The Commitment to Pelvic Health

The Commitment to Pelvic Health

Just like any other form of physical therapy, pelvic health rehabilitation requires the client to be committed to their care for their symptoms to improve. On the other hand, pelvic health rehab also requires the clinician to be committed to helping the client improve. Rehab is a two-way road that requires a unique partnership and trust between the patient and the provider. While pelvic health rehab can be much like any other form of rehab (after all, the pelvis is full of muscles, tendons, nerves, and fascia!), there are some characteristics about it that make this type of physical therapy different from other forms of PT.

One thing that makes pelvic health PT unique is the obvious: the muscles and tissue of interest are located inside the pelvis, making them inconveniently difficult to access. The primary mistake that can often be made by a physical therapist is the assumption that the patient knows and understands exactly what these muscles do and how they behave after simple verbal education and instruction (especially with regards to performing a pelvic floor muscle contraction). Unfortunately, this is an unfair assumption. Research suggests that simple verbal instruction is not the best approach for a patient to engage in a pelvic floor muscle (PFM) training program 1. As pelvic health PTs, it is our role to assist patients along the curvy path to discovering the full function of the pelvic floor muscles. It is often work that requires attention to detail, imagination, precision, teamwork, and most of all…patience.

In recent years, pelvic floor dysfunction is gaining increasing awareness in the public eye. Furthermore, it is beginning to be more common knowledge that tight pelvic floor muscles can frequently cause pelvic pain and dysfunction (vs muscles that are too long and weak). As noted in prior blog posts, short and tight PFM can cause similar symptoms compared to long and weak PFM (example: urinary incontinence). If someone’s PFM are short and tight causing urinary incontinence, a rehab approach will promote lengthening and letting go of the tension in order to reduce pain and improve function. However, this process requires time and guidance. Patients are all too often told to simply relax and meditate in order to have less pain and less tight muscles. While relaxation and meditation are certainly helpful, patients are often left to their devices to navigate through the process of letting go without skilled guidance of HOW does a person simply let go of their PFM?

Accessing the PFM is one thing but attempting to relax and lengthen the deeper muscles is a whole different ball of wax. Successful pelvic health rehab requires consistent biofeedback and guidance from the pelvic health physical therapist. Therapist-assisted biofeedback facilitates improved brain-muscle connection for the patient because the therapist can use both tactile cues (palpation) and verbal cues to assist in pain relief and general muscular awareness. The patient and the therapist interact and work as a team in order to help the muscles gain range of motion and overall improved function. This process can last anywhere from 4-6 weeks to several months depending on the patient. Usually visits that occur consistently (1x/week) yield the best results. Ultimately, the goal is to help the patient get back to function and resume their normal life activities as soon as possible (walking, running, HITT classes, caring for children/grandchildren, house chores, and more!). With a little dedication and teamwork, consistent pelvic health PT sessions can yield lasting results.

Resources: Assessment of Kegel pelvic muscle exercise performance after brief verbal instruction Richard C. Bump, W. Glenn Hurt, MD, J. Andrew Fantl, MD, Jean F. Wyman, PhD From the Department of Obstetrics and Gynecology, Medical College of Virginia, Virginia Commonwealth University, Richmond, Virginia. August 1991Volume 165, Issue 2, Pages 322–329.

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Covid-19 Notice

3/27/2020 Covid-19 Notice:

On March 19th, we made the difficult, yet important decision to close both clinics, in order to do our part to flatten the curve. We will reopen the clinics part time on Monday, April 6th, with an emphasis on telemedicine. This will allow us to comply as much as possible with the governor's Stay Home Stay Healthy order if it is extended, while also meeting our obligation as essential infrastructure workers. According to Dr. Matos, an expert in biological surety and the management of select agent programs at federal facilities: "Physical therapists are essential in flattening the curve of the Covid-19 pandemic. They play a key role in keeping people they can help out of doctors' offices and ER's. This will not only free up the medical teams to treat those impacted by Covid-19, but also limit the exposure of those seeking the care of the physical therapist." To that end, we will focus on telemedicine, but also allow for select, necessary in-office treatments for low risk, healthy individuals. This will be a joint determination between you and your PT. Many, if not all of our patients, have come to appreciate the effectiveness and efficiency of the hands-on manual therapy techniques our physical therapists use to help relieve pain and improve function. So, we recognize that a telemedicine visit may not seem as appealing. At this time, telemedicine is the appropriate and safe way to continue your care without further interruption and your physical therapists are prepared to alter their approach in order to still provide effective care.

During our temporary closure, your physical therapists have been on unemployment and not able to contribute to our communities financially as they normally would like to. Getting back to work, providing your care will allow us to resume caring for you and our community. For every telemedicine visit we provide in April, the clinic will donate $5 to the following organizations:

Kelsea Cannon, PT- Westside Baby
Lauren Esmailka, PT- Treehouse
Elizabeth Rogers, PT- Rainier Valley Food Bank

We remain passionate about helping you improve and maintain the function of your movement system so that you can do the activities you love. I remain available for urgent (i.e. post-op care, acute injury, treatment needed to decrease/avoid use of NSAIDs and Opiods) in-clinic treatment and telemedicine treatment from now until April 6th. We invite you to follow/Like our  Facebook page, where I am offering complimentary weekly Pilates mat class on Wednesdays at 7am and foam roller class on Fridays at 7am. All are welcome to participate in these classes or view them anytime on our Facebook page.

Please contact me directly with any questions or concerns. If you are a current patient, you should have received an email from me with scheduling/rescheduling info. Be in touch with your PT to schedule your telemedicine visit. I am available via clinic phone (206-535-7356) and email ( We will update you here and our Facebook page as things change.

We are counting the days until we get to resume our work together both virtually and in the clinic! Thank you for your support of this small, locally-owned physical therapy private practice!

Elizabeth Rogers, PT

Owner, Elizabeth Rogers Pilates & Physical Therapy, PLLC

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