Pelvic Health Physical Therapy

Pelvic health physical therapy includes exercises and manual techniques to strengthen the muscles of your pelvic floor. These muscles affect bladder and bowel function, pelvic pain, and sexual function.

A pelvic physical therapist evaluates how well your pelvic floor muscles are functioning in a private treatment room. The evaluation includes an external exam and an internal assessment using a probe in your rectum or vagina. Click here at to learn more about this therapy.

pelvic health ptEvaluation

Your physical therapist will ask you many questions – some might feel like TMI (taboo information) but this is part of the comprehensive exam process. They want to understand all the things that have happened to you and why they are causing symptoms so they can determine a treatment plan that will help.

They will perform external palpation which is feeling for the bony landmarks and muscles around your pelvic bones. They can do this without undressing if you are comfortable. They will assess your posture and movement patterns, looking for areas of tightness, sensitivity, and strength in the hip, lower back, and abdominal muscles that may be contributing to your pelvic floor problems.

Pelvic floor muscles are a series of deep internal muscles in your pelvis, located between the two sitting bones and the pubic bone. They support the bladder, uterus, and labia and have important roles in controlling the urinary tract, managing pressure changes with coughing or heavy lifting, preventing back pain, and helping control bowel movements. Men and women have these muscles and they are used by both!

The therapist will then do an internal exam of the pelvic floor muscles. This is done using a gloved finger, usually in the vagina or rectal canal. They will check for sensitivity in the muscles, see if you can contact them, and assess for symmetry, length, tone, and integrity of the muscles. They may also ask you to bear down or push out as if having a bowel movement, to check for the ability to voluntarily contract and relax the muscles. Unlike a gynecological exam, there is no need for a stirrup or speculum and the internal evaluation only takes a few minutes!


Your pelvic floor muscles support your core, help with bladder control and, for women, allow for orgasms. But, over time, they can weaken, leading to conditions such as urinary incontinence or prolapse. Strengthening these muscles with targeted exercises can relieve symptoms and in some cases cure conditions.

Your physical therapist will develop an exercise program to either relax or strengthen your pelvic floor muscles, depending on what your condition requires. You may also learn breathing exercises to improve the coordination between your abdominal and pelvic floor muscles. These may include diaphragmatic “belly” or chest breathing, which can decrease pain and help prevent muscle spasms.

You’re probably familiar with the Kegel exercise, an intentional pelvic contraction that tightens these muscles. It’s often recommended by gynecologists and pelvic health PTs as an easy way to tighten these muscles without straining. But, if you search “pelvic floor exercise,” there are many more options that can target specific problems such as prolapse and urinary incontinence.

Other exercises may involve laying on your back with your knees bent and feet flat on the floor, hip-width apart. Then, while keeping your spine neutral, bring one leg down by contracting your core muscles and gently tapping that toe on the floor. Repeat this exercise with the other leg for 12 to 20 repetitions.

Another popular exercise is the bridge pose. This is done while lying on your back with your knees bent and your feet flat on the floor, hip-width aside. Then, lift your hips toward the ceiling, concentrating on engaging the core and pelvic floor muscles to avoid putting pressure on your lower back or neck. This can be repeated for five to ten breaths, then rest.

Manual Therapy

The pelvic floor is a group of muscles that support your bladder and bowels. It also keeps your uterus and rectum in place, which is important for women to prevent pregnancy. Women and men both have pain or dysfunction in their pelvic floor, which can affect daily life activities. Pelvic floor physical therapy can help relieve those problems so you can live a healthy, active life.

Manual therapy techniques include myofascial release, joint mobilization, skin rolling, and muscle massage to address tightness and musculoskeletal misalignment in the area. These techniques can reduce pelvic pain and improve function by restoring normal movement patterns and muscle reeducation.

Trigger point therapy is a hands-on technique that involves applying precise pressure to the tight areas of the body, called trigger points. These tight areas can cause pain throughout the body and are often the root of your pelvic floor problems. Physical therapists who are trained in pelvic floor manual release techniques can help identify and treat these issues.

Stretching and relaxation are also part of pelvic floor manual therapy. Adding these strategies to your everyday routine can ease tension in the area and increase flexibility and mobility. This helps improve the effectiveness of your exercise program and overall treatment results.

Your physical therapist will teach you how to use these strategies at home, helping you manage your symptoms and keep them from returning. They will provide you with a comprehensive plan to help you reach your goals. They will assess your progress and adjust your treatments to ensure you are making good progress.


Often used in conjunction with manual therapy and a comprehensive exercise program, biofeedback provides a visual representation of muscle activity to help patients learn to strengthen weak muscles and train tight ones to relax. Many at-home modalities, such as electrical stimulation and surface electromyographic (sEMG) biofeedback, are available that can be used to address a variety of impairments including urinary incontinence and pelvic pain.

