Category Archives: Find a Pelvic PT

Pelvic Floor Safe Options for Fitness

Exercise has so many incredible benefits for overcoming pain, optimizing cardiovascular health, and facilitating psychological well-being. Unfortunately, for many struggling with pelvic floor dysfunction (whether it is in the form of pelvic pain, urinary/bowel dysfunction, or pelvic organ prolapse), thoughts of exercise and fitness are often accompanied by fear. Fear that moving incorrectly will lead to a worsening of their symptoms. Fear of a set-back. Fear of creating a new problem. Finding an exercise program that will not only be safe, but actually aid in a person’s recovery and pelvic floor health is a fine art. Seeing a skilled pelvic floor physical therapist can be a good step in finding an individualized exercise program, but many may not have the luxury of working with a professional.

Recently, I did some research to help a few my patients find on-demand options for guided fitness that were pelvic floor friendly. I am grateful to have such an incredible community of pelvic health professionals to learn from and learn with, and I wanted to share these fantastic resources with you here. As always, please know that what works well for one person may not work well for another, thus, an individualized assessment is always the best option to determine the most appropriate exercise program for you.

For those with pelvic pain or pelvic floor tension (often the case in cases of pelvic pain, constipation, overactive bladder):

For those with pelvic floor weakness (often the case–but not always! in situations like urinary incontinence, pelvic organ prolapse, diastasis rectus, fecal incontinence):

  • Mutu System: This is an excellent post-partum recovery program. Very helpful for those with pelvic floor weakness or diastasis rectus after having a baby. This is often my “go-to” for people having these problems that are unable to travel to see a pelvic PT. She does a great job at encouraging appropriate referral for further evaluation as well.
  • Fit2B: This is an online program with options for purchasing specific programs or for membership. It has a postpartum series, diastasis recti series, prenatal workshop, and foundational courses. I have had patients use this program who really enjoyed it.
  • The Pelvic Floor Piston: Foundation for Fitness by Julie Wiebe: Julie has an excellent course for individuals with pelvic floor dysfunction that incorporates education, exercises, as well as strategies for movement. It is a self-paced 90 minute video.
  • Your Pace Yoga by Dustienne Miller: Dustienne has expanded her video library to include videos such as “Optimizing Bladder Control” which includes sequences to support pelvic floor engagement through yoga.
  • Creating Pelvic Floor Health with Shelly Prosko: Part B Pelvic Floor Muscle Engagement. “40 minute practice that includes engagement of the pelvic floor muscles with various mindful movements and yoga postures integrated with the breath pattern.” Shelly was kind enough to offer blog viewers 10% off her combined package using the discount code: ClientDiscount10
  • FemFusion Fitness by Brianne Grogan: Brianne has an excellent video series (free too!) on youtube called, “Lift” Pelvic Support. This series includes a progression for safe progression through strengthening to better support the organs in the pelvis.
  • Pelvic Exercises by Michelle Kenway: Michelle has done excellent work creating videos and ebooks on safe exercise progressions for pelvic floor muscle weakness, prolapse, bowel dysfunction and surgical recovery. Check out her excellent videos here.

I hope these resources are helpful! Did I leave anything out? If you have other wonderful home exercise options that are “pelvic floor friendly” please let me know in the comments below!

~Jessica

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Finding a Pelvic PT

Now, before I get started, I have to say that there are many, many websites/blogs with information on how to find a pelvic PT. But, I felt it necessary to have a post here so that people reading this site who needed a pelvic PT have a quick resource to understand how best to find one, and how to “shop around” and know that the person he or she is seeing is skilled. I hope it is helpful to someone at some point! So, once you have determined you would like to see a Pelvic PT or a Women’s Health PT, how do you find one? 

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Databases and PT Locators: 

There are two main PT locators for Pelvic Physical Therapists and they are: The American Physical Therapy Association’s “Find a PT”  and Herman & Wallace Pelvic Rehabilitation Institute’s Practitioner Directory. The APTA’s directory requires an APTA membership and H&W’s is open to any practitioner. The benefit of these directories is that they will help you locate a practitioner nearby and will provide information on any credentials or areas of specialty that person has designated.  The limitations are of course that there is no guarantee that a person listed is skilled in your specific need, so you will have to do a little more work from here. The APTA’s directory does provide a space for the PT to put more practice information, etc–so you get a little more information there.

Ask a friend…or the mafia: 

Social media is amazing and has truly revolutionized healthcare. Now, patients are really able to have experts at their fingertips with facebook, twitter, linkedin etc. Asking for a personal recommendation can be a great way to find a skilled PT. Patient groups online are also great resources for finding someone skilled in your particular need.

The #pelvicmafia is a twitter community of pelvic PTs who are truly doing great things to advance patient care, share research, and improve practice patterns across the board. Feel free to ask us for a recommendation by tweeting #pelvicmafia after your question. If we know of someone skilled living near you, we will be more than happy to share!

