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What do you want in 2016? I want to hear from YOU!

Ok, first, I promise a real, educational post is coming this week. So, don’t fret.

In planning for 2016, I really want to help this blog be more informative and helpful to YOU my dear reader. So, I have a little favor to ask… will you pretty pretty please fill out this quick survey to let me know who you are and what you want to learn about? I promise it will take less than 2 minutes (maybe even 1 minute, if you’re fast!). It will help all of us— me, to write posts more of you are excited about… and you, to have better posts that actually meet your learning needs.

Thank you, thank you, thank you!!!! (Survey results are anonymous, FYI!)

Click here to be the most awesome blog reader ever and help me make 2016 our best year yet! 


2015 in Review! Happy New Year!

As we close 2015, I just wanted to say a huge THANK YOU to those of you who have started this journey with me to better understand pelvic health problems, pain, and really, the whole human body. It has been a wonderful blessing in my life, and a surprisingly great first year of the blog!

In this first year, we have had close to 35,000 views from 145 different countries, and that is so very humbling and exciting! I have really enjoyed learning, writing, and journeying with you all, and I am thrilled for some super fun new content to come in 2016 (hint: video editing software was on my Christmas list!)

So, to re-cap, as we tend to do at the end of a year… our top 5 blog posts of 2015 were:

#5 Is Running Bad for a Woman’s Pelvic Floor?

#4 A Pain in the Tail…bone (Part 2- Treatment)

#3 Pelvic Floor Problems in the Adult Athlete: Pelvic Floor Muscle-Related Pain

#2 A Pain in the Tail…bone (Part 1- What is it? How does it happen? How does it feel?) 

annnndddd number 1, without a contest…….Druummmrolllllll…..

#1 6 Reasons Why the Diaphragm may be the Coolest Muscle in the Body

2015 is a wrap! I’ll see you in the NEW YEAR!!

~ Jessica

Why get Pelvic PT first? And, join me for a webinar Thursday 12/10!

If you didn’t know, December 1st was a day that all PTs came together to share with the public all of the benefits of seeking PT! My colleague, Stephanie Prendergast, founder of the Pelvic Health and Rehabilitation Center in California, wrote an amazing blog post on why someone should get pelvic PT first. I thought it was great (as you know…I post lots of Stephanie’s stuff), and Stephanie gave me permission to re-blog it here. So, I really hope you enjoy it. If you aren’t familiar with Stephanie’s blog, please check it out here. You won’t regret it. 

On another note, I will be teaching a live webinar Thursday 12/10 on Pelvic Floor Dysfunction in the Adult Athlete. I really hope to see some blog followers there! Register for it here.  

Now… enjoy this great post by Stephanie. ~ Jessica 

Why get PT 1st? Here are the Facts. By Stephanie Prendergast


Vaginal pain. Burning with urination. Post-ejaculatory pain. Constipation. Genital pain following bowel movements. Pelvic pain that prevents sitting, exercising, wearing pants and having pleasurable intercourse.

When a person develops these symptoms, physical therapy is not the first avenue of treatment they turn to for help. In fact, physical therapists are not even considered at all. This week, we’ll discuss why this old way of thinking needs to CHANGE. Additionally, we’ll explain how the “Get PT 1st” campaign is leading the way in this movement.

We’ve heard it before. You didn’t know we existed, right? Throughout the years, patients continue to inform me the reason they never sought a physical therapist for treatment first, was because they were unaware pelvic physical therapists existed, and are actually qualified to help them.

Many individuals do not realize that physical therapists hold advanced degrees in musculoskeletal and neurologic health, and are treating a wide range of disorders beyond the commonly thought of sports or surgical rehabilitation.

On December 1st, physical therapists came together on social media to raise awareness about our profession and how we serve the community. The campaign is titled “GetPT1st”. The team at PHRC supports this campaign and this week we will tell you that you can and should get PT first if you are suffering from a pelvic floor disorder.

Did you know that a majority of people with pelvic pain have “tight” pelvic floor muscles that are associated with their symptoms?

