How to Find {and What to Ask} a GOOD Pelvic Floor Therapist

Bottom line: Surgery isn’t your only option when you have diastasis recti, feel like your vagina is falling out, intimacy is painful, or you’re personally keeping Poise and other panty products in business. Whether you pursue surgery or not, the right women’s health specialist can provide you with the right rehab and the right exercises that will improve your movement strategies and overall outcome. You absolutely do NOT have to choose between surgical treatment or accepting dysfunction. You can choose to find a good pelvic floor physical therapist who will help you navigate your surgical and non-surgical options.

While millions of women deal with bulging and pain “down there” or leaking when they laugh, sneeze or cough – sadly believing it’s totally normal – hopefully you’ll be excited to go out and find the perfect PT or women’s health physiotherapist (as they’re called outside the USA) to meet your needs after you’ve finished reading this article.

Here is a video interview I had with Kelly Dean, LPT and founder of The Tummy Team, who joined me to talk about pelvic floor physical therapy. If you watch it, you’ll see how we both believe it’s so important for women to address the root cause of their core and pelvic floor issues, rather than just padding or plugging their problems so they can keep running and pressing through the pain WITHOUT working toward a solution.

Gillian Sukachevin is another pelvic floor physical therapist and specialist whom I’ve also collaborated with as I create safe routines here on Fit2B for those dealing with prolapse, diastasis, hernia, fascia adhesions, and other issues related to core strength. She hangs out in my private member forum to help answer questions, and I love her heart and how she said this:

“I am a physical therapist who works with the pelvic floor and I teach with Kelly Dean in the new Floor of Your Core Program at The Tummy Team. Having a prolapse can create a lot of anxiety and discouragement but there is help. I lived with prolapse myself.

“The thing about prolapse symptoms is that it tells you what you need to care for. Just like pain. It is not something to ignore. The key is knowing how to manage it on a daily basis. 

“I am so grateful that Beth incorporates pelvic floor exercises in Fit2B. I refer to them all the time for prolapse. While rest is crucial because prolapse symptoms do get worse when we are tired – and we need that horizontal position for our tissues to rest – we also need movement to nourish the area.

“I love working with women with prolapse in the clinic. I’ve literally had a uterus in my hands. We have seen this time and again. We treat menopausal and post menopausal women too, and a lot of their issues stem from poor postpartum follow-up. There is more help available now.” – Gillian Sukachevin

Some helpful tidbits for your lady bits when they’re falling to bits

First, you are always qualified to ask questions and make decisions about your care. You have a choice and a say in your treatment! You don’t have to settle for pat answers and 15-minute appointments that don’t help at all or lead to expensive {often unnecessary} surgeries. Good therapists will be motivated by recent research to update their patient protocols, not just rest on their college laurels.

But HOW do you find the right therapist in your area like Kelly or Gillian who can truly help you with the best, most up-to-date treatment options?

The following questions are what you need to ask when you’re searching for the perfect PT to meet your needs. You are the one who determines what the right answers are. Blank stares and “I don’t know” answers are unacceptable. Listen and take notes, and then go with the clinic that makes you the most comfortable and gives you peace and perspective.

Look before you book an appointment:

• Where did the specialist receive his/her training?
• Do they incorporate safe exercise plans with their program?
• Will there be any internal examinations or treatments such as scar tissue release?
• Do they just do manipulations and modalities, or do they also incorporate a rehab plan?
• Are they up to date on the relationship between diastasis recti and pelvic floor dysfunction?
• Do they offer more than kegels, splinted crunches and planks?
• How much time do they spend with each client?
• Do they accept your insurance plan? If not, do they offer a cash discount or deferred billing?
• Do they collaborate with and refer their clients to a certified athletic trainer like Beth Jones for those clients who get depressed if they are not allowed to run or lift weights?

Know before you go! Questions to ask prior to your first appointment: 

• Is there anything I should watch for or avoid between now and my first appointment?
• What can I expect to happen during my first appointment?
• How much will my first appointment cost?
• If you don’t accept my insurance or I’m uninsured, do you offer a cash discount, or can you bill me later, and I’ll pay installments?
• Is it okay if I bring my partner or friend along?

Some women won’t go unless they have a comforting hand to hold, while some clinics rather you come alone. Some therapists/specialists/physios incorporate exercises while others refer out for that piece or ask you to avoid fitness altogether. Sometimes a tens machine is used for biofeedback while other’s may use gloved fingers to assess and release restrictions.

The most important thing is that if the answers YOU get in response to YOUR questions leave YOU at all dissatisfied or conflicted, YOU need to politely end the conversation and keep looking for the right person who can meet YOUR needs.

You have to be comfortable with whomever is working on your who-ha, know what I mean? If you can’t relax above, you will have trouble relaxing below, and that will slow your healing down.

If you don’t resonate with your physiotherapist and start seeing some basic results within a few weeks – and high quality providers will want to see you several times over the course of 6-10 weeks to give you time to work on and apply what they initially taught you before they add a layer of progression that furthers you to the next stage of restoration of function and strength – again, you need to keep looking. The right person will know how to assess and provide methods that are specially geared toward your specific needs relatively quickly.

Above all, do not give up on this. Bulging, leaking and pain in your pelvis have a high impact on your quality of life, but the proper help and exercises can restore your function and confidence again.

And can I just say that most guys would slap any amount of money down to deal with problems with their penis? If they are wetting themselves, and someone says it costs a few PT visits and a few hundred bucks to fix it, they’re going to say, “Where do I sign up?!” Meanwhile, so many women aren’t sure their privates are worth the same? C’mon, ladies.

And the lover in your life is NOT going to say, “No, your undercarriage isn’t worth taking care of.” They sort of have a vested interest, right? You being functional and pain-free will bless and benefit them, too!

So this isn’t just about you and your confidence! It’s about your ability to say yes to playing with your kids, no to pads and pessaries, yes to trampolines, no to girlfriends who say it’s normal, yes to making love without discomfort.

This is treatable. Start calling around today. Perhaps our directory here will be a good place to start?

Routines on Fit2B to help you safely connect with your pelvic floor between now and your first PT appointment:

• Foundational Five
• The SPD Routine
• Restorative Poses.

P.S. That’s my sister walking in the Cascade Lakes Relay a few years ago. She didn’t really get toilet paper stuck in her shorts. She did that on purpose to make people laugh while she walked. It worked 😉 I love you, Aleta!