Part 1: An Introduction to Pelvic Health Therapy Services

Throughout my studies in Duke’s Doctor of Physical Therapy program, I have become exposed to many different types of physical therapy that I never knew existed. In addition to the more common fields of physical therapy, such as orthopedics and neurological, physical therapists are critical health care providers for premature infants in the NICU, for injured dogs and horses, and for individuals with pelvic floor dysfunction.

Pelvic health physical therapists can help treat patients with such as urinary or fecal incontinence, pelvic organ prolapse, dyspareunia (pain during intercourse), pelvic pain, chronic low back pain, sacroiliac joint dysfunction, and a variety of other conditions. To treat some of these conditions, physical therapists help relax spasming of pelvic floor muscles through manual therapy manipulations, strengthen pelvic floor muscles through biofeedback systems and exercise prescription, and re-educate the bladder with strategies such as bowel/bladder diaries or bladder voiding schedules. As such, physical therapists play a vital role in an individual’s reproductive and sexual health. Through my conversations with pelvic health physical therapists, some report that their patients have had dysfunction for years because they were not aware that services even existed, or that it was a realm of physical therapy. Patients are extremely satisfied with their care because of they are able to return to sports, sexual intercourse, or previously active lifestyles without fear or shame from pelvic pain or incontinence, truly showing the significance pelvic health physical therapy has on patients’ lives.

As the awareness about pelvic health physical therapy has grown among the public, OB-GYNs, and primary care physicians, pelvic health therapy services are being sought out around the country. Hospital systems and physical therapy practices around the country are looking to hire pelvic health therapists as patient waitlists for such services can be up to 200 people long and take 3 months to get an initial evaluation. Although treating pelvic floor dysfunction is not a practice setting I plan to work in, I appreciate the meaningful change these therapists can provide to patients. I am excited to see my profession continue to excel in this field by treating pelvic floor dysfunction and increasing awareness of such services.

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