What if you Can’t Find a Pelvic Floor PT?

In Female Pelvic Pain, Male Pelvic Pain, Post-Surgical Pelvic Floor Rehabilitation by Stephanie Prendergast40 Comments

 

By Guest Blogger Sara Sauder

In this week’s post, blog contributor and fellow pelvic floor PT, Sara Sauder, who practices in Austin, Texas at Sullivan Physical Therapy, provides us with an honest, thoughtful answer to this all-too-common dilemma. Take it away Sara!

If you’re lucky enough to find a pelvic floor physical therapist in your area, good for you!  You are hopefully on your way to seeing some change in your quality of life.

Unfortunately, however, there are many people that do not live close to an experienced therapist.  This means that some travel may be involved. Many of my patients come from neighboring cities to get weekly treatments for their pelvic pain.

It is not a perfect scenario as some of them have an increase in their symptoms in just the drive that takes them to my clinic and back home. But, it is the only option that they have right now and they have decided that it is more beneficial to make the drive and get care than to stay at home without care.

If you know of a good pelvic floor physical therapist in a neighboring city, weigh the pros and cons of becoming their patient. You might want to give it a trial run for a few weeks to see if making the effort to see them is worth it for you. This is a huge commitment. It could mean taking off a considerable amount of time from work for you and possibly for someone that might need to drive you. (Some of my patients just cannot sit so they cannot drive themselves. Therapy itself is not going to preclude you from driving independently.)

For those of you who live in a city or even a state that does not have pelvic floor physical therapy options – you can still get help. A few clinics in the country have programs for out-of-state patients, mine included. This means that you can make appointments in a clinic and get treatment by a very experienced therapist.

The therapist should be teaching you a home program that is tailored to your needs. Some of these clinics even encourage you to bring a guest. This could be either a physical therapist from your hometown that is willing to learn new techniques to treat you, or it could be a loved one that will be trained in safe, effective techniques that could benefit you in the long run.

The treatment that you will receive at home will be helpful and move you forward, but it will not substitute seeing a very experienced pelvic floor physical therapist consistently.  This scenario is not perfect, but it is the best available option if you live in an area without a lot of pelvic floor knowledge.

Another issue that arises from only going for an out-of-state visit is that there is poor follow-up.  See if your therapist can continue communication with you for several weeks after your visit so they can continue to tweak your home program as necessary.

Treatments are not cookie-cutter for each diagnosis, so while we might be able to teach you some really powerful stuff for a home program, once you go home and get it started, you might need to change a few things.  This is where keeping email or phone communication for a bit will come in really handy.

Below is a list of pelvic floor physical therapy clinics that have out-of-town patient programs:

Contact me with any questions at Sara@sullivanphysicaltherapy.com or leave them anonymously in the comment section below.

More about Sara:

SaraBAPPSara K. Sauder PT, DPT is a pelvic floor physical therapist from Sullivan Physical Therapist in Austin, Texas. She received her Bachelor’s degree in Biology from the University of Texas in Austin and her Masters and Doctorate degrees from Texas Woman’s University in Houston.

Sara’s primary interest is pelvic pain. She is consistently learning about new treatment techniques, reading about complex pain treatment approaches and pursues opportunities to learn from pelvic pain specialists across the country. Her goal is to help people living with chronic pain learn how to manage, improve and abolish their symptoms. She feels patient education is vital to recovery and she works to have open communication with each patient’s medical team.  Check out her awesome blog at: blogaboutpelvicpain.com!

Comments

  1. The article was very helpful! Do you know of any pelvic floor PTs in New Jersey? Thanks

  2. Hi Sara, i’ve been suffering with pelvic pain for over a year and a half now and have made considerable progress mostly on my own. Lots of stretching and i learned to do my own internal massage but i have one area that i cant seem to loosen up and that is the area along the alcocks canal. I make minor progress each morning only for it to return to its original state by the next morning. Not sure but i think its the puborectalis muscle. Is there any advice or technique that you can pass along that might help. I can’t seem to find anything on the web about loosening this area. Any info would be greatly appreciated. Thanks!

    1. Hi Chris,

      I’m sorry that you are dealing with pelvic pain, but it is good to hear that you are making considerable progress on your own. I would suggest trying diaphragmatic breathing. This will relax your pelvic floor muscles collectively. If you make this a habit as a daily practice and also something that you do when you are particularly stressed, it can be very helpful. Also, some physicians will prescribe a rectal suppository to assist in relaxing pelvic floor muscles. Some physicians prescribe this to be used once nightly and others prescribe it to be used as needed up to 4x/day. It just depends on the dosage and the medication itself.

