Most of my patients politely inquire, “How did you decide to become a pelvic floor physical therapist?” at some point during their course of care, when what they really want to know is, “Why on earth would anyone want to be doing physical therapy in vaginas and rectums? Wouldn’t you rather just fix someone’s sprained ankle?” To be fair, I did not enter physical therapy with the intention of becoming a pelvic floor specialist. I barely knew the specialty or the need existed. I initially wanted to help people who had experienced strokes or traumatic brain injuries, and I was also very interested in people who had neurological diagnoses. I worked for a number of years as a physical therapist in the ALS Clinic at Columbia University and rotated through various specialties at the New York Presbyterian Hospital at Columbia, gaining a wide range of experiences.
Then, I got pregnant with my first son. I started experiencing shooting pain into the front of my pelvis with every step I took around 32 weeks into my pregnancy. My OB-GYN ultimately advised me to go to the emergency room because I was unsure if this was how labor would feel. After examining me, a young resident speculated that I may have separated my pubic symphysis and gave me a prescription for Percocet to treat the pain (during my pregnancy!). The resident gave me no other advice. While pregnant, I made the decision to stay away from the world of opioids, and as my pregnancy went on, the excruciating pain only got worse. It seemed there were simply no other options, whether I talked to my husband, my coworkers, my parents, my brother, my friends, my dog, my doorman, or random strangers I approached on the street. And that’s what I did, despite the fact that I was unable to move forward by even a single step. Fortunately, I eventually gave birth to a healthy boy. Unfortunately, I was in so much pain that I was unable to get out of bed.
As the weeks went on, I became more despondent. Mothers with new babies seemed to be recovering much more quickly than I was at lactation support groups, on the streets of NYC, and on magazine covers. I was afraid I must be doing something wrong because I didn’t think I’d ever get better. Someone mentioned a pelvic floor physical therapist who they thought might be helpful somewhere in the postpartum fog. At my scheduled 6-week follow-up appointment, I informed my OB/GYN of this, and she skeptically wrote me a prescription for pelvic floor physical therapy. “I felt like someone finally understood what I was going through after speaking with the physical therapist and telling her my story, and even more importantly, had a plan for how to help me,” the patient said. “.
I can still picture myself waiting for my initial evaluation at the physical therapy office among the frail older women using walkers and canes. Since becoming a physical therapist, it was the first time I had ever been a patient seeking rehabilitation. I was scared, in pain, weak, and hopeless. I immediately felt like someone finally understood what I was going through after speaking with the physical therapist and sharing my story with her. More importantly, I felt like she had a plan for how to assist me. I recall making the decision there and then that I wanted to return the favor to others that this wonderful woman had shown me.
I learned a ton about my pelvic floor and pelvic floor physical therapy over the following six months. There weren’t many people in my area who practiced this specialty, but there was obviously a need. As I recovered, I discovered that my condition’s treatment wasn’t even that difficult; it was just a matter of knowing what to do. I’ll admit that I was anxious when it came time to think about getting pregnant again because I knew that I would probably have similar symptoms to the first time. But I eventually gave birth to a second son because I knew I would be able to recover and also lessen the pain during my subsequent pregnancy. The second time wasn’t any easier, but I didn’t feel as lost as I did the first time.
I’ve since treated well over a thousand different patients with pelvic floor dysfunction, established the pelvic floor physical therapy rehabilitation program at New York Presbyterian Hospital at Columbia University, obtained my Pelvic Rehabilitation Practitioner Certification (PRPC) from the Herman and Wallace Pelvic Rehabilitation Institute, and started a private pelvic floor rehabilitation practice. It’s incredible to reflect on how my career path has been influenced by my personal journey.
I provide care to both male and female patients who present with a range of pelvic floor dysfunction-related symptoms. Patients with urinary or fecal incontinence, difficulty urinating, frequent urination, interstitial cystitis, chronic prostatitis, constipation, pelvic pain, painful sex, erectile dysfunction, coccyx (tailbone) pain, hip pain, lower back pain, diastasis recti (separation of abdominal wall muscles), pelvic organ prolapses, rehabilitation requirements following colorectal or urogenital (
Many men and women who have had trouble finding relief have been successfully treated by me thanks to my education and experience. Additionally, even though it’s not a requirement for being a good physical therapist, my expertise and treatment methods have been improved by my own significant pelvic floor dysfunction and chronic pain.
- Earn a bachelor’s degree. …
- Complete a Doctor of Physical Therapy program. …
- Get licensed as a physical therapist. …
- Take courses in pelvic floor therapy. …
- Gain experience practicing pelvic floor therapy.
What does a pelvic floor therapist do?
A pelvic floor therapist can perform a variety of tasks to assist patients and enhance their pelvic health. For instance, the majority of pelvic floor therapists conduct internal and external pelvic exams on new patients to determine their current state of pelvic health and to talk about their individual therapy goals. Pelvic floor therapists can lead their patients through exercises made to strengthen the muscles in a pelvic floor as well as the ligaments and tissues surrounding it when providing pelvic floor therapy. Breathing exercises are another technique that pelvic floor therapists employ to keep their patients calm and concentrated throughout treatment.