During the biofeedback session, your physical therapist will place one or more sensors on the skin and attach them to a machine that monitors your muscular responses. A computer screen displays the information, allowing you to watch your muscles contract and relax as you work to improve muscle control. Your physical therapist will also teach you to use these techniques at home.

Because the pelvic floor muscles are a group of internal muscles that are difficult to access, the biofeedback process can be helpful in both strengthening and training. In one study, using a combination of exercise and biofeedback with levator ani syndrome, biofeedback improved the symptoms significantly more than traditional physiotherapy.

Although some people are hesitant to try the method because of its association with mind-body treatments, it seems safe and does not have any negative side effects. It is an effective treatment for urinary incontinence and other health problems, such as constipation that results from tight muscles in the rectum (dyspareunia).

The first step is to get an evaluation done by a physical therapist to determine whether you might benefit from a pelvic floor biofeedback approach. Most patients undergo treatment over six to 12 one-hour sessions. The evaluation usually includes a review of bladder/bowel function and daily bowel/bladder habits and may include a non-invasive physical exam.

Electrical Stimulation

During the evaluation, your physical therapist will be able to determine the cause of your symptoms and will work with you to create a treatment plan. This will include hands-on techniques to stretch and strengthen the pelvic muscles, educating you on how to contact your pelvic floor muscles and biofeedback.

Electrical stimulation uses a gentle current to stimulate muscles and nerves for increased contraction and flexibility, normalizing of nerve function, and mobilizing restricted joints. It is usually a pulsed “bi-directional and biphasic” current to reduce skin and tissue irritation. This helps increase the number and strength of slow twitch fibers in the muscles making it easier to achieve stronger pelvic floor muscle contractions.

Depending on your symptoms, your physical therapist may also utilize internal techniques such as trigger point therapy (in which pressure is placed against specific points in the body, internally or externally through the vagina or rectum) and musculoskeletal mobilization techniques like skin rolling, myofascial release and joint mobilization.

Your therapist will be sensitive to your comfort level with these techniques and will not introduce them until you are ready to do so. If you are uncomfortable with these internal treatments, your therapist will provide you with a home exercise program that will help alleviate your symptoms without the need for these more invasive techniques.

Your therapist will be happy to answer any questions you have about the evaluation and treatment process. We will work together to establish your goals for physical therapy and how they relate to your daily activities. Common goals include: not having to urinate in your underwear at the office, being able to go for long walks or participate in your favorite hobbies without feeling an urgent need to use the restroom, reducing pain or discomfort during sex and enhancing orgasms, and returning to sports and exercise without bladder control problems.


Laser Hair Removal – What You Need to Know

Laser hair removal is an effective and permanent method of reducing unwanted body hair. This procedure reduces or eliminates the need for shaving, waxing, and depilatory creams.Laser Hair Removal

It works best for people with light skin and dark hair, as the contrast in pigment makes it easier for the laser’s energy to reach and destroy the hair follicle.

Unlike other methods of hair removal, laser treatments actually kill the hair follicles, preventing them from growing. Laser treatment is relatively safe, and it can be used for a variety of areas. However, this treatment does have a high upfront cost. You may need multiple sessions to achieve your desired results, so it’s important to weigh the pros and cons of this procedure before committing to it.

The cost of laser hair removal can vary depending on the area you are treating. Larger areas will be more expensive than smaller areas. For example, a full leg session will be more expensive than a half leg treatment.

It’s also important to consider the location of the treatment center and its reputation. For example, a med spa with a good reputation will likely charge more for this procedure than a less-reputable one. In addition to this, the number of sessions and the body area being treated will affect the cost of laser hair removal.

Preparation for laser hair removal is critical, as it can make or break the outcome of your treatment. In the week leading up to your appointment, you should avoid any products that remove the hair from the surface of the skin. This includes waxing, tweezing, plucking, and threading. Additionally, you should not use any products that can cause increased photosensitivity. This includes retinols, alpha-hydroxy acids, salicylic acid, Vitamin C, and hydroquinone.

Laser hair removal is considered a cosmetic procedure, so it’s usually not covered by private insurance. However, it’s possible to get it through your health plan if it’s needed for medical reasons. Those who are interested in this option should consult with their insurance company for guidance and more information.

In general, you can expect to spend a few hundred dollars per session on laser hair removal. You can reduce your costs by purchasing a package or using a payment plan. You should also track how much you spend on other hair removal methods every year to see how much you can save with laser treatment. This can help you determine if laser treatment is worth the investment.


