pelvic pain rehab
pelvic pain rehab

Physical therapists undergo advanced post-graduate education in pelvic floor anatomy and physiology to help meet the pelvic health needs of patients. Considering the field of physical therapy as a whole, pelvic floor physical therapy is a more recent, but quickly emerging field and we are excited to be part of it. While we have advanced training in pelvic health we are first and foremost physical therapists that take the entire body and mind into consideration.

We can help people recover from symptoms that stem from impairments in the musculoskeletal, nervous, reproductive, urologic, and gastrointestinal systems. Pelvic health symptoms generally fall into a few categories: bladder, bowel, and sexual dysfunction and pelvic pain. The symptoms may develop for many different reasons, including injury, trauma, surgery, medication-induced, pregnancy, and menopause, to just name a few. We recommend checking out the rest of our website for more specific information on the symptoms listed below. 

Symptoms

Bladder Symptoms

  • Urinary urgency, frequency, hesitancy and pain in the absence of infection
  • Weak urinary stream
  • Leaking urine (incontinence)
  • Urethra and bladder pain
  • Pain before, during or after urination
  • Nocturia (nighttime urination)
  • Pediatric bed wetting (nocturnal enuresis)

Bowel Symptoms

  • Straining to evacuate stool
  • Adult and pediatric constipation
  • Need for excessive toilet paper
  • Fecal and/or gas leakage and incontinence
  • Hemorrhoids and fissures
  • Pain before, during or after bowel movements
  • Anal/rectal pain, burning or itching

*Male Sexual Symptoms

  • Erectile dysfunction: poor quality, inability to achieve erection, inability to maintain erection, premature ejaculation
  • Decreased force or inability to ejaculate
  • Climacturia (incontinence with orgasm)
  • Post ejaculaory pain: tip and/or shaft of penis, perineum, scrotum
  • Discoloration in penis/scrotum/perineum

*Female Sexual Symptoms

  • Inability or decreased ability to lubricate
  • Pain upon vaginal penetration, with deep penetration only, and/or continuous pain with penetration
  • Clitoral pain, hypersensitivity to touch
  • Pain and/or burning after sexual contact
  • Inability to orgasm, diminished orgasm
  • Urinary incontinence during sexual activity
  • Climacturia (incontinence with orgasm)

*Male Pelvic Pain Symptoms

  • Burning, itching, aching, or other types of pain in the penis, scrotum, testicles, perineal and/or anal area
  • Pain with sitting, certain types of exercises, and certain types of clothing
  • Post ejaculatory pain in the penis, scrotum and/or perineum
  • Gastrointestinal distress, bloating, and/or constipation
  • Symptoms can be provoked, such as in response to ejaculation or exercise, or unprovoked and spontaneous
  • Symptoms may be intermittent or constant

*Female Pelvic Pain Symptoms

  • Burning, itching, aching or other types of pain in the vulva, vagina, perineal, and/or anal area
  • Pain with intercourse, hypersensitivity when wearing pants and/or underwear, and pain with sitting
  • Exercise may provoke or exacerbate symptoms
  • Abdominal bloating, gastrointestinal distress, and constipation
  • Symptoms can be provoked, meaning with penetrative intercourse or tampon insertion, or unprovoked and spontaneous
  • Symptoms can be intermittent or constant

Transgender Pelvic Health Symptoms

  • Pain from surgical scars
  • Pain with vaginal penetration
  • Inability to achieve vaginal penetration
  • Difficulty or inability to achieve orgasm
  • Urinary dysfunction including urgency, frequency, hesitancy, incontinence and spraying
  • Pelvic and low back pain
pelvic pain rehab

Symptoms

Bladder Symptoms

  • Urinary urgency, frequency, hesitancy and pain in the absence of infection
  • Weak urinary stream
  • Leaking urine (incontinence)
  • Urethra and bladder pain
  • Pain before, during or after urination
  • Nocturia (nighttime urination)
  • Pediatric bed wetting (nocturnal enuresis)

*Male Sexual Symptoms

  • Erectile dysfunction: poor quality, inability to achieve erection, inability to maintain erection, premature ejaculation
  • Decreased force or inability to ejaculate
  • Climacturia (incontinence with orgasm)
  • Post ejaculaory pain: tip and/or shaft of penis, perineum, scrotum
  • Discoloration in penis/scrotum/perineum

*Male Pelvic Pain Symptoms

  • Burning, itching, aching, or other types of pain in the penis, scrotum, testicles, perineal and/or anal area
  • Pain with sitting, certain types of exercises, and certain types of clothing
  • Post ejaculatory pain in the penis, scrotum and/or perineum
  • Gastrointestinal distress, bloating, and/or constipation
  • Symptoms can be provoked, such as in response to ejaculation or exercise, or unprovoked and spontaneous
  • Symptoms may be intermittent or constant

Bowel Symptoms

  • Straining to evacuate stool
  • Adult and pediatric constipation
  • Need for excessive toilet paper
  • Fecal and/or gas leakage and incontinence
  • Hemorrhoids and fissures
  • Pain before, during or after bowel movements
  • Anal/rectal pain, burning or itching

