Pelvic Floor Physical Therapy

Just like other types of physical therapy, we assess and treat issues with muscles, nerves, connective tissue, and joints. In the specialty of pelvic health, we just do this to help you with concerns in your pelvic region (generally from your abdomen to your thighs) that can cause pain or issues with bladder, bowel, and sexual function. We still take a head to toe approach so that we can identify root cause issues, but can also more directly assess and treat your pelvic floor which is a group of muscles at the base of your pelvis.

Nope! Washington is a direct-access state for physical therapy services so you can see us without jumping through the hoops of seeing a physician first. Our therapists are well trained in screening for issues that would warrant a follow up with a physician and will make sure you are in the right place too. Some insurance providers do require a referral, so if you are worried about reimbursement for our services, you can call to check with them.

You should ALWAYS be in control of your own body and care. We often find it valuable to do an internal examination to get specific information about how your pelvic floor muscles are functioning and will explain why we are recommending an exam if it makes sense. However, if for any reason at all you’d prefer not to, we have plenty of tools to still be able to get you results with a purely external approach.

Your initial evaluation starts even before you walk in the door the first time. We send comprehensive paperwork for you to complete prior to your appointment so that your therapist can begin to get a picture of what you may be needing and plan a tailored evaluation. Then, on your first visit, we like to hear your story and chat about anything that is too hard to capture in the paperwork alone. From there, we complete an external and/or internal examination (internal work is never mandatory) to continue gathering information and work with you to build a plan of care to get your symptoms to go away and stay away!

Your treatment is always individualized to your specific needs as we do not believe in a cookie-cutter approach! Often, treatment will include a combination of manual therapy, education, and/or movement strategies that will target your specific issues. Each of our sessions is about an hour long, and within that time we check in to see how you are doing or if there is anything specific you want to discuss, do the actual interventions that we have planned for that day, and then make sure you are clear in what to be doing between appointments and where you are in your overall plan of care.

It is vastly different! First of all, depending on what is driving your dysfunction, kegels may be making your condition worse. Secondly, even if we determine you need to improve your pelvic floor strength, we want to make sure your strength is actually functional for your life. And finally, we feel strongly that we have to zoom out from just the pelvic floor to make sure other areas aren’t driving your problem. Our bodies work all together, so we can’t expect isolating one part is going to get you your best results!

1000%! We believe it is never too early or too late to start pelvic floor physical therapy. Occasionally there are a few more layers to peel back if your symptoms have been going on a long time, but we have seen people at all ages and stages feel better from things they thought just had to be their new normal.

Ultimately, you can wear whatever you feel most comfortable in, but sometimes it can be helpful to wear something you can move around in if exercise is a part of our plan together or we need to access certain parts of your body. We always have options available if you aren’t able to come in specific clothing and we decide it would be helpful to have you change.

It shouldn’t be! We stay in regular communication about how you are feeling with certain assessments or treatments an will let you know exactly what to expect. The majority of things we do should not be painful, and we can always modify or change course as needed.

We work primarily with adults at this time. Teenagers with concerns may also benefit from our care, we will just talk to you ahead of time to ensure we are a good fit and make any changes to our treatment approach to include age-appropriate interventions as needed.

Yes! Dr. Nathan Gilpin has a special interest in treating men’s health and has done extensive training specifically in this area. To get more details, check out our Men’s Health page.

We almost always  give you things to work on at home, but what that looks like will vary based on the person! If you are already overloaded with your life to the point that having one more thing to do feels impossible, we may just lean into how to make the things you’re already doing just a little bit better for your body. Maybe we help you figure out how to sneak in a few healthy habits in your schedule. Or maybe you are ready to build in a new exercise routine and want guidance in how best to do that.  The bottom line is that what you do outside of the clinic matters so we will be talking about things to implement on your own, but we are going to meet you where you are to make sure it is sustainable and not just another stressor. It will only work if it works for YOU!

We totally get that you want to know this and wish that it was a simple answer! Because the factors that could be impacting your condition are different for everyone, even people with the same diagnosis, we don’t know until we start working with you. Things such as how long you’ve been having a problem, your medical history, your daily habits, how much you can devote to your journey, etc. can all play a part. What we do know is that you should be seeing some positive change within the first 3-5 visits. Then, we will continue to work with you until your symptoms are not only gone but you have the tools to keep them away for good!