Pelvic Health is a Specialized Area of Physical Therapist Practice

Pelvic health physical therapists specialize in the treatment of women and men across the lifespan who are experiencing dysfunction in the lumbopelvic region, specifically influencing the pelvic floor musculature. More than 25 million people are affected by the loss of bowel or bladder control, with 17-24% women over the age of 65 and 11-31% of men experience urinary incontinence.   Common conditions treated include urinary incontinence, bladder or bowel dysfunction, pregnancy-related pelvic girdle pain, persistent pelvic pain, pelvic organ prolapse and sexual dysfunction. Interventions such as myofascial release, soft tissue mobilization, and neuromuscular re-education are applied to help rehabilitate the pelvic floor musculature via an internal and external manual approach. A Cochrane review revealed that women who underwent pelvic floor physical therapy intervention were 8 times more likely to report being cured of their urinary incontinence and 17 times more likely to report improvement, if not cure post-treatment.   

Pelvic health specialists undergo additional continuing education to assess and treat the musculoskeletal regions of the pelvis, including the lumbar spine, sacroiliac joint, abdomen, coccyx and the pelvic floor musculature, which entails both external and internal (vaginal or rectal) manual work . There are various avenues, including the American Physical Therapy Association’s Section on Women’s Health that offers continuing education courses, which are typically offered at 3 levels and divided into pelvic health and pregnancy training. For further training, there are currently nine women’s health physical therapist residencies in the US which offer specialized training encompassing pelvic health, pelvic-related oncology, pregnancy and post-partum, bowel dysfunction, lymphedema, breast cancer, osteoporosis and the female athlete triad. The highest level of achievement in this specialty is board certification as a women’s health clinical specialist (WCS), which is granted through the American Board of Physical Therapy Specialties. Applicants who complete and pass the required case study report and achieve the recommended clinical hours may sit for this examination. 

Physical therapists play an important role in education and interprofessional collaboration to address the needs and better improve the outcomes of this population. To assist in locating a pelvic health specialist in your area, the American Physical Therapy Association offers a physical therapist locator, which includes a list of providers and their areas of expertise.

image credit: Life Fitness Physical Therapy