Pelvic Floor Physical Therapy: Myths and What to Expect

By Dr. Brooke Meinema, DPT, FAFS

Because of the intimate nature of our pelvic floor, some women are apprehensive to take the leap and start their journey with pelvic floor rehabilitation and physical therapy. Knowing what to expect can make the process much more comfortable. So let’s go over some of the myths and frequent concerns some may have when first getting started with therapy.

• This may be TMI (too much information).
  • I have heard this more times than I can count, so I want to make something perfectly clear: there is nothing that is TMI if you believe it is impacting your pelvic floor or is something you want to work towards. Trust me when I say that we have probably heard it, seen it, and worked through it before. There is absolutely NOTHING that you need to feel embarrassed or nervous about when discussing your personal goals and pelvic floor dysfunction concerns. We are here to help YOU, so you should never feel the need to dance around any subject with your pelvic floor therapist!

• Every session will be working internally.
  • There will never be any point in time that an internal assessment or work is required. We strive to make sure each patient knows that they are in the driver’s seat for every session they have with us. If you are comfortable or hoping to have internal work to address your problems, great! We’ll be sure to address that. Not comfortable having any internal work done at any time? Great! We’ll find other ways to help you along this journey. There are always options for how we proceed with each session, and the most important part of this process is your comfort and goals. NEVER feel any pressure to do a treatment you are not comfortable with.

• Everyone who has leakage needs to do Kegels.
  • There is a time and a place for Kegels, but they are not for everyone. For more information on this topic, please see our previous blog post about Kegels!

• It’s normal for women to leak after having kids/as you get older.
  • While it may be common, please do not accept this as your new normal! There are things you can do to address this, and we would love to help.

• The speculums at the OBGYN hurt. Will pelvic PT feel like that?
  • Our goal is never to have someone leave here with increased pain. If we are doing internal therapy, we take a gentle approach to reduce tension and discomfort at your tolerance and comfort level, and will not be using a speculum.

• I’m going to be having surgery to fix the problem, so I don’t need pelvic PT.
  • While surgery can help with some issues, studies have shown a reoccurrence of prolapse and other issues down the line if no changes are made to your lifestyle, pressure management, and strength. Physical therapy can be a great tool to prevent future problems and aid in the recovery process.

• It is painful to have sex, but that’s normal…right?
  • Intercourse should not be painful. If you are experiencing pain, there may be underlying muscle guarding and tension creating this discomfort. Pelvic floor dysfunction and physical therapy can help you resolve this. (Same thing if you have pain inserting a tampon or from the speculum at your OBGYN!).

Not seeing the question or concern you have? Send us an email, give us a call, or stop by to see us. We offer free 10-minute phone consultations and 30-minute assessments with one of our pelvic floor physical therapists to discuss your specific needs and help figure out your next steps!