What to look for in a Pelvic Health Physical Therapist
Like I wrote in my last post, the pelvic floor is all the rage nowadays!
So let’s say that you’ve realized you have a pelvic health concern (which can include symptoms such as urinary incontinence, pain with intimacy or pain with pelvic exams, frequent and/or strong urinary urges, just to name a few) and are ready to make an appointment to see a Pelvic Floor Physical Therapist.
Now how do you decide who to see? After all, you’ll be talking to them about deeply personal & vulnerable topics so you want to be sure they’re someone you can trust. You also want to get the results you’re looking for (aka resolving your pelvic symptoms) so you want to make sure they know their stuff! But reading practitioners’ bios on websites can sometimes be overwhelming with a lot of medical jargon and alphabet soup. So what should you be looking for? Here are a few things I’d recommend keeping in mind as you search for a provider.
A great Pelvic Physical Therapist should be:
Someone who has received training to perform internal exams
The industry standard for assessing the pelvic floor muscles is an internal pelvic exam. Of course there are some reasons why a clinician may decide against performing an internal exam (and the patient always has the final word - you can decline one if you aren’t comfortable with it), but my point here is that a Pelvic Floor Physical Therapist should be trained to perform internal pelvic exams.
Unfortunately, with the growing popularity of pelvic health, some PTs have begun to offer “pelvic floor therapy” without having gone through the appropriate training to do so. Many unsuspecting patients wind up in these offices, don’t find the results they’re looking for, then feel as though pelvic floor therapy won’t work for them when this couldn’t be further from the truth! You deserve the standard of care, which is someone trained to fully assess the pelvic floor muscles.
When vetting a Pelvic Floor Physical Therapist, you can either ask on the phone whether or not they are trained to perform internal exams, or you can look for at least Level 1 training from Herman & Wallace or the APTA (the two certifying bodies in our profession) when reviewing someone’s qualifications. That is the bare minimum course that someone needs to have taken in order to specialize in the pelvic floor. (And ideally, a practitioner will have taken multiple pelvic health courses.)
Someone who specializes in pelvic health
And speaking of specializing…you deserve someone who specializes in the pelvic floor! You would think this would be a given in a Pelvic Floor Physical Therapist but just as I wrote above, there are a lot of people who are trying to capitalize on the newfound popularity of pelvic health. Unfortunately, what this can sometimes mean is that someone offers pelvic health as an aside when that’s not their true passion or focus.
While this sometimes works out for simpler cases, what I’ve seen before in my practice is that people who have had chronic symptoms or have a complex case will often not get better while working with a PT who doesn’t specialize in pelvic health. This wastes time and money, not to mention it may lead the patient into thinking that pelvic floor therapy didn’t work for them, when in fact they did not receive true pelvic health care (are you sensing a theme here?). Pelvic health physical therapy is best delivered by those of us who are experts in pelvic health and who have dedicated our careers to this awesome field!
Someone who understands your goals
Okay now that we’ve got the big rocks out of the way, let’s dive into a few of the nitty gritties. Luckily, there are so many wonderful Pelvic Floor Physical Therapists out there! If someone has the above qualifications, then I encourage patients to look for a therapist who understands and can help you meet your goals.
A yogi and a runner will likely have very different goals. Likewise, a CrossFitter’s goals will be quite different than someone who has never stepped foot inside a gym. Your PT should understand your goals and outline a plan to help you meet them. That’s not to say they have to be exactly like you (I’ve treated lots of marathon runners, but have never had the desire to run a step over 5k), but they should at least understand what it takes to get you to where you want to be. For example, if you want to get back to squatting heavy, but your PT doesn’t see the value in lifting more than 10 pounds, it’s probably not going to be a good fit.
This will be a quality that you may have to feel out over the phone or during your first visit. But don’t be afraid to be up front with your therapist about what you’re hoping to get back to and see how they respond!
Someone who you’re comfortable with
Finally, you have to find someone you’re comfortable with. I can’t stress this enough. You are entrusting us with a lot of your vulnerabilities so you want someone who you can feel safe with. I know that I may not be the right fit for every patient, and that’s okay because like I wrote above, I have a lot of wonderful colleagues! I want you to feel comfortable and if for whatever reason, you don’t, then I want you to find someone who you can be comfortable with.
Pelvic health is such an intimate specialty that I think finding the right fit is even more important than it would be with a typical PT. So even if your therapist is wonderful, if you feel withdrawn around them, then you likely won’t make as much progress as you could, and we all want you to make the most progress possible! Trust me, we know the nature of our work, and we don’t take it personally.
So there you have it! My top 4 things to look for when choosing a Pelvic Floor Physical Therapist. Hope this is helpful! And if you feel like we might be the right fit and you’re local to Durham, feel free to reach out because I’d love to help you.
💜 Dr. Rachel J