*Female Sexual Symptoms

  • Inability or decreased ability to lubricate
  • Pain upon vaginal penetration, with deep penetration only, and/or continuous pain with penetration
  • Clitoral pain, hypersensitivity to touch
  • Pain and/or burning after sexual contact
  • Inability to orgasm, diminished orgasm
  • Urinary incontinence during sexual activity
  • Climacturia (incontinence with orgasm)

*Female Pelvic Pain Symptoms

  • Burning, itching, aching or other types of pain in the vulva, vagina, perineal, and/or anal area
  • Pain with intercourse, hypersensitivity when wearing pants and/or underwear, and pain with sitting
  • Exercise may provoke or exacerbate symptoms
  • Abdominal bloating, gastrointestinal distress, and constipation
  • Symptoms can be provoked, meaning with penetrative intercourse or tampon insertion, or unprovoked and spontaneous
  • Symptoms can be intermittent or constant

Transgender Pelvic Health Symptoms

  • Pain from surgical scars
  • Pain with vaginal penetration
  • Inability to achieve vaginal penetration
  • Difficulty or inability to achieve orgasm
  • Urinary dysfunction including urgency, frequency, hesitancy, incontinence and spraying
  • Pelvic and low back pain
pelvic pain rehab

Treatment:

How We Can Help You

pelvic pain rehab

If you suffer from any of these symptoms, getting a pelvic health physical therapy evaluation is the right step towards recovery. During the evaluation, the physical therapist reviews your history and symptoms with you, what you have been diagnosed with in the past, the treatments you have undergone and how effective or not effective these treatments have been. Importantly, we understand what you have been going through and that most people are frustrated by the time they get to see us. During the physical examination the physical therapist examines muscles, tissues, joints, nerves, and movement patterns. Once the examination is complete your therapist reviews your findings with you. The physical therapist creates an assessment which explains how you developed your symptoms and creates short and long-term goals for your treatment plan. Typically, the frequency of physical therapy treatment is one to two times per week for roughly 12 weeks. You are given a home exercise program to compliment your in-person sessions, and your physical therapist will help to coordinate your recovery with the other members of your treatment team. We are here to help you recover and live your best life! 

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Treatment:

How We Can Help You

Office information

PHRC expanded to Walnut Creek in 2018 when we were invited to share space with our colleagues from Innovative Wellness. We are happy to meet the needs of our patients on the eastern side of the Caldecott Tunnel. Free parking is available for our patients in the attached parking lot.

Office information

PHRC expanded to Walnut Creek in 2018 when we were invited to share space with our colleagues from Innovative Wellness. We are happy to meet the needs of our patients on the eastern side of the Caldecott Tunnel. Free parking is available for our patients in the attached parking lot.

Frequently Asked Questions

What are the symptoms of pelvic floor dysfunction?

The pelvic floor muscles are responsible for urinary, bowel and sexual function. When the muscles become impaired patients may experience things such as urinary and/or bowel hesitancy, urgency, frequency, pain, or leaking. People may also experience pain during or after intercourse, orgasm challenges, and genital pain.

What is an evaluation like for pelvic floor physical therapy?

The evaluation appointment is typically one hour and the goal is to figure out what the main contributing factors are to the persons’ symptoms. The PTs at PHRC act like investigators uncovering all of the potential reasons for why one might be experiencing their symptoms. First, the physical therapist will conduct an interview to best understand the patient’s history and symptoms. Following this discussion the PT will conduct a physical examination which includes a manual examination of relevant structures and a biomechanical evaluation. After the physical examination, the PT will discuss the findings with the patient and they will establish a treatment plan. This includes short term and long term goals and the expected frequency and duration of treatment.

What is a physical therapy assessment?

An assessment is always part of our treatment plans. This is when the physical therapist links a patient’s history to their physical impairments and symptoms. Pelvic floor dysfunction comes with a number of symptoms, helping our patients understand how and why they developed these issues helps to reduce fear and anxiety and helps the PT develop an effective treatment plan.

Melinda Fontaine, DPT

Melinda is a native of Concord, California. Melinda earned her bachelor’s degree in exercise biology from UC Davis and her doctorate in physical therapy from Simmons College in Boston. She enjoys working with children and adults of all ages, and she believes in listening to a person’s whole story when making a treatment plan. When she’s not at PHRC, you’ll find her either dashing around in her running shoes or cooking up delectable meals for her family. She’s famous for her killer baked chimichangas and her inability to stick to a recipe.

melinda

Courtney Mikowicz, DPT

Courtney is an East Bay, CA native. She received her Bachelor’s Degree in Biochemistry from Cal Poly, San Luis Obispo, and her Doctorate in Physical Therapy from the University of Florida in Gainesville. She began her career working in orthopedics and developed a passion for pelvic floor physical therapy after the birth of her first child. She is passionate about working with the peripartum/postpartum populations and is excited to help reach more patients who need additional support in order to feel their best. She is currently working on becoming a pregnancy and postpartum certified specialist (PCES). In her free time, you can find her spending time with her husband, and chasing her two kids around the East Bay parks. She also enjoys music, coffee, traveling, baking cookies, and HGTV.

Courtney-Mikowicz