Physical therapy is first-line treatment that can help women eliminate vulvar pain

Chronic vulvar pain affects approximately 8% of the female population under 40 years old in the USA, with prevalence increasing to 18% across the lifespan. (Ruby H. N. Nguyen, Rachael M. Turner, Jared Sieling, David A. Williams, James S. Hodges, Bernard L. Harlow, Feasibility of Collecting Vulvar Pain Variability and its Correlates Using Prospective Collection with Smartphones 2014)

Physical therapy is first-line treatment that can help men and women with  Interstitial Cystitis

Over 1 million people are affected by IC in the United States alone [Hanno, 2002;Jones and Nyberg, 1997], in fact; an office survey indicated that 575 in every 100,000 women have IC [Rosenberg and Hazzard, 2005]. Another study on self-reported adult IC cases in an urban community estimated its prevalence to be approximately 4% [Ibrahim et al. 2007]. Children and adolescents can also have IC [Shear and Mayer, 2006]; patients with IC have had 10 times higher prevalence of bladder problems as children than the general population [Hanno, 2007].

Physical Therapy is first-line treatment that can help men suffering from Chronic Nonbacterial Prostatitis/Male Pelvic Pain

Chronic prostatitis (CP) or chronic pelvic pain syndrome (CPPS) affects 2%-14% of the male population, and chronic prostatitis is the most common urologic diagnosis in men aged <50 years.

The definition of CP/CPPS states urinary symptoms are present in the absence of a prostate infection. (Pontari et al. New developments in the diagnosis and treatment of CP/CPPS. Current Opinion, November 2013).

71% of women in a survey of 205 educated postpartum women were unaware of the impact of pregnancy on the pelvic floor muscles.

21% of nulliparous women in a 269 women study presented with Levator Ani avulsion following a vaginal delivery (Deft. relationship between postpartum levator ani muscle avulsion and signs and symptoms of pelvic floor dysfunction. BJOG 2014 Feb 121: 1164 -1172).

64.3% of women reported sexual dysfunction in the first year following childbirth. (Khajehi M. Prevalence and risk factors of sexual dysfunction in postpartum Australian women. J Sex Med 2015 June; 12(6):1415-26.

24% of postpartum women still experienced pain with intercourse at 18 months postpartum (McDonald et al. Dyspareunia and childbirth: a prospective cohort study. BJOG 2015)

85% of women stated that given verbal instruction alone did not help them to properly perform a Kegel. *Dunbar A. understanding vaginal childbirth: what do women understand about the consequences of vaginal childbirth.J  Wo Health PT 2011 May/August 35 (2) 51 – 56)

Did you know that pelvic floor physical therapy is mandatory for postpartum women in many other countries such as France, Australia, and England? This is because pelvic floor physical therapy can help prepartum women prepare for birth and postpartum moms restore their musculoskeletal health, eliminate incontinence, prevent pelvic organ prolapse, and return to pain-free sex.

Did you know that weak or ‘low tone’ pelvic floor muscles are associated with urinary and fecal incontinence, erectile dysfunction, and pelvic organ prolapse?

Physical Therapy can help with Stress Urinary Incontinence

Did you know that weak or ‘low tone’ pelvic floor muscles are associated with urinary and fecal incontinence, erectile dysfunction, and pelvic organ prolapse? 80% of women by the age of 50 experience Stress Urinary Incontinence. Pelvic floor muscle training was associated with a cure of stress urinary incontinence. (Dumoulin C et al. Neurourol Urodyn. Nov 2014)

30 – 85 % of men develop stress urinary incontinence following a radical prostatectomy. Early pelvic floor muscle training hastened the recovery of continence and reduced the severity at 1, 3 and 6 months postoperatively. (Ribeiro LH et al. J Urol. Sept 2014; 184 (3):1034 -9).

