March 26, 2021
Sure – you may have heard of physical therapy. Someone may come in
for a shoulder injury, low back pain or even a knee replacement. If so, when
you think of therapy, you probably think of doing repetitions and sets of
certain exercises, lifting weights, pulling on colorful rubber bands, and being
in a gym full of other patients. So when your physician recommends physical
therapy for pelvic pain or bladder symptoms, you may be a little confused.
Our physical therapists create individual treatment
programs for patients with urinary incontinence, chronic pelvic pain,
vulvar pain, pelvic organ prolapse and interstitial cystitis/painful
bladder syndrome. They perform external and internal pelvic floor
examinations, as well as address the musculoskeletal components of
Julia Kajen, physical
therapist in our Philadelphia location, is one of our therapists who specialize in Pelvic
is a Board-Certified Specialist in Orthopedic Physical Therapy and has pelvic
health training through the Herman & Wallace Institute. She plans to earn
her Pelvic Rehabilitation Practitioner Certification in the next few years. She
emphasizes corrective exercise and manual therapy during her treatment
sessions. She empowers her patients by teaching them relevant anatomy,
physiology, pain science, and symptom management techniques. Julia sat down to
with us to explain Pelvic Floor further and some misconceptions. Julia was able
to explain a bit more about Pelvic Health Therapy…
are the Functions of the Pelvic Floor?
Support of the pelvic and abdominal organs.
Stabilization of the bony pelvis including the pubic symphysis and
Sphincteric functioning, maintaining urinary and fecal continence.
Sexual functioning, including sensation, maintaining erection, and
1. Kegels fix incontinence.
There are many factors that may
contribute to urinary or fecal incontinence. These include poor bladder or
bowel habits, poor fluid intake, tight pelvic floor muscles, restrictions of the abdominopelvic fascia and viscera,
impaired movement patterns and more. When these factors are corrected, which
may not include Kegels at all, urinary and fecal incontinence will resolve.
2. Occasional urinary leakage with laughing,
coughing or sneezing is normal.
This is common, but not normal. Athletes participating in high
impact sports, and hormonal changes throughout life can impact urinary leakage.
Urinary leakage can (and should!) be fixed.
3. Pelvic PT is only relevant for
postpartum patients or older adults.
Pelvic PT is important for people of all genders, ages and
activity levels. Populations that benefit from pelvic PT include athletes,
people with chronic pelvic pain, people recovering from oncology treatment, and
people with neurological disorders.
4. Pain with sex is normal.
Pain with sex, either external stimulation or penetrative sex, is
not normal. Dyspareunia - painful sex that isn’t caused by an underlying
disease - is most common during the 3rd and 4th decades of life. Dyspareunia as
well as other pelvic pain conditions are successfully treated with pelvic
5. Pelvic Health Physical Therapy always
requires internal vaginal or rectal work.
Although internal examination and treatment may be most helpful
with some patients, pelvic health PT includes a variety of treatment
techniques. You never need to be treated with internal manual therapy to have
positive outcomes with pelvic health PT.
- Julia Kajen PT, DPT, OCS ... Read Julia’s bio here.
questions about Pelvic Health and which of our locations offer this specialty?
directly at [email protected]!