3rd World Congress on Abdominal and Pelvic Pain Pain Updates, Part I

In Pelvic Floor Physical Therapy by Stephanie Prendergast1 Comment


By Stephanie Prendergast


Last month, pelvic pain enthusiasts traveled from all over the globe to attend the 3rd World Congress on Abdominal and Pelvic Pain in Washington, DC. The World Congress on Abdominal and Pelvic Pain is joint scientific meeting between the International Association for the Study of Pain Special Interest Group on Abdomino-Pelvic Pain, Convergences in pelvic-Perineal Pain, and the International Pelvic Pain Society (IPPS). This was the first time the meeting was held in the United States, hosted by the IPPS, and I was honored to serve as a Scientific Program Chair with Erin Carey, MD and current IPPS President Amy Stein, DPT.


We are pleased to say this year was a huge success! We made a few changes to our normal conference format because of the special and joint nature of the World Congress:


  • We lengthened the scientific session to 3 days, allowing us to have 27 speakers!
  • The pre-conference Basics course sold out!
  • Lorimer Moseley and Paul Hodges presented a killer post-conference course!
  • The expert lunch roundtables sold out!
  • We created cluster topics with expert speakers, one expert moderator, and awarded one oral poster presentation per section to a researcher for their novel work in the following areas:
      • Endometriosis
      • Bowel and Gastrointestinal disorders
      • Interstitial Cystitis/painful Bladder Syndrome
      • Central Nervous System Disorders
      • Vulvar pain disorders
      • Musculoskeletal Pain Syndromes
      • Sexual pain disorders
      • Peripheral Neuralgias
      • Biopsychosocial Considerations


Pelvic health professionals traveled from 26 countries, 30 exhibitors participated, and 89 researchers submitted abstracts. The entire Pelvic Health and Rehabilitation Center clinical staff attended the conference to learn from the best, and that we certainly did. As an added bonus for us at PHRC, the World Congress was a wonderful opportunity to all be together in one place for a number of days. We meet every Wednesday for our staff meeting via video hangout but obviously face-to-face time allowed us more quality time together.



The latest research on how to best evaluate and treat complex pelvic pain syndromes was covered in detail and we are bringing this information to our blog. Before the conference, each PHRC physical therapist chose one lecture to blog about. We want to share the latest research with our patients, with people recovering from pelvic pain, and with our colleagues who could not be there. Starting next week, our series of posts from the World Congress will begin and will continue through February. We stand with the IPPS in their mission to raise awareness about pelvic pain and to help men and women get the help they need. We hope others will share this information with people less informed and we hope this information will encourage medical providers to join the IPPS and attend future conferences. We hope you enjoy the series and please feel free to share you own thoughts and comments with us!



What are pelvic floor muscles?

The pelvic floor muscles are a group of muscles that run from the coccyx to the pubic bone. They are part of the core, helping to support our entire body as well as providing support for the bowel, bladder and uterus. These muscles help us maintain bowel and bladder control and are involved in sexual pleasure and orgasm. The technical name of the pelvic floor muscles is the Levator Ani muscle group. The pudendal nerve, the levator ani nerve, and branches from the S2 – S4 nerve roots innervate the pelvic floor muscles. They are under voluntary and autonomic control, which is a unique feature only they possess compared to other muscle groups.

What is pelvic floor physical therapy?

Pelvic floor physical therapy is a specialized area of physical therapy. Currently, physical therapists need advanced post-graduate education to be able to help people with pelvic floor dysfunction because pelvic floor disorders are not yet being taught in standard physical therapy curricula. The Pelvic Health and Rehabilitation Center provides extensive training for our staff because we recognize the limitations of physical therapy education in this unique area.

What happens at pelvic floor therapy?

