In the United States, pelvic floor therapy is a relatively new specialty.
Yet, according to the World Continence Foundation, bladder leaks alone affect one in three people worldwide, and are more common than hay fever (which, by the way, can also lead to bladder leaks).
Addressing Women’s Health
Julie Cohn is a Doctor of Physical Therapy and Pelvic Floor and Women’s Health Specialist
for Pregnancy and Postpartum Care in Philadelphia. Her mission is to get the world out about why women should visit a trained pelvic floor therapist.
When Dr. Cohn graduated, she started working in an outpatient (mostly orthopedic) clinic. She got lots of calls about incontinence and prolapse, but had to send those patients away. Dr. Cohn felt like pelvic floor therapy was a big portion of women’s health that wasn’t being addressed. The hospital she works for has a mission to help women and children, and she made a case for the specialty.
Fortunately for her patients, the hospital agreed, and Dr. Cohn is now able to offer those services as well.
“I would love it if this became standard knowledge, because every woman has a pelvic floor.”
What Do Pelvic Floor Therapists Do?
So what, exactly, does a therapist do?
In Dr. Cohn’s case, she starts with an extensive history and an orthopedic exam. She looks at movement as a whole, to try to find clues to why a woman would have incontinence.
She insists that her patients see their gynecologist prior to a pelvic floor exam, to rule out underlying conditions such as sexually transmitted diseases. Then she does an internal exam.
That really is just what it sounds like: Her fingers inserted into your vagina.She’s trying to determine tone, length and strength of the pelvic floor muscles.
Physical therapy of any kind is uncomfortable, and hard work.
Dr. Cohn includes an anatomy lesson, because most of us don’t have an understanding of the complexity of the pelvis, pelvic floor, and pelvic organs, and the role they all play.
“Our pelvic floor muscles are made up of skeletal muscles just like our bicep. Once the biceps muscle is tight, it is not going to work in an optimal way. That’s length. Strength for pelvic floor is an amount of time that a woman can hold the contraction and what strength they can hold that contraction. Our pelvic floor muscles need to work through out the day. We need them for a quick contraction when we sneeze or cough, but also for posture motions, for walking throughout the day or standing for a long period of time. We need a regular resting tone in our pelvic floor, so that we avoid things like incontinence.”
A Plan for Improvement
Just as a physical therapist designs an exercise plan for an injured joint, Dr. Cohn designs a plan for better pelvic function. And just as with any other physical therapy exercises, these exercises will only work if you practice them.
Finding a Pelvic Floor Therapist
Dr. Cohn suggests that women do research and ask a lot of questions before they visit a pelvic floor therapist. See if you can speak to the therapist on the phone directly.
“They should be looking at you as a whole, not just a pelvis. If they are only doing an internal examination, that’s not enough.”
Again, in the United States, this is a relatively new specialty. Courses in the specialty are provided by the American Physical Therapy Association, and Pelvic Rehab Institute (Herman and Wallace). If you are looking for a specialist, don’t be afraid to ask about their training.
In the last year or so, the Herman and Wallace Institute started http://www.pelvicrehab.com, where you can put in your zip code and search for therapists certified in your area.
Don’t Put Off Diagnosis
The average woman waits six and a half years before she gets a diagnosis of bladder leaks with her doctor.
Don’t wait any longer. See if a specialist can help you.
For more information, follow Dr. Cohn @the_pelvic_life on Instagram.