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

06/09/2020 Covid-19 Notice:

Our clinics are open for in-clinic physical therapy visits, telemedicine physical therapy visits and virtual Pilates sessions. This allows us to comply as much as possible with the phased reopening of WA State, while also meeting our obligation as essential infrastructure workers. For in clinic treatment, the PT will wear a mask and patient needs to wear a mask of their own, social distancing is observed throughout the clinic and rigorous cleaning guidelines will be followed. At times during your treatment, it may not be possible for your PT to observe social distancing, such as during certain manual therapy techniques. The need for in-clinic treatment vs. telehealth treatment will be a joint determination between you and your PT. You may review our Covid-19 Exposure Control, Mitigation and Recovery Plan for the details of how we provide safe in-person care.

We are grateful for and support all of our clients who have been able to march and protest in support of Black Lives Matter. In order to continue to provide the safest clinic experience possible for our clients and providers, we are asking that any client who has participated in a march or protest do one of the following: 1.) Switch to telehealth visits for 14 days. 2.) Get tested for Covid-19 and provide us with negative results. Note that Seattle's mayor has cleared the way for those who march to get tested without symptoms and encourages participants to get tested. 3.) Wait 14 days after marching/protesting to return to the clinic. Thank you for understanding that this policy is in place to allow us to meet our responsibility to all clients, which is to do no harm.

We remain passionate about helping you improve and maintain the function of your movement system so that you can do the activities you love. We invite you to follow/Like our  Facebook page, where I am offering complimentary weekly Pilates mat 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. Be in touch with your PT to schedule your physical therapy visit. We are available via clinic phone (206-535-7356) and email ( We will update you here and our Facebook page as things change.

Thank you for your support of this small, locally-owned physical therapy private practice!

Elizabeth Rogers, PT

Owner, Elizabeth Rogers Pilates & Physical Therapy, PLLC