At Alpine Physical Therapy, we are doing our best to navigate the rapidly changing environment that the coronavirus pandemic is creating. Our priorities lie in the continued health and safety of our patients, staff and the central Oregon community. https://alpinephysicaltherapy.com/covid19

Specialized pelvic health for men and women

Pelvic pain and dysfunction may not be your favorite topic of conversation (we understand!), but it is certainly vital to your quality of life.

Pelvic Floor Health FAQ

1). What should I expect on my first visit with a Pelvic Floor Therapist?

On your first visit, you will have a 60 minute one-on-one session with your physical therapist. A thorough medical history will be performed where we will discuss how your current condition is affecting your quality of life. From this discussion, you and your therapist will set meaningful goals and make a plan to meet them. Your therapist will also take time to explain basic anatomy of the pelvic floor to help you better understand why you are experiencing symptoms. The physical exam will include an external pelvic floor exam as well as an exam of your spine, hips, pelvis, breath and general movement. If deemed appropriate, your therapist will perform an internal exam of the pelvic floor. All of our pelvic floor therapists have advanced training to perform internal assessments in order to assess the strength, coordination and endurance of the pelvic muscles. This is a very gentle and informative exam that is performed with your comfort in mind. With this full assessment we are better able to piece together the contributing factors to your condition and make a plan. Sometimes only an external assessment may be utilized if you are currently pregnant, less than 6 weeks postpartum, or simply uncomfortable with the idea of an internal assessment. Your pelvic floor PT will also take time to discuss lifestyle habits and may give you diaries or logs to track the daily rituals and habits that can commonly contribute to pelvic floor dysfunction.

2). Am I going to have to have a pelvic exam?

Whether it is external or internal, your therapist will make a recommendation as to which will be most appropriate. Our pelvic floor exams are different than the typical pelvic exam you may have at your gynecologist or general practitioner’s office. Most people are pleasantly surprised by the comfort of our exams. In its simplest form, a pelvic assessment evaluates the function, coordination, and strength of the pelvic floor muscles. We observe the tissue quality and overall health of the pelvic floor. If you have reservations regarding having an internal assessment, you and your PT can talk about other options or defer to a time when you both feel it is more appropriate.

3). How is Pelvic Floor Therapy different from regular PT?

Pelvic floor physical therapy doesn’t differ from regular physical therapy in its principles, strategies and outcomes. As physical therapists we are movement, strength, coordination and muscle experts. We have been trained to assess the strength, endurance, and coordination of skeletal muscle and the biomechanics of the body.  All of our pelvic floor physical therapists have received extensive post-graduate education to take that same knowledge and apply it in a very specific ways to the pelvic floor. Just like any muscle in the body the pelvic floor muscles respond really well to manual therapy, therapeutic exercises, and neuromuscular re-education. In addition to all of this, pelvic floor physical therapy also takes into consideration lifestyle and daily habits that play a role into your pelvic floor’s function. Pelvic floor PTs evaluate daily habits via a bladder or bowel log and sometimes a food log.

4) How long should I expect to need treatment?

Every person is different. Every issue and individual responds at a different rate to treatment therefore making this a difficult question to answer. Generally, we see patient’s one time per week for the first month then reduce visits to once every two weeks, for a total of 6 to 8 visits. However, visits can range to as many as 16. You and your therapist will work together to get an initial estimate in the first few visits and will update this time frame as appropriate throughout your time of rehab.

5) What is the pelvic floor and what is pelvic floor dysfunction?

The pelvic floor refers to a group of muscles that lies at the bottom of the pelvis. This “sling” of muscles attaches from your pubic bone to your tailbone. The primary function of the pelvic floor is to maintain continence by holding back urine, gas, and stool. They also play a role in sexual function and appreciation, as well as play an important role in core stability of our spine, pelvis and hips.  If functioning efficiently, a person is continent and free of sexual dysfunction and pain. Unfortunately, like any muscle in the body, the pelvic floor muscles can start behaving incorrectly. A person may start experiencing leakage, constipation, pelvic pain, sexual dysfunction, low back pain, tailbone pain, hip pain or pelvic organ prolapse. We refer to this as pelvic floor dysfunction. Most often people think this is a strengthening issue, however this is not always the case. Roughly half of our patients that have pelvic floor dysfunction have pelvic floors that are too tight and non-relaxing.

6) What is biofeedback?

At Alpine, we use many different modalities to help patients strengthen, relax, and regain control of their pelvic floor muscles. One method that we frequently use is called Biofeedback. Biofeedback can be performed in many ways, however it usually refers to a machine that uses sensors and a computer screen to relay information about pelvic floor activity in real time through audio and visual feedback. This machine can be another avenue within PT for your body to learn the correct way to perform a pelvic floor contraction (aka kegel) with the aim of increasing your ability to perform them correctly and independently.

