Pelvic Floor Therapy

I'm glad you asked! People often describe Pelvic Floor Physical Therapy as "the specialty of physical therapy which focuses on the pelvic floor", which is not technically wrong, however it's also not that helpful if you are unfamiliar with the specialty. So let me describe what I do in a way that hopefully makes things feel a little less foreign.

I am a Physical Therapist by trade which means that I went to school for 7 years (studying topics such as anatomy, physiology, and exercise) to obtain a Doctorate in Physical Therapy. I then took additional coursework that focused on the pelvic floor muscles, which are the muscles in our nether regions that support our organs & posture and play a huge role in our bowel, bladder & sexual health!

Just as in traditional orthopedic physical therapy, pelvic floor physical therapy can involve many different treatments including hands-on work (such as massage, cupping, dry needling, etc.), exercise, and/or education on healthy habits. Sessions are individualized to each client, depending on their unique needs.

Pelvic floor physical therapy treatment can sometimes involve a pelvic muscle exam. Just as a physical therapist might touch your knee if it was hurting, this is the same idea - pelvic floor muscles may be hidden but they are still muscles! An exam is never required if you are uncomfortable with one as there are often many things we can work on that don't directly involve (but still influence) the pelvic floor. It's also important to note that a pelvic floor muscle exam is also quite different than a gynecological exam as it is performed using a finger rather than a speculum and is done at a slower pace. We will go over what a pelvic floor exam involves together in person as well.

I’m so glad you asked. This is an extensive list of symptoms and diagnoses, but if you are not seeing something in particular, feel free to book a free consult call and ask about it there!

General women's health symptoms and diagnoses and pelvic floor disorders

• Pelvic organ prolapse

• Pelvic pain

• Vaginismus

• Vulvodynia

• Dyspareunia (painful intercourse)

• Endometriosis-related pain

• Interstitial cystitis/painful bladder syndrome

• Menopause-related pelvic floor changes

• Post-gynecological surgery recovery

• Diastasis recti

• Urinary incontinence (stress, urge, mixed, or functional)

• Urinary urgency and frequency

• Overactive bladder

• Fecal incontinence

• Constipation related to pelvic floor dysfunction

• Irritable bowel syndrome (IBS) with pelvic floor component

• Chronic pelvic pain

• Coccydynia (tailbone pain)

• Pudendal neuralgia

• Levator ani syndrome

• Pelvic floor muscle tension/hypertonic pelvic floor

• Pelvic floor weakness

• Anismus (paradoxical contraction of pelvic floor during defecation)

• Bladder and bowel concerns

• Sexual function concerns

Pregnancy/postpartum-related symptoms and diagnoses

• Pregnancy-related pelvic pain

• Postpartum recovery

• Diastasis recti

• SI joint pain

• Birth preparation

• Core weakness

• Return to activity after birth

• Staying active and strong during pregnancy

Other related conditions

• Lower back pain

• Hip pain

• Sacroiliac joint dysfunction

• Core weakness

• Pelvic instability

• Bowel and bladder issues during activities like lifting, running, etc.

• Post-abdominal surgery recovery

• Post-colorectal surgery recovery

• Sports-related pelvic floor dysfunction in athletes

• Pelvic pain following trauma or injury

• Leaking while running or lifting

Your first appointment will be one hour together with me, your Doctor of Physical Therapy. First, we'll sit down together to discuss your concerns. I'll ask you questions about your medical history and we'll dive into your goals (meaning I want to know how you'd like to live your life if you didn't have to worry about your pelvic floor!).

From there, I will take you through a full body assessment, where I'll be looking at how you move. I may suggest a pelvic floor muscle exam, however it is not always necessary. Pelvic exams are always based on patient preference so if you'd prefer not to have one, that's okay! While an exam can give us more insight into how the pelvic floor muscles are functioning, there are so many things outside of the pelvic floor that we can work on too. I've had patients have great results without ever having undergone a pelvic exam.

At the conclusion of the hour, I will discuss the results of your exam and we'll work together to create a plan to address the factors contributing to your symptoms so that we can resolve them and I can help you reach your goals!

Nope! The state of North Carolina allows patients direct access to physical therapy. This means that patients can seek out a physical therapist on their own, without needing to first visit a physician. At your evaluation, I will assess whether you may need further medical care and will make that recommendation if appropriate. Often patients who have pelvic health conditions benefit from a team approach, meaning they see me while also under the care of another healthcare provider.

This is individual to each patient as it depends on how long symptoms have been present, how severe they are, and what factors are contributing to them. However, I typically see most patients for about 8 to 20 visits. Some patients then choose to continue on with a maintenance plan for additional support.

Durham Pelvic is not in-network with any insurers.

I have chosen this model for my clinic because I am able to offer my patients a higher quality of care without the constraints of insurance.

Insurance companies unfortunately do not value holistic care. They limit which treatments I’m able to provide, how much time I’m able to spend with each patient, and how many sessions I’m able to see each patient for, thereby reducing the standard of care.

(I once heard a colleague say that having insurance pay for your medical care is like having your mother-in-law pay for your wedding - she’s going to have a lot of input and you may not get exactly what you want!)

Patients who have out-of-network benefits are welcome to submit for possible reimbursement. I am happy to provide you with an itemized receipt, called a superbill, to submit. However, please note that reimbursement is not guaranteed so you are encouraged to contact your insurance company to better understand your benefits if you are planning to submit your claims.

You are also able to use HSA or FSA funds to pay for sessions.

My office is located at 21 W Colony Pl, Suite 150 in Durham, NC, which is near University Tower off the 15-501.

Directions are:

You will turn off of Pickett Rd onto Colony Rd (near the Triangle Dermatology sign). From there, turn onto Colony Pl (at the red DAN sign) and drive all the way back until you see building 21 on your left.

Enter the building from the first floor and my office (#150) will be the second door on your right. If the door is closed, please take a seat in a chair in the hallway and I will come welcome you when ready.

Please call or text 919-283-3864 if you have difficulty finding the office. I look forward to having you in!

Yes, dry needling is a tool that I use with many of my patients. It can be wonderful to help reduce pain and improve mobility. However, it is not appropriate with every patient, and is certainly not required if you are uncomfortable with it.

While I specialize in Women's Health, I have worked with many male patients who have hip or lower back pain or other orthopedic injuries. I am happy to work with men in this capacity. However, at this time, I do not treat male pelvic health.

Of course! Many women who have not had children suffer from pelvic floor symptoms. And if you plan to have children in your future, improving your pelvic floor health now will help you have a healthier pregnancy when the time comes!

Pelvic floor issues often show up as leaking, pressure, pain, constipation, or even low back and hip discomfort. But sometimes symptoms are subtle, like needing to pee “just in case,” difficulty starting or stopping your flow, or discomfort with certain movements. During your evaluation, we’ll figure out whether your pelvic floor is playing a role.

That’s actually really common. Kegels aren’t always the right solution and can sometimes make symptoms worse if your pelvic floor is already overactive or tight. In our sessions, I’ll assess what your muscles actually need—sometimes that means strengthening, and other times it means releasing and retraining.

Each session with me is 60 minutes long and completely one-on-one. You’ll never be passed between therapists or techs. That means your plan stays consistent, your progress gets tracked closely, and we can make adjustments as needed in real time.