Pelvic Health Physical Therapy

Many people with uncomfortable or upsetting pelvic health problems wonder: Will I have to live like this forever? The answer is almost always no.

The muscles, nerves and ligaments deep in your pelvic floor contribute to many bodily functions that can greatly impact your quality of life. These include the ability to support your internal organs, control your bladder and bowels, and enjoy a healthy sex life – without pain.

Our team of physical therapists (PTs) have years of specialized training and experience treating pelvic health conditions in both men and women. Each year, we help hundreds of people with pelvic organ prolapse, pelvic pain, pain during sex, incontinence, overactive bladder and other pelvic health issues feel happier, healthier and more confident. 

Our care starts with listening closely and understanding your unique symptoms, needs and goals. From there, we educate you about the essential role of your pelvic health systems, including how to have better muscle balance and breathe more effectively. We also teach you about changes you can make to your daily routine and behaviors to help you achieve your goals. Together, we make improving your pelvic health not just as comfortable as possible – but potentially life-changing.

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Pelvic Health Conditions We Treat

• Pelvic organ prolapse.
• Urinary incontinence and overactive bladder.
• Fecal incontinence.
• Gas incontinence.
• Obstructed defecation (difficulty having bowel movements).
• Pain with arousal, sex or post sexual activity (in both men and women).
• Vaginismus (involuntary tensing of the vagina), which can lead to painful sex or muscle spasms with insertion.
• Vulvodynia (burning, stinging, or discomfort in the outside area of female genitals).
• Pelvic pain, including pain in the vagina, penis, scrotum, urethra, anus, rectum, groin, coccyx (tailbone) and abdomen.
• Complications from previous surgeries.
• Side effects from cancer treatment, including prostate cancer, anorectal cancers, gynecological cancers and gynecological changes associated with breast cancer treatments.

Pelvic Health Physical Therapy Treatments and Services

• Counseling for lifestyle and behavior changes. We educate you about methods and tools you can use at home that can improve bladder control, ease bowel movements or help with pain during sex and sexual function. Many people notice great improvements for these problems with low-tech, simple solutions like scheduling when you drink fluids, adjusting toilet positioning, or using vaginal lubrication.
• A comprehensive pelvic exam. We’re specially trained to include an internal pelvic floor exam as part of your physical exam. This exam helps us assess the status and health of your pelvic floor muscles, fascia and nerves. It also helps us identify if you have scar tissue, pain or pelvic organ position issues that could affect the function of your bladder, bowels or sexual organs. These internal examinations are always optional, performed with consent and can be done with a second person present – if you choose. 
• Pelvic floor exercises. The exercises we teach you are based on the unique findings of your exam. We may help you learn better breathing patterns or better integrate your core and pelvic floor muscles. We may also teach specific exercises to recruit, train and strengthen muscles that can help avoid leaking urine, stool or gas. Sometimes, we teach people how to relax muscles to allow better voiding, emptying of the bowels and pain-free sex.
• Manual release and internal therapy. We use mobilization and stretching techniques to help release tight muscles or scarred tissues around the spine, hips and pelvis. These techniques can increase muscle length, tissue mobility, and a muscle’s ability to relax.
• Vaginal training and dilation. We empower people to use tools like dilators to become more involved in their own care. Dilators are progressively sized cylinders, typically made of silicone or plastic, that help stretch and release vaginal tissues. Using a dilator can help reduce pain during sex – and can be life-changing after gynecological or rectal cancer surgeries and treatments. 
• Biofeedback. We use tactile (manual) feedback and biofeedback with sensors to monitor and train your pelvic floor muscles how to tense and relax. This technology can help with pelvic floor muscle weakness, pelvic floor tension and muscle coordination issues that may affect bowel and bladder functioning,  
• Electrical stimulation. This treatment sends electrical pulses to stimulate pelvic floor muscles and assists in strength training or addressing nerve related issues. 
• Biopyschosocial care. We recognize the role of stress and other factors in overall well-being and are equipped to recommend resources that help people feel better in mind and body.

Taking the time to get to know you and develop a truly personalized treatment plan

We developed our own set of health history questions to make sure we fully understand why you’re coming to see us, how long you’ve been experiencing your symptoms – and what you can’t do that you’d like to be able to do. Our goal is to help you live the life you want to live, which sometimes means uncovering more than one area of pelvic health to improve. Because we take the time to do a detailed, holistic health history, we’re often able to help people who did not find relief or effective treatment elsewhere.

Each physical therapy session with us is highly personalized. For example, we take great care not to overwhelm a new mom with recommendations or exercises she can’t possibly find time to do at home. We make sure the treatment you get and the exercises we prescribe are realistic and tailored to your life – giving you the best chance for success. 

Treatment built on trust and continuous consent

We know that talking about sex and going to the bathroom can be difficult. We also know that because of the intimate nature of the genital and pelvic organs, you need a provider you can trust and that makes you feel comfortable.

Every time you come to see us, we’ll explain what we plan to do and why and we’ll ask for your consent. You are always the boss, and we are always the helper. At any moment of any visit, you can change your mind about the plan of care because everything we do is always optional. You can also decide if you want a second person in the room. You’re welcome to bring that person with you, or request that one of our medical assistants be present during the exam and treatment.

Several of our physical therapists have trauma-informed training, which is special training in caring for people who have experienced trauma.

A passion for education

Our pelvic floor region has many parts that are not easily observed, examined – or talked about. Because the pelvic floor is so important and not always well-understood, our care focuses a lot on education. We use visual aids to help you understand where your pelvic muscles, ligaments, organs and structures are located and their importance in your day-to-day functioning.

As part of our passion for helping men and women better understand their pelvic health, we teach classes at or near Overlake’s main campus in Bellevue and at the HighMark Medical Specialty Clinic in Issaquah. 

Learn more about pelvic health classes offered through Overlake.

Specialized experience for cancer patients

If you’ve had treatment for gynecological cancer, breast cancer – or colorectal, prostate, kidney or bladder cancer – it’s not uncommon to experience pelvic health issues.

These cancer treatments can:

• Result in scar tissue that can lead to pelvic pain and discomfort.
• Deplete hormone levels, which can affect mood and libido (sexual desire) and cause vaginal dryness and pain.
• Result in vaginal shortening.
• Cause sexual dysfunction in men, including erectile dysfunction and Peyronie disease.

Our PTs have specialized training to help people experiencing these side effects. And we can often improve their quality of life with customized treatment programs.

At Overlake Physical Therapy, we provide effective, holistic pelvic rehabilitative care for a broad range of people. Our specially trained PTs have years of experience helping people gain control over their bladders and bowels, reduce pelvic pain and get back to activities they enjoy. Our care starts with taking the time to find out what’s most important to you. And then, we tailor treatment sessions to what you feel most comfortable with. To make an appointment or to ask us a question, call us today at (425) 688-5900.