Pelvic Health FAQ
What should I expect on my first visit?
At your initial appointment, I will take time to ask you questions about the specific concerns bringing you to physical
therapy and discuss your goals for treatment. I will then observe how you move and examine your hips, pelvis,
abdomen, spine and muscles impacting your pelvic girdle. Depending on the particular condition, an internal assessment
of the pelvic floor musculature (usually vaginal for people with female anatomy and rectal for people with male anatomy or
colorectal dysfunction) may be an important part of this first visit. While this assessment may give me the most information
about your pelvic floor and pelvic wall, it is never a requirement for therapy and can also be performed at later
appointments. Please feel free to communicate any concerns or preferences with your therapist.
How long does it take to get better?
Every patient is different, of course, but most patients with bladder dysfunction get better in 4-8 weeks with once a week visits. Pelvic pain patients usually need 6-12 weeks of weekly visits. Again, it completely depends on the specific problem, exam findings and patient participation.
I have been to PT before and was scheduled on different therapists. Will I be able to see the same PT for pelvic health?
Yes, I believe that it is important for the same PT to provide your pelvic health sessions consistently. I do not use techs or PTAs in my clinic. Your visits will be one on one with the me, the same physical therapist that evaluates you initially.
Will I be in the gym working out or talking about my symptoms, like normal physical therapy?
No, all evaluations and treatments take place in a private room, behind a solid door.
Will I be working with a Certified Pelvic Health Physical Therapist?
Yes, Mary Swartz has received the Certificate of Achievement in Pelvic Health (CAPP-Pelvic) from the American Physical Therapist Association (APTA) and is listed on
Does it matter if I select a PT that is Certified in Pelvic Health PT?
The Certificate of Achievement in Pelvic Health Physical Therapy (CAPP-Pelvic) is awarded to licensed Physical Therapists (PTs) who complete a series of comprehensive in-person evidence-based education courses (90+ hours in the treatment of pelvic pain, urinary and bowel, incontinence, and colorectal, pediatric, male-specific issues), written and clinical testing at each level, at least 1 year of experience treating pelvic health patients, and a written case report rigorously reviewed by the CAPP Case Reflection Committee. Any PT clinic can offer "Pelvic Health" because there is not a standard of education that must be completed to do this. Always ask what courses the pelvic health therapist has had prior to scheduling an appointment and select a therapist with the most education in your locale for the best and the most comprehensive treatment. You can find a list of CAPP-Pelvic providers on https://aptapelvichealth.org/education/capplist/
Can I come to pelvic physical therapy if I am on my period?
Yes, menstruation does not get in the way of physical therapy initial visits or follow-ups. Sometimes seeing what your
muscles are doing during your period can be helpful, and you always have the right to defer any treatments you don’t feel
comfortable with while you are menstruating.
I have had medical, sexual, or physical trauma that I am concerned will affect my physical therapy treatment and ability to tolerate therapy; what should I do?
I regularly work with people who have experienced a wide variety of trauma. My primary goal is always to help you feel
comfortable and safe. It is also common for people to be working concurrently with therapy mental health therapists while in pelvic health physical therapy. If there is something, in particular, you know that will help you to feel more comfortable
during your therapy sessions, it is ok and encouraged to communicate this with me.
I have other conditions I think are causing my pelvic pain (interstitial cystitis, endometriosis, IBS); what will therapy do for me?
Often there are associated musculoskeletal findings (overactive or short muscles, poor posture, and/or trigger
points) in the abdomen or pelvic girdle associated with these conditions. It can be very helpful to learn to manage the
musculoskeletal findings often associated with these conditions to help you learn to live more comfortably in your
body.
I am pregnant, is this safe?
I see many people who are pregnant for therapy for a variety of reasons related to the pelvis; however, we will usually not perform internal assessments or treatments of the pelvic floor musculature for people who are pregnant without special permission from your ob/gyn or midwife. Please let us know if you think you might be pregnant.
How is pelvic floor training different from doing Kegels at home?
Pelvic floor training is more specific to your needs. I find that Kegels are effective if strength is the only issue and a person has the correct pelvic alignment and nerve innervation to the pelvic floor muscles. But it is often not this simple. Many times there is an asymmetry to the patient's pelvic area that needs to be corrected that is creating muscle or nerve tension. Also, most studies show that Kegels are done incorrectly and ineffectively more often than not which can make the issue worse.
What if I have a question that wasn’t on here?
Feel free to email Mary with any other questions or concerns you have at harmonyptwellness@gmail.com