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

04/06/2021 Covid-19 Notice:

For the past year we have safely operated under our Covid-19 Exposure Control, Mitigation and Recovery Plan. This has allowed us to continue caring for our community and helping our clients return to the activities they love! Our entire team of PTs has been fully vaccinated since mid February. We are available for both in-clinic and virtual physical therapy visits and Pilates sessions. This allows us to comply with government guidance, while also meeting our obligation as essential infrastructure workers. For in-clinic treatment/Pilates sessions, all clients are screened prior to entering the clinic. The PT will wear a mask and the client needs to wear a mask of their own. Social distancing is observed throughout the clinic and rigorous cleaning guidelines are followed. At times during your PT 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. virtual or 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.

If you are traveling via plane and you are not yet fully vaccinated, we ask that you inform your PT so that we may switch your visits to telehealth for 10 days after your return. (Fully vaccinated is defined as 2 weeks past your final vaccination dose.) 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 there is a year's worth of recorded Pilates mat classes that you may access. 

Please contact me directly with any questions or concerns. I am 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