During an evaluation for pelvic floor dysfunction the physical therapist will take a detailed history. Following the history the physical therapist will leave the room to allow the patient to change and drape themselves. The physical therapist will return to the room and using gloved hands will perform an external and internal manual assessment of the pelvic floor and girdle muscles. The physical therapist will once again leave the room and allow the patient to dress. Following the manual examination there may also be an examination of strength, motor control, and overall biomechanics and neuromuscular control. The physical therapist will then communicate the findings to the patient and together with their patient they establish an assessment, short term and long term goals and a treatment plan. Typically people with pelvic floor dysfunction are seen one time per week for one hour for varying amounts of time based on the severity and chronicity of the disease. A home exercise program will be established and the physical therapist will help coordinate other providers on the treatment team. Typically patients are seen for 3 months to a year.

What is pudendal neuralgia and how is it treated?

Pudendal Neuralgia is a clinical diagnosis that means pain in the sensory distribution of the pudendal nerve. The pudendal nerve is a mixed nerve that exits the S2 – S4 sacral nerve roots, we have a right and left pudendal nerve and each side has three main trunks: the dorsal branch, the perineal branch, and the inferior rectal branch. The branches supply sensation to the clitoris/penis, labia/scrotum, perineum, anus, the distal ⅓ of the urethra and rectum, and the vulva and vestibule. The nerve branches also control the pelvic floor muscles. The pudendal nerve follows a tortuous path through the pelvic floor and girdle, leaving it vulnerable to compression and tension injuries at various points along its path.

Pudendal Neuralgia occurs when the nerve is unable to slide, glide and move normally and as a result, people experience pain in some or all of the above-mentioned areas. Pelvic floor physical therapy plays a crucial role in identifying the mechanical impairments that are affecting the nerve. The physical therapy treatment plan is designed to restore normal neural function. Patients with pudendal neuralgia require pelvic floor physical therapy and may also benefit from medical management that includes pharmaceuticals and procedures such as pudendal nerve blocks or botox injections.

What is interstitial cystitis and how is it treated?

Interstitial Cystitis is a clinical diagnosis characterized by irritative bladder symptoms such as urinary urgency, frequency, and hesitancy in the absence of infection. Research has shown the majority of patients who meet the clinical definition have pelvic floor dysfunction and myalgia. Therefore, the American Urologic Association recommends pelvic floor physical therapy as first-line treatment for Interstitial Cystitis. Patients will benefit from pelvic floor physical therapy and may also benefit from pharmacologic management or medical procedures such as bladder instillations.

Who is the Pelvic Health and Rehabilitation Team?

The Pelvic Health and Rehabilitation Center was founded by Elizabeth Akincilar and Stephanie Prendergast in 2006, they have been treating people with pelvic floor disorders since 2001. They were trained and mentored by a medical doctor and quickly became experts in treating pelvic floor disorders. They began creating courses and sharing their knowledge around the world. They expanded to 11 locations in the United States and developed a residency style training program for their employees with ongoing weekly mentoring. The physical therapists who work at PHRC have undergone more training than the majority of pelvic floor physical therapists and as a result offer efficient and high quality care.

How many years of experience do we have?

Stephanie and Liz have 24 years of experience and help each and every team member become an expert in the field through their training and mentoring program.

Why PHRC versus anyone else?

PHRC is unique because of the specific focus on pelvic floor disorders and the leadership at our company. We are constantly lecturing, teaching, and staying ahead of the curve with our connections to medical experts and emerging experts. As a result, we are able to efficiently and effectively help our patients restore their pelvic health.

Do we treat men for pelvic floor therapy?

The Pelvic Health and Rehabilitation Center is unique in that the Cofounders have always treated people of all genders and therefore have trained the team members and staff the same way. Many pelvic floor physical therapists focus solely on people with vulvas, this is not the case here.

Do I need pelvic floor therapy forever?

The majority of people with pelvic floor dysfunction will undergo pelvic floor physical therapy for a set amount of time based on their goals. Every 6 -8 weeks goals will be re-established based on the physical improvements and remaining physical impairments. Most patients will achieve their goals in 3 – 6 months. If there are complicating medical or untreated comorbidities some patients will be in therapy longer.


  1. Your blog is really helpful and I always look forward to it!! Thanks for putting great info out there.

Leave a Comment