Pelvic floor therapy
Would you answer “yes” to any of the following?
1. I sometimes have pelvic pain (in genitals, perineum, pubic, or bladder area, or pain
with urination) that exceeds a ‘3’ on a 1-10 pain scale with 10 being the worst pain
2. I can remember falling onto my tailbone, lower back or buttocks (even in childhood)
3. I sometimes experience one or more of the following urinary symptoms:
- Accidental loss of urine
- Feeling unable to completely empty my bladder
- Having to void within a few minutes of a previous void
- Pain or burning with urination
- Difficulty starting or frequent stopping/starting of urine stream
4. I often or occasionally have to get up to urinate two or more times a night.
5. I sometimes have a feeling of increased pelvic pressure or the sensation of my pelvic organs slipping down or falling out.
6. I have history of pain in my low back, hip, groin, or tailbone or have sciatica.
7. I sometimes experience one or more of the following bowel symptoms:
- Loss of bowel control
- Feeling unable to completely empty my bowel movements
- Straining or pain with a bowel movement
- Difficulty initiating a bowel movement
8. I sometimes experience pain or discomfort with sexual activity or intercourse.
9. Sexual activity increases one or more of my other symptoms.
10. Prolonged sitting increases my symptoms.
If you answered “yes” to 3 or more, you would likely benefit from seeing a pelvic health physical therapist! These are not issues you have to live with; relief is possible.
(Pelvic Dysfunction Screening Protocol form by Nicole Cozean, PT, DPT, WCS, CSCS and Jesse Cozean, MBA)
Who does a pelvic health physical therapist treat?
Everyone! Both men and women have pelvic floor muscles, so both men and women can have pelvic floor dysfunction.
What is pelvic floor dysfunction?
The group of muscles in the pelvic area make up the pelvic floor. Similar to a sling, our
pelvic muscles support the bladder, rectum, uterus in women and prostate in men. Bowel
and bladder movements are controlled when we contract and relax the pelvic muscles.
When the muscles, ligaments and connective tissue that support pelvic organs don’t work
as they should, this can lead to symptoms such as:
● Frequent urination or an urgent need to go to the bathroom
● Urinary leakage
● Enlarged prostate
● Bowel incontinence
● Pain during intercourse
● Pelvic pain or pressure
● Diastasis rectus abdominis (abdominal muscle separation)
● Postpartum scar treatment after a perineal tear, episiotomy, or c-section
● Tailbone, lower back or hip pain
What can I expect?
● All sessions are one on one in a private room and last about one hour.
● During your first visit, you’ll have the opportunity to share your history and concerns. We’ll discuss the exam so your questions are answered right away.
● An internal exam allows us to assess the pelvic floor most effectively; however, if
this is something you’re uncomfortable with you can request an external exam only.
● Your physical therapy sessions will be with the same therapist.
● If you’re currently menstruating you can still participate in a full exam.
What is the goal of therapy?
With diligent self-care and guidance, we can help you:
● Gain control of your bladder/bowel
● Reduce pain and increase activity tolerance
● Increase function during pregnancy
● Postpartum recovery
● Reduce medication used for incontinence and pain
● May prevent the need for surgery
● Recover and rehabilitate from surgery
We also can assist you in finding a trusted referral if your condition does not improve with
How can a physical therapist help?
We use therapeutic exercise, manual therapies, lifestyle and activity modification, and
modalities to decrease pain. By the end of your care plan, you will feel confident managing
your condition independently!
How long will it take to get better?
We see most of our patients for an average of 6-12 visits. Some people require less and
Do I need a referral?
Yes! A prescription for pelvic floor physical therapy is required from a physician, nurse
practitioner, physician’s assistant, midwife or chiropractor. Talk to your provider about a