Question 1

What is pelvic health physical therapy and is it right for me?

Accepted Answer

Pelvic health physical therapy looks specifically at how the function of pelvic muscles, bones, nerves, and immune system interacts with the movement and integration of the whole person.  Many people hear about pelvic health physical therapy through friends, media, and sometimes their medical providers.  As a direct access provider, Dr. Joanna Hess will be able to add to your understanding if physical therapy would help with your problems... or if not, help you find more appropriate help somewhere else.

Question 2

What is pelvic floor dysfunction?

Accepted Answer

Pelvic floor dysfunction is the difficulty coordinating pelvic floor muscles for everyday activities.  This may lead to problems with symptoms related to the functions of the genitalia and surrounding organs that include pelvic pain, uncontrolled urination with certain movements and activities, urinary frequency or hesitation, excessive urge for urination or defecation, painful urination, difficulty with bowel movements, bloating, abdominal cramping, pain with pelvic penetration, decreased or unwanted perineal sensations, decreased or painful orgasms, pelvic heaviness, and protruding pelvic organs.

The local pelvic floor muscles and nerves are not the only reason why these symptoms might be happening so it's important to look at your health and body holistically.  At Hazel Physical Therapy, we coordinate care with your health care team to make sure we get the right answers.

Question 3

What are some diagnoses or symptoms associated with pelvic floor dysfunction?

Accepted Answer

Common medical diagnoses:
 • Stress urinary or fecal incontinence
 • Urinary or fecal urge incontinence
 • Interstital cystitis/Painful bladder syndrome
 • Irritable bowel syndrome
 • Crohn's Disease
 • Dyspareunia
 • Genital arousal disorder
 • Genitourinary syndrome of menopause
 • Endometriosis
 • Fibromyalgia
 • Connective tissue disorders (Ehlers Danlos Syndrome)
 • Chronic Prostatitis
 • Vulvodynia
 • Pelvic organ prolapse: cystocele, uterine prolapse, rectocele, rectal prolapse

Urinary:
 • Leakage
 • Frequency
 • Hesitation/retention
 • Pain

Bowel:
 • Leakage
 • Constipation
 • Frequency
 • Hemorrhoids, Fissures
 • Bloating

Sexual/Penetrative:
 • Pain with penetration
 • Decreased sensation
 • Decreased or unpleasant arousal or orgasms
 • Erectile dysfunction

Pain:
 • In perineum, genitalia, groin, abdomen
 • At pelvis, hips, sacroiliac, lumbar or thoracic spine
 • Central sensitization

Prenatal/Postpartum/Post-operative:
 • Tissue care after Caesarean delivery, gender affirmation, prostate, endometriosis excision/ablation, pelvic organ removal, colectomy, etc.
 • Deconditioning and weakness
 • Diastasis recti abdominis
 • Return to sport
 • Scar management
 • Concurrent pelvic floor dysfunction
 • Lymphatic drainage

Question 4

Can I have pelvic dysfunction if my symptoms aren't just in my pelvis?

Accepted Answer

Yes!  The body is connected.  Endometriosis, spinal dysfunction, GI distress, lower extremity pain and fatigue, diastasis recti abdominis, and postural issues can have strong relationships with pelvic floor dysfunction.  At Hazel Physical Therapy, we treat the body as whole to break the cycle of dysfunction.

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