Also, know that most pelvic PTs are happy to help you if you ask! I have gotten several random phone calls from patients living in different areas, and I am always happy to give a recommendation if I have one! Find a reputable clinic anywhere in the US, and most PTs will be happy to do the same!

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Finding the right PT for you: 

Once you locate a PT, you’ll want to reach out and talk with her to make sure she is a good fit for you. First, what’s in a name? There are a few specializations/credentials you may need to be aware of.  Let’s go through the basics:

  • Entry-level degree- BS, MSPT, or DPT: The first few letters behind the PT’s name basically just give you some information on when that person received his or her initial degree. A while back, becoming a physical therapist just required a bachelor’s degree (4 years of study)–then it became a master’s degree (6 years of study)–then became a doctorate (7 years of study) ~ 10 years ago. That being said, many people who originally had a BS or MS have gone on to receive additional education to attain a transitional doctorate degree.
  • WCS (Women’s Health), OCS (Orthopedic), SCS (Sports), etc. Clinical Specialists: These letters will be behind someone’s name who has either 1) completed a residency in that specialty and passed a written examination or 2) had 2000 hours of experience within that specialty, completed a case study reviewed by a board, and passed a written examination. The current field of women’s health includes not just pelvic floor disorders in women and children, but also includes evaluation and treatment of breast cancer related musculoskeletal dysfunction, lymphedema, osteoporosis, fibromyalgia as well as female athletes. The WCS has been around for about 8 years (my educated guess).
  • BCIA-PMDB: This is a certification for using EMG biofeedback for pelvic floor muscle disorders through the biofeedback certification international alliance. Becoming certified requires 28 hours of education, a 4 hour personal training session and 12 hours of mentoring time reviewing 30 cases with a mentor. This also requires passing a certification exam. This has been around for a longer period of time in terms of the Pelvic specific certifications.
  • PRPC: This refers to the Pelvic Rehabilitation Practitioner Certification through Herman & Wallace. This test is offered to other health care practitioners as well, but of note requires  2000 hours of patient care and a written exam to attain. This certification is specifically focused on treating pelvic floor disorders and has only been around for about 1 year.
  • Other letters: I could spend quite a chunk of time defining all of the letters out there and still probably would miss quite a few!! Fellowships, certification programs, and even some continuing education courses will assign letters that a person can put after his or her name. I recommend looking at those letters, then typing them into google and finding out what they mean and whether they apply to you.

After you have decoded the PT’s name, ask about any continuing education the PT has had after graduation. This will give you insight into how that person has chosen to advance his or her education. In my mind, this is one of the most important pieces for many reasons.

  • Most entry-level programs have minimum to no training included on evaluating and treating pelvic floor dysfunction. I graduated from Duke University which has more training than most–but even that only included a few lectures and a short elective course. That being said, most Pelvic PTs end up being trained while on internship, residency or after graduating from school via continuing education courses.
  • The largest continuing education training programs are the APTA Section on Women’s Health (SOWH) and Herman & Wallace Pelvic Rehabilitation Institute. I am involved with both, have taken courses through both, and think both are wonderful programs! Both include training for internal examinations and treatments which is so important and both have plenty of lab assistants to help make sure participants know what they are doing. I lab assist for H&W and I am on the Educational Review Committee for SOWH. SOWH also has a certification option called “CAPP” for both Pelvic and Obstetrics to indicate a person has gone through the series of courses and passed a reviewed case study. Note: Although not all pelvic floor dysfunctions require internal vaginal or rectal treatment, I do believe that having formal training in this is important for a PT who is specifically treating pelvic floor disorders.
  • Internships: Some students who are interested in pursuing pelvic health or women’s health will choose to do internships working with clinicians in those fields. I did this as a student and worked with Darla Cathcart, PT, DPT, WCS in Shreveport, LA for 5 months (She’s awesome!) . I have taken 2 students from Duke University myself. These internships are a great way to learn and give you information that the person you are seeing has had one-on-one training.
  • Residencies: These are 1-year programs focused on treating women’s health physical therapy. There are less than 10 of these in the country, so if your PT has done a residency, it shows a strong commitment to education, in my opinion.
  • Other Continuing Education: I really think this is so important so cannot emphasize this enough. There are so many options for education including courses, conferences and national meetings. Feel free to ask the PT to see his or her resume or CV to see which courses have been attended and how they fit with what you need.

Hopefully this information helps you shop around and find a PT who fits what you need! Please do not feel lost or hopeless if you cannot find a pelvic PT who lives close by– the unfortunate thing is that there are way more people who need pelvic PTs then there are currently PTs to treat them! In the field of physical therapy, it is one of the “newer” specialties, so we definitely have room to grow! If you find a PT who may not have the training you desired– don’t fret! All of us had to begin somewhere, and there is so much to be said for a passionate, dedicated person who desires to learn! I have known PTs with less than 1 year of pelvic experience who I would easily refer to because of their passion and dedication alone!