Physical Therapy can help with Erectile Dysfunction

Several studies have looked at the prevalence of ED. At age 40, approximately 40% of men are affected. The rate increases to nearly 70% in men aged 70 years. The prevalence of complete ED increases from 5% to 15% as age increases from 40 to 70 years.1

Physical Therapy can help with Pelvic Organ Prolapse

In the 16,616 women with a uterus, the rate of uterine prolapse was 14.2%; the rate of cystocele was 34.3%; and the rate of rectocele was 18.6%. For the 10,727 women who had undergone a hysterectomy, the prevalence of cystocele was 32.9% and of rectocele was 18.3%. (Susan L. Hendrix, DO,Pelvic organ prolapse in the Women’s Health Initiative: Gravity and gravidity. Am J Obstet Gynecol 2002;186:1160-6.)

Pelvic floor physical therapy can help optimize musculoskeletal health, reducing the symptoms of prolapse, help prepare the body for surgery if necessary, and speed post-operative recovery.

Did you know….

In many states a person can go directly to a physical therapist without a referral from a physician? (For more information about your state:

You need to know….

Pelvic floor physical therapy can help vulvar pain, chronic nonbacterial prostatitis/CPPS, Interstitial Cystitis, and Pudendal Neuralgia. (link blogs:,

Pelvic floor physical therapy can help prepartum women prepare for birth and postpartum moms restore their musculoskeletal health, eliminate incontinence, prevent pelvic organ prolapse, and return to pain-free sex:

Early pelvic floor muscle training hastened the recovery of continence and reduced the severity at 1, 3 and 6 months in postoperative men following prostatectomy. (Ribeiro LH et al. J Urol. Sept 2014; 184 (3):1034 -9). (Link blog:

A study from the University of the West in the U.K. found that pelvic exercises helped 40 percent of men with ED regain normal erectile function. They also helped an additional 33.5 percent significantly improve erectile function. Additional research suggests pelvic muscle training may be helpful for treating ED as well as other pelvic health issues. (link blog:

….that you can and should find a pelvic floor physical therapist and  Get PT 1st.

To find a pelvic floor physical therapist:

American Physical Therapy Association, Section on Women’s Health:

International Pelvic Pain Society:


Stephanie Prendergast, MPT

stephanie1-150x150Stephanie grew up in South Jersey, and currently sees patients at Pelvic Health and Rehabilitation Center in their Los Angeles office. She received her bachelor’s degree in exercise physiology from Rutgers University, and her master’s in physical therapy at the Medical College of Pennsylvania and Hahnemann University in Philadelphia. For balance, Steph turns to yoga, music, and her calm and loving King Charles Cavalier Spaniel, Abbie. For adventure, she gets her fix from scuba diving and global travel.

5 Tips to Reduce Pain During Sexual Intercourse

A few years ago, I participated in a Women’s Health Fair with my pelvic health team from Greenville, SC:

fuzzy--but a rocking team none-the-less! Proaxis still has a rockin' WH team, so if you need help and live in Greenville, SC, check them out!

fuzzy–but a rocking team none-the-less! Proaxis still has a rockin’ WH team, so if you need help and live in Greenville, SC, check them out!

If you notice in the photo, we had a “Test Your Women’s Health IQ” game at our booth. The premise: 10 True/False questions… with an awesome prize if you get them all right. So, we had a group of about 4 or 5 guys (mid 20s-30s, all working for some tech company, I believe) come up to our booth, and confidently ask to take our test. The test was going pretty smoothly, and they were actually doing surprisingly well….until we reached this question:

True or False. It is normal for women to have discomfort/pain during sexual intercourse.

The guys chatted among themselves briefly, then confidently said, “Yeah, that one’s true… not always, but sometimes, yeah.”

Seriously guys?? In that moment, I felt a mixture of annoyance that there really are so many people out there who believe that women should have pain during sex, and also a whole lot of compassion for the poor women who may or may not have these guys as sexual partners.

Unfortunately, I hear this misconception frequently. Pain during sexual activity is fairly common (up to 1 in 5 women have pain during sex!), and somehow, women became convinced that this is “normal” and they just have to “deal with it.” But, I’m hear today to tell you that is not true!! There really are so many things that can cause pain or discomfort during sexual activity, and there are so many things that you can start today to help!