      I hope this is helpful. If you have any more questions specifically for me, feel free to email me at Sara@Sullivanphysicaltherapy.com

      Have a great day,

      Sara

  3. Thank you for your ideas! However, an experienced therapist just moved to the Los Angeles area, & even though I’m willing to pay cash for treatment, she refuses to see anyone with Medicare. They sent me some article, which I don’t understand. Can you explain what is going on?
    Sincerely, Adele Casden. Acasden@securakey.com
    Phone 818 222-6336

      1. I don’t want to use my Medicare. She doesn’t accept their r payment. I want to pay her cash for the physical therapy. However, she says because I have Medicare, she can’t accept my cash or treat me. I’m desperate for some help from a knowledgable physical therapist. I called Medicare twice & they say it’s ok for me to pay cash & not use my Medicare. There is some new rule which stops her from accepting cash from a person who has Medicare. This can’t just be in California. What’s going on? From what I understand Medicare is trying to force PT to accept their payment. This is unfair to patients who need help. Medicare doesn’t pat a fair amount.

    1. Hi Adele,

      Unfortunately, I do not know much about insurance so my best suggestion is to read the post suggested by Stephanie.

      I need to brush up more on this myself. Sorry I can’t be of more help.

      Have a great day,

      Sara

  4. There are other great pelvic floor PTs in New York
    1. Lila Abatte in Long Island
    2. Pamela Morrison in New York CIty

    1. Thanks for the information. I will email these therapists and see if they have an out of town program.

      Sara

  5. You recommended a suppository to relax ones pudendal muscle. Is this suppository made with Valium in it? Does this have to be made by private pharmacy to order for you? Is there a company that makes these in a regular pharmacy? My Dr. Ordered them for me but they had to be made to order, which was expensive.
    Thanks for your help,
    Sincerely, Adele

    1. Author

      Dear Adele,

      Valium suppositories, which are often prescribed for pelvic pain symptoms, are made by a compounding pharmacy. Baclophen suppositories are another option for pelvic floor muscle spasm.

      All my best,
      Stephanie

  6. Hi Sara, Are you aware of any pelvic floor PTs in South Dakota?
    I’ve been struggling with PN? for about 7 years and its not getting any better. I have seen a neurologist but nobody seems to know much about this here. Have pain on the left buttock whenever I sit for more then a minute or 2. Nerve activity in the vagina drives me crazy and i cant sleep on my back anymore.Usually by morning the pain has subsided from rest and if i’m very active I tolerate everything better. But I’m Self employed and researching at a computer is a lot of my work.
    Don’t know what to do next.

    1. Hi Gail,

      As far as therapists go, I found two names off the Herman and Wallace website: Sarah Groher and Robin Lund. Both are in Sioux Falls. I do not know these practitioners, so you might want to google them and give them a call. Talk to them on the phone about your symptoms and see if they have experience in treating your symptoms. It’s very important that you see someone qualified to treat potential PN.

      I looked at the International Pelvic Pain Society’s link of providers and I found Dr. Kevin Benson in Sioux Falls. You might give him a call and see whom he sends his pelvic pain patients to. In addition, you might ask him about your symptoms.

      If all else fails, you can do an out of town treatment program with any of the clinics I have listed in my post. This can be very helpful, especially if you have a loved one that can go with you and can help with the rehabilitation process.

      Hope this has been helpful. Feel free to email me at Sara@Sullivanphysicaltherapy.com if you have any more questions.

      Sara

  7. Hi Sara, my brother has a pudendal neuropathy more than one year ago,he lives in egypt and he failed to find a pt. who can deal with his pelvic floor sever pain.do you have any branches for your center in the middle east like in UAE,Egypt,kSA or any other gulf countries?and if not do you know any therapist who is working or visiting the middle east?..thanks so much for your time and efforts

    1. Hi Maha,

      I’m sorry, but the best way I know to look up international contacts is via the International Pelvic Pain Society website.

      http://www.pelvicpain.org/Patients/Find-a-Medical-Provider.aspx

      In the bottom right hand corner there is a link for other countries for you to look through.

      Stephanie Prendergast was the president of the International Pelvic Pain Society last year. Perhaps she can be of further assistance?

      I hope this has been helpful.

      Sara

  8. Can PF problems cause a rotated pelvis? When someone puts my pelvis in alignment it just goes back out & I have tightness in PF so am thinking possible this is why it won’t hold. I have an ilium outflare and don’t know if PF muslces are strong enough to pull like that.

    1. Author

      Dear Anne,

      A rotated pelvic girdle is often the result of muscle imbalances which can involve tightness and/or weakness, of the muscles that attache to the pelvic girdle, including the pelvic floor musculature. So the answer is yes, the pelvic floor muscles could be contributing to the misalignment of your pelvic girdle.

