Finding a Pelvic Physical Therapist: Where Do I Even Start?

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You have to be ready!

This is kind of an important point. Pelvic physical therapy (PT) can be quite intimate. There's often both external work and internal work (as in vaginal and sometimes rectal) depending on the issue. It's not quite the same as going to rehab for tennis elbow because we carry so many emotions in that region. When it's not working properly we can feel vulnerable in very private ways. Having a stranger look, touch, stretch, move, exercise that area requires an emotional commitment first.

It doesn't matter how much you think (or someone else thinks) you physically need rehab for the vagina. If you don't feel ready, you're not.

So how do I know I'm ready? Only you can answer this question.

For me, it took seven months after giving birth to get myself to see a pelvic PT. I unquestionably needed it, and I knew this kind of help was out there before I gave birth. Time and ultimately desperation go me into a clinic.

Here's how I went from knowing I needed help to getting it:

  • As a first time mom without a lot of hands on help, at around six months I stopped feeling like I was struggling just to keep my head above water. I finally had more control over my nights and days.
  • I got sick of tolerating a lot of things I knew weren't normal, some of which included but weren't limited to: having trouble controlling my farts, constant spotting coming from vaginal granulations, feeling like my vagina weighs a ton, not being able to run without feeling like my lower back is going to crap out, and feeling my perineal scar tissue bunching in weird ways.
  • Fear! I was terrified of never again feeling normal down there. I knew the longer I waited the longer it would take to rehabilitate my pelvic dysfunction. I wanted to not be afraid of sex and to not have any pain with it. I also wanted to not fear the OBGYN.
  • I felt like a fraud. "Bouncing back" to my pregnancy weight quickly gave people around me the false sense that my pregnancy and delivery were no biggie. I'm just fit like that! How I looked physically didn't match how I felt physically. I wanted to feel as good as I supposedly looked.
  • I started to feel resentful about giving birth, toward my husband for not "getting it," toward girlfriends for not giving any warning, and at my body for deeply disappointing me. I was in a dark and desperate place. My resentments were absolutely delusional. I knew this and decided to help myself to a better place.

You may already know exactly who you want to see, or you may have absolutely no clue how to start your search for a pelvic PT. When I started my search I didn't have any local recommendation for the D.C. area since I just moved. Luckily, a good girlfriend of mine is in the industry and she pointed me in the right direction.

Qualifications

Pelvic PT is fairly new, but it's an emerging specialty in the physical therapy world. As it should be! Dr. Hollis Herman is a leading guru and pioneer in the field. Those certified from the Herman and Wallance Pelvic Rehabilitation Institute are trained by the industry's gold standard.

Here are some tips to help in your search

  • Ask your health professional, a girlfriend, or Google.
  • Check out the clinic's website. This is the face of the practice and often the clinic's first interaction with you. The clinic website should put in the effort to answer common questions a prospective patient may have, explain what to expect at your first visit, educate you on what they do and how they can help, highlight the therapists' experience and credentials, and convey that their practice is an inviting and safe space.
  • Reach out to the clinic. I emailed and called my clinic. The office manager listened to my questions and concerns. She also suggested I email one of the therapists for more detailed information. I emailed and the therapist and she wrote back within a few days and answered all my questions.
  • Find out if your insurance provider will cover pelvic PT sessions. At best, most insurers consider pelvic PTs "out of network providers." Why this isn't standard postpartum care and isn't covered fully by insurance companies is criminal.
  • Talk to and try more than one therapist. Personal comfort and fit are important, also you gain different perspectives from each therapist. There are many paths to healing. Find one that feels right for you.
  • Find out if you'll get one on one attention. This is very intimate care. You shouldn't be left alone with a device or exercises, while the therapist is off working on another patient or doing paperwork.
  • Make a list of questions you want answered to help inform your decision. No question is too small. A good pelvic PT should patiently and empathetically answer your questions.
  • ASK YOURSELF, "AM I READY?"

What obstacles stand in your way of seeing a pelvic PT? Are you curious about seeing one but still not sure how to start? Posts your questions and comments below.