are trained in pelvic P.T. which is why you may not have heard of it. Some physical therapists such as myself, choose to do post graduate coursework in the field of pelvic health to be able to serve certain groups of people who need and can greatly benefit from what we do.


The first group of people that I help through this specialty training is pregnant women. I help expectant moms stay strong and maintain a balanced pelvis during pregnancy and prepare their pelvis and pelvic floor muscles for a successful, more natural and less complicated labor and delivery process by making sure that the pelvic bones are correctly aligned and able to move the way they are required to move during labor and delivery, and by ensuring that the pelvic floor muscles are supple and able to relax enough to let the bones move and allow the baby out. If the muscles are too tight or are unbalanced, (one side may be tighter than the other) not only will the pelvic bones not be able to move appropriately to let the baby out, but an imbalance or any restriction in the soft tissues of the pelvic area will affect the orientation of the baby and could make delivery take longer and be more difficult. I also partner with one of the doulas in Longview to provide education on pregnancy, labor and delivery through workshops. Of course, if the mom is experiencing back pain or pelvic pain during pregnancy, I help with resolution of those issues too.


The second group of people that I help through the Pelvic PT branch of my practice, is post- partum women. This does not only refer to women who have recently had a baby. Once you’ve had a baby you are always considered post-partum, even if its 5, 15 or 55 years since you have given birth. Some of the post-partum complications that a pelvic PT helps with are urinary incontinence, pelvic organ prolapses, c-section recovery, diastasis recti correction, restoration of pelvic alignment, and recovery from episiotomies or tearing during delivery. Although it’s best to get help for these issues as early as possible, it is never too late to address them with pelvic physical therapy. Some women do not experience incontinence or pelvic organ prolapse until menopause or later in life, due to changes in the tissues that occur with age, generalized weakness from lack of maintaining their strength, or from (repeated) heavy lifting with poor core strength or incorrect body mechanics. It is always best to address these issues with pelvic physical therapy before deciding to undergo surgery, which is not applicable to all forms of urinary incontinence and has a “shelf life” of about 5 years, meaning that symptoms of bladder leakage often start to return after about 5 years. As always, any surgery has risks associated, including scar tissue formation, pain, infection and the like, so always do your research well or consult a pelvic physical therapist before making your final decision. Even if you do end up having surgery for prolapse or stress incontinence, you will be better off with pelvic floor training or retraining preferable before and after surgery to improve your chance of a successful outcome.


The third group of people that I assist are those with pelvic pain. This can be pain with intercourse, otherwise known as dyspareunia, pain in the genitalia (Vulvodynia for women, penile or scrotal pain for men) which often interferes with intercourse, and generalized pelvic pain from injury to the pelvis, tailbone or pelvic floor either due to trauma such as falls, sexual trauma, a complicated labor and delivery of a large baby, or one requiring instrumented or manual assistance. Pain can also be caused by overactive muscles or compressed nerves due to sporting activities or habitual postures. Pelvic pain is not often spoken about, but is fairly common, and pelvic physical therapy is one of the best ways to address it.


The fourth group of people that Pelvic PTs can help (although some choose only to work with the female pelvis) are males with post prostatectomy issues such a urinary leakage, ED, and pelvic pain. Yes, everyone has a pelvic floor with similar muscles, just a slightly different orientation, and although men are less likely to experience urinary incontinence, it is often a complication of prostate surgery which can also be helped by pelvic PT.


Lastly, the fifth group of people that can benefit from pelvic PT are those with GI issues such as chronic constipation, fecal incontinence, IBS, those who have had colorectal surgery, and even those dealing with conditions such as hemorrhoids or fissures. 


If you have any of the conditions referenced above and would like to know more about how I can help, I offer free 15 minute in-person or phone consultations where I will be happy to answer any questions you have or explain more about how I can improve your quality of life and get you back to living life to the full! Know that there is help for you and Vital Life Physical Therapy may be just what you’ve been looking for.



Sarah Rudolph

Vital Life PT


Helping you live life abundantly!



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