First things first, if you or your partner is having discomfort or pain during sexual activity, it is very important to be medically evaluated. Pain can be caused from urinary tract or vaginal infections, STDs, ovarian cysts, low estrogen, endometriosis, vulvodynia/vestibulitis, overactive, tender pelvic floor muscles**, abdominal scar immobility (yes, that c-section can play a role!)…and many other things! So, your first step is to call your medical doctor and get evaluated. I know that for some people, talking with a health care provider (HCP) about sexual problems can be very uncomfortable–but just remember, we’re professionals. We hear these things every day, and guess what? It’s very very unlikely that you will surprise or shock us by what you say. So, try to get past the embarrassment you may feel, and talk with your HCP. I think you’ll be very very happy you did.

**See note at the bottom of this post

Once you have been evaluated , here are 5 tips to help to improve pain during sexual intercourse!

1.Communication is Key. Yes, between you and your health care provider–but more importantly, between you and your sexual partner. I often treat men and women who will tell me that their partners have no idea that they are having discomfort during sex. It’s easy for people to see sexual pain as a “me” problem–but if you are having pain with sexual activity with a partner–it really is an “us” problem. Approaching the problem together can be so so helpful! It tends to be much less isolating, and often, people will find that they can have more enjoyable sex with better intimacy in the process.

2.Lubrication. Lubrication. Lubrication. There is absolutely no shame in using lubricant during sex. In fact, I recommend it for everyone! Using a quality lubricant can reduce pain significantly! Typically, I recommend a water-based lubricant like Slippery Stuff or Sliquid–but I have had good success with my clients using Coconut Oil or even Olive Oil (be careful if using condoms though or if you are prone to infection). Several gynecologists I know especially recommend a natural oil for women who have vulvodynia or vestibulitis/vestibulodynia.

3.If At First You Don’t Succeed…Try A Different Position. Seems pretty basic, right? But many couples will get in habits of using the same positions, and sometimes, position alone can make all the difference in the world. A different position changes how anatomy interacts, so depending on why you are having pain, a new position may be much more comfortable. If you’re having pain while on top, try switching to the bottom or on your side. And, pillows are your friend. Use them to support your legs or back to help you be more comfortable.

4.Foreplay. Pain can really impact the mood. Many times, couples who are struggling with pain during sex will find that sexual desire and arousal become significantly impacted. Setting the mood, and making time for romance and foreplay can help to improve arousal. Arousal is really so important as there will be more natural lubrication and overall body relaxation which should help to improve the experience.

5.Don’t be afraid to ask for help! These little tips are meant to be helpful suggestions–but they won’t necessarily be a fix for many people who are having pain! If you or someone  you know are struggling with pain during sexual activity, it really is important to get some help! Pain during sexual intercourse should not be something you have to “just deal with.” I don’t care if you’ve 1) had a baby 2)have a partner who happens to be larger 3) have some dryness as you’ve gotten older 4) have any other excuse for why YOU having pain is normal. Pain is NOT normal. Take the first step–do something about it today!

There are so many wonderful resources out there for people who are experiencing pain during sexual intercourse! Here are a few books I recommend:

Sex Without Pain, by Heather Jeffcoat, PT

Excellent resource by Heather–who happens to be a Duke alum! This book is a self-treatment guide for those experiencing pain with sexual activity.

 To Bed Or Not To Bed, by Steve and Vera Bodansky

This book is one I often recommend for those struggling to experience pleasure with sexual activity. Although explicit (**warning), this book does provide step-by-step recommendations to make sex more pleasurable– and also covers other information on romance, foreplay, etc.

Reviving Your Sex Life After Childirth by Kathe Wallace, PT,

This book recently came out about a year ago, and is based on tons of wonderful research by my friend and colleague Kathe Wallace. Kathe has taught pelvic floor education for professionals for years, and this book is awesome!

As this is my first post dedicated to sexual dysfunction, this post is just scratching the surface of a HUGE topic! What else should we learn about? Let me know in the comments below! 

