What We Treat

Our physical therapists are trained to evaluate and treat health issues, including those that affect bladder, bowel and sexual function.

We can also treat pregnancy- and postpartum-related issues, such as muscle and bone pain, getting ready to deliver your baby, and healing after you deliver.

While many of these issues may be hard or embarrassing to talk about, know that we are here to help you. We strive to provide high-quality and patient-focused care.

What to Expect

Each physical therapy session will take place in a private treatment room so you can talk to your therapist one-on-one.

During your first appointment, you and your therapist will talk about your concerns, your medical history and your treatment goals. Then, your therapist will perform a physical exam that may check:

• Your posture
• Your breathing patterns
• Alignment or mobility of your spine and pelvis
• Flexibility of your hip, back, and leg muscles
• Strength of your abdominals, hips, and pelvic floor
• Mobility of the soft tissue of your abdominal wall, hips, and any surgical scars
• Pelvic floor muscle tone and function

With your permission, we will perform an external and internal exam of your pelvic floor muscles. These exams help us check how strong, tense, coordinated and mobile those muscles are. Depending on your symptoms, this exam may be performed vaginally or rectally; your therapist will insert one finger internally.

If you have a history of pain with gynecologic exams or vaginal penetration and an internal pelvic floor muscle assessment is not possible at your first visit, we will work with you to find the right time to attempt the internal assessment. The comfort of our patients is a priority to us.

Please bring a completed copy of the Physical Therapy Screening Questionnaire to your first appointment.

Physical Therapy Screening Questionnaire (PDF): English | Spanish

After the physical exam, your therapist will talk with you about what they found and give you their treatment recommendations.

Follow-Up Visits

Additional therapy visits may include different treatment techniques that fit your needs and goals, such as:

• Manual therapy
• Strengthening
• Neuromuscular re-education
• Behavioral changes
• Bladder retraining
• Posture
• Core stabilization
• Biofeedback
• Dry needling
• Electrical stimulation for weak or overactive muscles

Your therapist may also prescribe some exercises for you to do at home. The exercises will help the work you do with your therapist during your follow up visits. They may include:

• Stretches
• Breathing exercises
• Strengthening exercises
• Pain relief positions

Patients are typically scheduled for visits once a week for approximately 12 sessions; each person needs a different number of sessions. Your therapist will communicate regularly with you about your progress. They may recommend adjusting your scheduled visits as needed.

Pelvic Floor Physical Therapy Is Important

Pelvic floor disorders affect millions of people every year. These issues often impact pelvic health, such as bowel and bladder changes or pain during sex. They can develop due to pregnancy or childbirth, after surgery or as part of aging.

You do not have to live with the discomfort or embarrassment that pelvic floor disorders can cause. Find the help and compassionate care you need from the specially trained physical therapists at Northwestern Medicine.

What is the Pelvic Floor?

The pelvic floor is a group of muscles at the bottom of your pelvis. The muscles extend from front to back and form a sling-like structure that has three different layers.

These muscles support your internal pelvic organs, including your bladder, uterus and rectum. If you are pregnant, the pelvic floor also supports the weight of your baby. If your pelvic floor is not providing enough support, it can lead to pelvic organ prolapse (when organs fall downward into the vagina) or the feeling that something is falling out of your vagina or rectum. You may also feel pain or heaviness in your pelvis or abdomen.

Your pelvic muscles also surround the openings of your urethra, vagina and anus. They are important for controlling urination and defecation, as well as releasing or holding back gas. If your pelvic floor muscles cannot function properly, you may experience leakage of urine, stool or gas. It may also be hard or painful to pass urine, stool, or gas.

These muscles are also involved in sexual function. The pelvic floor muscles contract and relax during arousal so the right amount of blood flows to the genital area. When these muscles do not work properly, it can cause pain, reduce sensation during sexual activity, make it difficult to orgasm or make arousal painful.

The pelvic floor muscles are also connected to the deep muscles of your abdominal wall (called the transversus abdominis). The pelvic floor works with our deep abdominal muscles, our lower back muscles (multifidus) and our diaphragm to stabilize our spine and pelvis when we move. If the pelvic floor is not working properly, it can lead to poor stability, or pain in your lower back or pelvic joints.

Learn More

To learn more about the different locations offering Women’s Health Physical Therapy, please visit the following sites:

• Northwestern Medicine Women’s Integrated Pelvic Health Program
• Northwestern Medicine Center for Complex Gynecology
• Northwestern Medicine Obstetrics and Gynecology
• Northwestern Medicine Center for Sexual Medicine and Menopause
• Northwestern Medicine Faculty Obstetrics and Gynecology