7) I've tried Kegels and it didn't help. Should I still try Pelvic Floor Therapy?

We get this question all the time and the answer is always yes! Why? Studies show that 70% of women with pelvic floor dysfunction perform a kegel incorrectly with verbal instructions alone. Many individuals (men, women, and children) adopt incorrect muscle patterns and compensations. With our expertise we can help you find your pelvic floor muscles and ensure that you are using them in coordination with the rest of your body.

8) Do you treat men?

Yes! Men have pelvic floors too. Enlarged prostates and pelvic surgeries can be traumatizing to the pelvic floor muscles which can lead to leakage and/or pain in the penis, testes, and scrotum. At Alpine, all of our pelvic floor therapists have special education to assess and treat the pelvic floor in a way that is specific to the male patient.

9) Do you treat children?

Yes! Common diagnoses seen in the pediatric population include but are not limited to incontinence, bed wetting, voiding dysfunction, and constipation. Parents are always present during evaluation and treatment. Biofeedback can be a very helpful tool in this population and is often used. As a general rule, internal pelvic floor assessments are not performed on children under the age of 18.

10) My doctor referred me to physical therapy for constipation. How can physical therapy help with constipation?

Refer to the answers of question number 3 and 5. There is typically a combination of contributing factors to constipation that include muscular coordination and daily habits. We evaluate them within pelvic floor rehab to help many people improve (and sometimes resolve) their constipation.

11) What type of pelvic floor issues do you treat?

We treat a wide variety of pelvic floor issues. Below is a brief list of what we treat:

  • Incontinence of urine, feces, and gas
  • Pelvic Organ Prolapse
  • Male and Female Pelvic Pain Syndrome
  • Incomplete emptying of the bladder
  • Constipation
  • Interstitial Cystitis and Painful Bladder Syndrome
  • Endometriosis
  • Coccydynia and rectal pain
  • Post-surgical and post-radiation pain and dysfunction
  • Pre- and postnatal pain, dysfunction

Sacroiliac Dysfunction

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Eastside Clinic
2698 NE Courtney Dr.
Suite 100
Bend, OR 97701
Westside Clinic
336 SW Cyber Dr.
Suite 107
Bend, OR 97702

Phone: 541.382.5500

E-mail: [email protected]

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Molly Nelson, DPT-CLT

Molly grew up in Red Wing, MN and came to physical therapy after a PT helped her return to running following a cross country injury. A lifelong athlete, Molly is passionate about returning fellow outdoor enthusiasts to their sport. While she enjoys working with patients of all ages and conditions, she specializes in pelvic health as well as pre- and postnatal care. Meet Molly

Mackenzie Van Loo, DPT

Mackenzie pursued further education to enhance her treatment of orthopedic conditions through the North American Institute of Manual Therapy and pelvic health conditions through Herman and Wallace, and APTA section on Women’s Health. She is an active member of the American Physical Therapy Association (APTA), an Oregon chapter member, and member of the APTA Section on Women’s Health (SOWH).  Meet Mackenzie

Diana Spring, DPT

Diana brings extensive manual therapy training and a diverse treatment perspective to the Women’s Health program at Alpine. She specializes in the treatment of pelvic health issues in men, women, and children. She’s an avid cyclist and came to physical therapy after working as an organic baker and in an Alaskan fishery. Meet Diana

Emily Dutton, DPT

Emily has a strong interest in rehabbing general orthopedic injuries, pelvic floor issues, and helping the post-natal mama safely return to her prior level of activity. The core of her women’s health training is through the Herman & Wallace Institute in addition to extensive mentorship and self-study. She is passionate about helping those with incontinence, pelvic pain, and prolapse. Meet Emily

Conditions we treat

Do you urinate more than 7-8 times a day? Perhaps you “leak” when you sneeze, cough, laugh, or exercise. Or maybe you find yourself always “rushing” to the bathroom when you need to urinate.

Urinary leakage is common but never normal and is certainly no laughing matter. Nearly 60% of women between the ages of 40 and 60 experience urinary incontinence. On average, women put up with urinary leakage for 4 or more years before seeking help. One of the most effective treatment options for women’s incontinence is physical therapy.

Chronic Pelvic Pain (CPP) is pain in the pelvis, back, buttocks and/or abdomen that lasts 6 months or longer. It is a complex problem and may have several causes.

According to a study published in the January 2011 edition of the Journal of the American Medical Association65 percent of men may still experience some bladder leakage up to one year following prostate cancer surgery. You’re not alone!

Targeted therapies such as pelvic floor muscle training and bladder control strategies can reduce incontinence episodes in men by more than 50 percent following prostate-cancer surgery.

Vaginal and vulvar pain encompass several painful syndromes including Vulvodynia, Vulvar Vestibulitis, and Vaginismus. We specialize in the treatment of vulvar and vaginal pain and will be sensitive to your special needs.