How Pelvic Floor Rehabilitation Transforms Women's Health at UHS

We’re all familiar with physical therapy as it relates to recovering from an accident, injury or joint replacement. It’s easy to picture a rehab gym environment with weights and machines, and tables where therapists can apply ice or Kinesio tape or move a muscle through its full range of motion. But what about therapy for important muscles you can’t see or feel easily?

Your pelvic floor – the voluntary muscle group that closes off the abdominal cavity – isn’t something you consider much unless it malfunctions. This muscle group plays a significant role in core stability, sexual function, urine and fecal continence, and supporting the pelvic organs. Like any other muscle group, the pelvic floor can experience stress or injury.

UHS pelvic floor therapist Megan Gottlieb PT, DPT, WCS, a Doctor of Physical Therapy with board certification as a clinical specialist in women’s health physical therapy, said, “Pelvic floor physical therapy can treat a variety of diagnoses, including urinary leakage/incontinence, pelvic pain, pelvic organ prolapse, fecal leakage/incontinence, and painful intercourse. We also work with patients experiencing back or pelvic pain during pregnancy and postpartum.” Pelvic floor dysfunction is not always related to a gynecological cause, such as pregnancy or childbirth: Someone may experience stress urinary incontinence purely as a result of trunk instability and poor core strength.

UHS is the only local health system offering pelvic floor therapy with board-certified practitioners. Dr. Gottlieb, fellow physical therapist Sydney Cuomo, DPT and Jacalyn Westcott, PTA offer compassionate care for your pelvic health concerns. “We use guided exercise plus hands-on techniques that manipulate the abdominal wall and pelvic floor. Some patients also receive biofeedback and electrical stimulation to help re-train the pelvic floor muscles. The goal is to help patients recover as much normal function as possible.” Dr. Gottlieb emphasized that it’s never too late to seek help, even if the issue is long-standing or the causative event happened years ago

Dr. Gottlieb highlighted the proliferation of incontinence pad and disposable undergarment advertising leading women to believe they should expect some urinary leakage as part of the aging process: “Urinary frequency, urgency and leakage are not age-related or part of the normal aging process,” Dr. Gottlieb said.

At a first visit, patients complete a symptom questionnaire and have a comprehensive external and internal examination of the musculature surrounding and attaching to the pelvis to determine the best treatment approach. Dr. Gottlieb assesses strength, flexibility and muscle tone, and the visit usually takes about an hour.

Most insurance plans cover pelvic floor therapy, and patients generally have 30 to 60-minute appointments once or twice a week depending on diagnosis and severity of symptoms. Length of treatment depends on patient progress. The ultimate goal of pelvic floor therapy is to resolve pelvic pain and improve patients’ quality of life.

Although patients can make a direct appointment, Dr. Gottlieb recommends an initial visit with a primary care provider to rule out an easily-correctible issue (such as a urinary tract infection) and obtain a referral. To schedule an appointment, call (607) 757-2600.