A laser hair removal treatment is a series of sessions that target specific areas of the body to remove unwanted hair. It involves exposing the skin to light that’s absorbed by pigment in the hair follicle, which then converts into heat and damages the follicle so that it can no longer grow hair. The results are long-lasting and can eliminate the need for depilation, shaving, or waxing. During the procedure, you might feel a slight pain or tingling in the area being treated. However, you can take steps to minimize the discomfort. For example, you can apply a topical anesthetic or use numbing cream to help reduce the pain. In addition, you should shave the area before the treatment and avoid using products that may damage your skin barrier.

A medical specialist will clean the area of the skin that needs to be treated and may apply numbing gel. They will then use a handheld device to press against the skin and activate the laser. The sensation can be similar to a series of stings or a rubber band snapping against the skin. The process can take as little as a few minutes or up to an hour, depending on the size of the area being treated.

It’s important to note that even if the laser successfully destroys the hair follicle, it may not permanently stop it from growing hair. That’s because the follicle can regenerate and produce hair after being destroyed by the laser, but it might be less dense or lighter than before. However, many people find that they have fewer and fewer hairs regrowing over time.

Some people may also experience swelling and redness in the affected area after the treatment, but this is normal and should resolve within a few days. You can reduce the symptoms by putting a cold compress on the affected area. It’s also a good idea to avoid exercising in the area or exposing it to sunlight for several days after the laser treatment. This will prevent the area from becoming too sweaty and damp, which can cause the hair to stick to the skin.


The pain associated with Laser Hair Removal can vary depending on the individual and the area being treated. It can be felt as a snapping sensation or a sunburn-like sting, and it can last for a few minutes. Many people find that a topical anesthetic can help to reduce the pain and discomfort caused by the procedure. Using a cold compress on the treatment site can also relieve any discomfort or swelling.

Keeping skin moisturized and staying out of the sun can help to lower the risk of pain during laser hair removal. It is recommended that a person avoids tanning beds or sun lamps for several days before the treatment, as it can increase the skin’s sensitivity. A person should also stop waxing or plucking hairs in the treatment area prior to a session. It is a good idea to consult with the practitioner to determine the best way to prepare for the procedure.

Before a laser hair removal treatment, it is recommended that a person takes an over-the-counter pain reliever such as Acetaminophen or Tylenol. It is also a good idea to drink water to stay hydrated, as this can also help to stabilize the pain tolerance. It is also a good idea to refrain from caffeine, as this can significantly lower a person’s pain threshold.

It is important to note that it may take multiple treatments before the results of Laser Hair Removal become permanent. This is because some hair follicles grow slower than others. Some people will need to return for touch-up sessions, as they may begin to grow hairs that were previously not impacted by the laser treatment. This may happen due to hormonal changes in the body, such as after pregnancy or during periods of menstruation.

Another factor that can influence how painful a laser treatment will be is the experience and skill level of the practitioner. Choosing an experienced practitioner who has worked with different types of machines and skin types can significantly reduce the likelihood that the treatment will be painful. It is a good idea to avoid any clinics that advertise low prices, as these are likely to be using inferior equipment or inexperienced staff.


Laser hair removal works by delivering energy to dark target matter (melanin) in the skin or hair follicle without damaging light target matter such as water or surrounding skin. The heat from the laser destroys the basal stem cells in the hair follicle that produce and maintain hair growth, causing the hair to fall out and not regrow.

The results from laser hair removal can be permanent, but it may take several sessions to achieve desired results and to prevent future hair growth. A medical professional will evaluate your skin and hair color to determine the appropriate laser type and settings. During the procedure, patients might feel a sensation that is similar to the snapping of a rubber band or a sunburn-like sting. Some patients also experience redness of the treatment area, but this usually disappears within one to two days. Occasionally, the skin may develop pigment changes, such as lightening or darkening, which can be avoided by avoiding exposure to sunlight following the treatment.

A number of factors influence the effectiveness of laser hair removal, including skin and hair type, the color of the hair, and the skill of the laser technician. The ideal candidates are people with darker hair and lighter skin because the contrast between the hair and the skin helps the laser to detect the melanin in the hair, which is the target of the laser’s action. Lasers do not work as well on white, blonde, or gray hair because the melanin is too low in concentration to be detected.

After the laser treatment, your hair will begin to fall out, but it can take up to a week for all of the dead hairs to come out. Some of the hairs will be pushed up by the surrounding skin and appear as ingrown hairs. This is normal, but you can prevent it by using a topical anesthetic to reduce the discomfort prior to the laser treatment.

Some hairs will grow back after the first laser treatment, but most of these hairs will be weaker and finer than the original hairs that were damaged during the treatment. As a result, the treated hairs will be less likely to cause problems such as razor bumps.