      All my best,
      Liz

    1. Author

      Dear Phil,

      Below is a pelvic floor PT that has taken our class:

      Cody Alison PT Nashua NH 6035982401 St. Joseph’s Hospital

      Best, Liz

  9. Hi, can you recommend a PT that treats Pelvic Floor issues in Georgia. I have vulvodynia from PFD, we think it is due to a fall I had from a horse that fractured my pelvis. I live south of Atlanta, Ga. Thanks.

    1. Author

      Dear Amelia,

      I’m so sorry to hear about all that you are going through. The only PTs that we are familiar with in Georgia are below; I’m not sure if any of them are near you as I’m not super-familiar with Georgia. We’ll also ask a few of our PT colleagues in the country if they know of anyone. IN the meantime, check out his blog post we wrote that gives a few tips on finding PTs:

      Howell Lone PT Auburn GA 7709955242 lone_howell@msn.com Physiotherapy Associates Lawrenceville
      Hunt Jenny PT Alphretta GA 678-819-8720 provenance.rehab@gmail.com Provenance Rehabilitation of the Greater Atlanta Area

      Blog on finding a PT: https://pelvicpainrehab.com/pelvic-floor-physical-therapy/545/how-do-i-find-a-pelvic-floor-pt/

      All my best,
      Liz

  10. Do you know of any PTs who specialize in Pelvic floor dysfunction in Rockland County, NY or Northern New Jersey?

    1. Author

      Hello Debbie,

      Here are our recommendation in New Jersey:

      Niva Herzig, MSPT
      Core Dynamics PT
      Englewood NJ
      201-568-5060
      info@coredynamicspt.com

      Nancy Ely-Maskal, PTA
      Physical Medicine and Rehabilitation Center
      Englewood NJ
      201-567-2277

      Best,

      Rachel

  11. Anybody can share some pelvic floor PT’s in Southern New Jersey? sip code 08360

    1. Author

      Hello Denisse,

      Michelle Dela Rosa, DPT is located in Columbus, NJ. Her information is below:

      Connect Physical Therapy
      (609) 584-4770 or (609) 379-0900

      Kindly,

      Stephanie

  12. What treatment do you recommend if you are diagnosed with a hyperactive cremaster muscle? Do you have any information on therapists in the Toledo, Ohio area?

  13. Can you suggest a pelvic floor specialist PT who would be open to treating male patients near Lawrenceville NJ (08540).

  14. Hello !
    I am. 53 year old male and I need to find a pelvic floor specialist ,hopefully close to home . I live in Rockland County and have looked online and I see that there are a few . My question is I really don’t want to pick a place out of a hat and hope they are good at what they do . Do you know of a reputable place that has had success with anyone and that is close to home ?
    Thanks for any help
    Chris

  15. I have suffered from erectile dysfunction since I was 18, been to many doctors and urologist with no help at all….had ultrasounds, exams, blood works, nite time test, all normal. About a year ago I started having UTI symptoms and pain in my tail bone with many negative Urine screens. Doctors said I had prostatitis, which subjected me to months of different anti biotics with no improvement. I did, however, find relief after reading the book a headache in the pelvis and started doing pelvic floor stretches. All symptoms subsided within a week. My question is, could I have some sort of underlying pelvic floor dysfunction still causing my ED??

    1. Hi Matt,

      It sounds like you may have a pelvic floor disorder. Unfortunately we cannot make specific recommendations without evaluating you. We would be happy to evaluate you in one of our locations or you can use our website to find a pelvic floor physical therapist in your area that can help.

      Regards,
      Admin

  16. Hi, I was diagnosed with pelvic floor dysfunction and was seeing a physical therapist in New York City. Unfortunately they do not take insurance and it has become so expensive over $2000 for eight sessions. Would you be able to recommend any pelvic floor therapist that take insurance in Staten Island, New York or close to it . I am currently taking Valium suppositories, taking hot baths and doing Diaphragmatic breathing and it is helping a little but I think the therapy and combined with the Valium will be very helpful. Thank you!

  17. Helpful info,I also live in middle Ga. I had pudendal nerve release surgery in Houston Tx. 3 years ago with no help, a year ago I had chryoblation in Atlanta on the left side with good results but it was temporary. Dr. Ansil did my Surgery in Tx.,Dr.Prologo in Atlanta.I have had nerve blocks also.I have PGAD upon sitting, going on 7 years now.what are the best meds to be on?I need help please…..

    1. It sounds like you may have a pelvic floor disorder. Unfortunately we cannot make specific recommendations without evaluating you. We would be happy to evaluate you in one of our locations or you can use our website to find a pelvic floor physical therapist in your area that can help.

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