Support Through the Ebb and Flow of the Childbearing Year

Pelvic Floor Manual Therapy

Pelvic Floor 101

The pelvic floor is a complex interconnected system of muscles inside everyone's pelvis. It dynamically works to support and stabilize your pelvic organs, allow sexual function, contract firmly and steadily around pelvic openings to prevent urinary and rectal leakage, facilitate lymphatic flow, aid in posture and also assist with breathing. Pretty big job, right? And for many people, it does all those jobs regularly and without complaint.

But sometimes, due to injury, childbirth, trauma, underlying medical conditions, or even just postural and lifestyle stress like sports or too much sitting, our pelvic floor muscles can either get overly tight, or they can be weak. Some people have a combination: some pelvic floor muscles are weak and others are too tight. Any of these imbalances can have repercussions for our bodies. Some of the concerns which might be relieved through pelvic floor manual therapy are:

  • Pelvic pain, including:
    • Dyspareunia/ pain with sex
    • Interstitial Cystitis/ Painful Bladder Syndrome
    • Dysmenorrhea/ painful menstruation
    • Endometriosis
    • Vulvodynia or other genital pain
    • Perineal pain or rectal pain
    • Prostatitis
    • Painful scar tissue from trauma, childbirth, or surgery
  • Bladder concerns, such as:
    • Incontinence/ leaking urine, especially when you cough, sneeze, run, etc, or when your bladder feels full
    • Urinary urgency/ sudden urge to pee without much warning
    • Urinary frequency/ peeing more often than you'd like
  • Pelvic organ prolapse
  • Erectile dysfunction
  • Any lower back or hip pain that persists despite other manual treatments. Sometimes tight muscles, fascial tension, and trigger points cause pain that radiates to other areas of the body.
  • Some folks also seek out pelvic floor balancing as part of their plan to optimize fertility. If this is your goal, we can address this from multiple angles in one appointment, where we can also go over fertility basics, discuss herbal allies, and review your cycle charts.

Pelvic Floor Manual Therapy

There are other types of treatments for the conditions listed above, but in many cases, a lot of progress can be made by addressing muscle function. Some of these muscles can be accessed externally, and others are best treated internally, either vaginally* and/or rectally. Because everything's connected, depending on your symptoms, we will also evaluate and treat muscle imbalances in the abdomen, hips and thighs. Pelvic floor therapeutic techniques include trigger point release, myofascial unwinding, breath work, and help with muscle activation and retraining. We might also discuss "mind over bladder" strategies to help with urinary symptoms.

Some clients won't be ready for internal exams or treatment at first, either due to physical pain or just not emotionally ready, and for these folks, we might work on external muscles for a while. It's ALWAYS up to you whether and when we do internal work. Other clients might be ready for internal work on our first session. There's no right way.

If you suspect that your pelvic floor might need some attention, please feel free to contact me.

* In my practice, I use your preferred words for your anatomy. For the sake of universal clarity, however, I have decided to use traditional anatomical terms for written descriptions on my website.

My Training

I'm a midwife and a massage therapist, and and I draw on skills from both in my pelvic floor work. I consider my primary training path to be with Herman & Wallace Pelvic Rehabilitation Institute. Their entire focus is on pelvic floor and pelvic pain-specific continuing ed classes. This institute is primarily geared toward physical therapists, but unlike a few other pelvic floor training organizations, they were open to and really excited to be working with me. They've expressed appreciation at the experience and perspective I bring to the field.

Some of my pelvic floor-specific classes:

  • Pelvic Floor Function, Dysfunction and Treatment Level 1, with Holly Tanner & Tina Allen, 22.5 hours
    (I will be attending their Pelvic Floor 2A, 2B, and Pelvic Floor Capstone within the next year.)
  • Functional Applications in Pelvic Rehabilitation, Parts A & B, with Kathe Wallace, 10 hours
  • Integrative Techniques for Pelvic Floor & Core Function: Parts A, B & C, with Bill Gallagher & Richard Sabel, 9.5 hours
  • Clinical Pelvic Floor Therapy, with Bryan Baisinger, 6 hours
  • Understanding Prolapse, with Michelle Lyons, 1.5 hours
  • Understanding Endometriosis, with Michelle Lyons, 1.5 hours
  • Sex and Sexuality in Physical Therapy Practice, with Talli Rosenbaum, 10.75 hours total
    • Part A
    • Part B: Sexuality for Pelvic Floor Practitioners
    • Part C: Clinical Tools for Treatment of Complex Sexual Pain Disorders - Addressing Psychosocial Factors in Treatment
  • Postpartum Physical Therapy Examination, with Cynthia Neville, 2 hours
  • Introduction to Female and Male Pelvic Pain*, with Holly Tanner, 4 hours
* I recognize this cissexist terminology as problematic, but the information is useful and can be extrapolated for all bodies. These trainings and websites generally all contain cissexist phrasing such as "female pelvis" and "male pelvis." I apologize for this, and avoid this type of language in my own practice.

Pelvic Floor Manual Therapy Rates and Logistics

Our first session may be an hour and a half to two hours for $150. General sessions are typically an hour, for $100. I typically do visits in your own home, for your ease and comfort, within the Portland area. We can also arrange a quiet studio space if you prefer.

If you'd like to sign up for pelvic floor evaluation and treatment, here are some of your options. Since this work is often done when there's a specific concern, it would be typical to have several sessions, so I have package options. That said, I know many folks want to see what this work is all about before signing up for three, so I offer sessions individually as well. Feel free to contact me with any questions you may have beforehand.

Type & # of Sessions

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