What is a pelvic floor therapist?
A physical therapist who focuses on helping patients strengthen their pelvic floors is known as a pelvic floor therapist. All of the muscles that surround the reproductive organs and urinary tract are part of the pelvic floor. Women who give birth, men recovering from prostate cancer, and general patients who want to pay more attention to their pelvic health are examples of common patients for pelvic floor therapists.
Physical therapy offices, clinics, and rehabilitation facilities that provide physical therapy are possible places for pelvic floor therapists to work. However, a lot of pelvic floor therapists open their own practices and hire patients that they track down through outreach, databases, and networking.
How to become a pelvic floor therapist
The following actions can help you launch your career as a pelvic floor therapist:
1. Earn a bachelors degree
As most physical therapists pursue a bachelor’s degree to prepare for the Doctor of Physical Therapy program they must complete in the future, obtaining a bachelor’s degree is typically the first step toward becoming a pelvic floor therapist. Many people who want to become pelvic floor therapists major in biology or anatomy to learn about the human body and the fundamentals of how it works. However, you can also select a major that is closely related to anatomy, such as physiology, psychology, or physics, and then take additional anatomy courses to receive a very similar education.
2. Complete a Doctor of Physical Therapy program
A Doctor of Physical Therapy (DPT) degree is required for all physical therapists, including pelvic floor therapists, who want to work in the United States. This is due to the fact that a DPT program can equip future physical therapists with the knowledge of cutting-edge theories and techniques as well as the opportunity to practice through actual application. The majority of DPT programs are three years long and cover a wide range of topics, including kinesiology, behavioral sciences, and exercise physiology. Additional topics you might encounter in a DPT program include the following:
3. Get licensed as a physical therapist
You can apply for physical therapist licensure after completing a DPT program. Researching your state’s regulations before applying for a license can be helpful because physical therapist licensing requirements can vary depending on the state where you live and want to practice. Some would-be pelvic floor therapists decide to pursue occupational therapy licensure instead, which can entail many of the same credentials and education.
You can submit an application to your state board for a physical therapist license, and after it is accepted, you can take a competency test.
4. Take courses in pelvic floor therapy
There are numerous expert programs that provide in-depth education and training in the ideas that pelvic floor therapists might require to be successful in the field. This can be very helpful for new physical therapists who are learning how to deliver pelvic floor therapy and recognize signs and conditions. Most pelvic floor therapist training programs include lectures and other classroom exercises that can give candidates extensive information about the work they might perform. To get ready for work as a brand-new pelvic floor therapist, you might want to take the following courses:
5. Gain experience practicing pelvic floor therapy
When you’re prepared to accept patients, you can start working as a pelvic floor therapist. For pelvic floor therapists who own and operate their own clinics, gaining professional experience can be especially crucial because it can help them build a reputation in the neighborhood and connect with new potential patients. To gain experience in clinical settings, you can also find work as a pelvic floor therapist at physical therapy offices, rehabilitation facilities, and clinics.
Skills for a pelvic floor therapist
Pelvic floor therapists may need to have a variety of hard and soft skills. For instance, pelvic floor therapists must have in-depth knowledge of the pelvic floor and the ability to recognize the therapeutic exercises that will help each patient they work with the most. In order to stay in touch with patients throughout their therapy sessions and ensure their comfort, pelvic floor therapists should also possess excellent interpersonal and communication skills. Manual dexterity is a skill that can be crucial for pelvic floor therapists because they frequently assist their patients by massaging them or adjusting their position while they are sitting or stretching.
Additional abilities that can help a pelvic floor therapist include the following:
Melissa’s journey to become a pelvic floor therapist
FAQ
Is pelvic floor therapy considered physical therapy?
A specialized form of physical therapy called pelvic floor physical therapy helps the muscles function normally and relieves the symptoms of pelvic floor dysfunction. This includes a number of exercises for relaxing and strengthening your pelvic muscles.
Can occupational therapists do pelvic floor therapy?
Domain and Process, Third Edition of the Occupational Therapy Practice Framework (OTPF) “Occupational Therapists (OTs) can be involved in many aspects of pelvic floor rehabilitation that affect our daily activities, such as using the restroom, resting, sleeping, and engaging in sexual activity,” according to the Framework-III published by the AOTA in 2014.
What do pelvic therapists do?
We teach you exercises to strengthen and stabilize your core, or the main muscles that stabilize the trunk, such as the pelvic floor, abdominal, back, and diaphragm, during pelvic floor therapy. This also involves re-training and strengthening your pelvic floor muscles.
What is pelvic floor therapy called?
Pelvic floor physical therapy may be recommended to treat incontinence, problems urinating or going to the bathroom, constipation, chronic pelvic pain, and painful sex. A pelvic floor physical therapist can treat a number of conditions in women, such as vaginismus or endometriosis.