**Yes, tender pelvic floor muscles can significantly contribute to pain or discomfort during sexual activity. Remember, the pelvic floor muscles stretch to allow for penetration and contract to provide pleasure. If the muscles are tender, hypervigilant, or overactive, they can contribute to pain or discomfort. If you believe your muscles may be a factor in the pain you are experiencing, it is definitely worth your while to seek out evaluation and treatment by a physical therapist trained in treating pelvic floor muscle problems. Give me a call if you live in the Atlanta area, or feel free to shoot me a message if you need help finding someone near you! 

Listen to Jessica’s podcast on Pelvic PT & Join us at our open house this SATURDAY 4/11!

Several weeks ago, I was honored to be interviewed with Ivy Radio on pelvic floor physical therapy! We had a few phone issues, but overall it went very well!

In the podcast, we discuss:

  • What the pelvic floor is
  • How problems happen with the pelvic floor
  • Common diagnoses treated in Pelvic PT
  • What you should expect in examination and treatment
  • Barriers involved in men and women seeking help
  • How to find a Pelvic PT

I hope you enjoy the podcast!! Don’t be too hard on me… We had some phone issues in the middle that made me fumble a bit!

Also- I would like to formally invite all of you to our official open house this Saturday April 11th, 11am-2pm!! I would love to meet anyone local and show you our beautiful facility!! Hope to see you there!

Does Sleep Really Matter for Chronic Pelvic Pain?

I have been so fortunate to collaborate with fantastic colleagues over the years of my journey in pelvic health. Tracy Sher, MPT, CSCS is an inspirational and compassionate practitioner, educator and advocate of all things related to pelvic health. She owns a fantastic clinic in Florida and runs the popular educational blog, I first wrote for Pelvic Guru in 2013 with 10 common misconceptions of pelvic PT (, and today, I am being featured again with this post on sleep and chronic pelvic pain. I hope you enjoy the post! For those of you unfamiliar with Tracy Sher, I strongly recommend following Pelvic Guru at as well as on facebook! Tracy regularly posts amazing articles, blogs, and resources! Let me know what you think!!

Pelvic Guru

Does sleep really matter for chronic pelvic pain?

Guest post by Jessica Reale, PT, DPT, WCS

Did you know that most people will spend about 22 years of their lives sleeping? Sleep is one of the most basic human needs and is at the very base of Maslow’s Hierarchy of Human Needs right next to eating, sex and toileting. (Can I just say how unfair it is that chronic pelvic pain often influences all of these things!) Inadequate sleep has become a major health crisis and the Institute of Medicine (IOM) estimates that close to 50-70 million Americans chronically suffer from a disorder of sleep and wakefulness.

maslow Image from:

Inadequate sleep has been shown to negatively impact the body and is related to (IOM):

  • Obesity in adults and children
  • Diabetes and impaired glucose tolerance
  • Cardiovascular disease and hypertension
  • Anxiety symptoms
  • Depressed mood
  • Alcohol use

Sleep has incredible benefits for…

View original post 1,070 more words


Greetings and welcome to my professional website & blog!

I hope that you will find the information on this blog to be enlightening, thought-provoking, educational, and hopefully occasionally inspiring :)! I am creating this blog for both personal and professional reasons–both to help myself process information, learn more, and thus help my patients more, and also to spread awareness about issues related to pelvic health and thus hopefully create hope for many men, women, and children struggling with these problems.

The mission of this blog is to motivate, educate and encourage all people to adopt healthy movement patterns and attain optimal health of the whole body. Of course, my heart lies in the pelvis, but the pelvis lies in the body and thus, I hope to spread awareness regarding the importance of treating the whole person, not simply a single body part. My hope is that this blog will be a helpful tool for both individuals and professionals in better understanding how to care for the pelvis within the body as a system.

I also hope this can eventually become a forum for positive, helpful conversation and intellectual debate. I hope to create an atmosphere of learning where patients and professionals alike can grow together to work as a team to improve current healthcare practices. I also plan to use this blog to share information from courses, conferences and literature I learn from to hopefully assist in educating the community as a whole.

Please let me know if there are any topics you are interested in, and I will do my best to address them! I hope we can all enjoy learning and growing together!