Did you have “pelvic floor PT” at your doctor’s office? Here are some things to know
Navigating the world of self care and healthcare has never been more complicated. Marketing, in many cases, intentionally obfuscates who is providing which services, what their qualifications are and how you can evaluate the quality of what’s being offered. It should never be this way in healthcare, and yet specifically in the field of pelvic health we see this one thing over and over again: People are being told they’re having pelvic floor PT at their doctor’s office, when in fact they’re never even seeing a physical therapist.
The most typical version of this story is someone being signed up to use the Emsella, or the TENS chair, at their doctor’s office. A number of different practices offering the Emsella service quote that in a 28 minute session, your body is doing the equivalent of 11,000 involuntary kegels. In other practices, people are hooked up to biofeedback machines and left to voluntarily contract their pelvic floors with a visual. These modalities are often touted as pelvic floor PT when in reality they are far from the real thing.
Here’s the thing - I am ALL for multidisciplinary teams and physical therapists practicing in OB, urology and other doctor’s offices. That kind of comprehensive care has incredible power. What I’m not here for is people being told they’re getting pelvic floor PT in an office that doesn’t employ physical therapists.
If you were sent to PT at your doctors office, read through today’s post for some background on what physical therapy is and isn’t and how to vet your experience to ensure you’re getting the care you deserve.
If you had “pelvic floor PT” at your doctor’s office, here are some things to know:
The terms “PT”, “physical therapy” and “physiotherapy” are recognized and protected by state licensure.
These terms are protected in order to ensure that PT care provided to the public is done a professional licensed to provide physical therapy in that state. Current PT programs require Doctorates of Physical Therapy, though there are older providers who practice with a masters.
Physical therapy can include treatment modalities like manual therapy, exercise therapy and electrotherapy, but it is not any one of these individual modalities.
PT is an evaluative and treatment *process* performed by a licensed physical therapist.
If you did go to PT at your doctor’s office, here are some questions to ask yourself:
If you received “PT” in your doctor’s office, who provided this service? Was it actually a physical therapist? Was it a nurse or another provider or technician?
Was a detailed physical evaluation performed prior to starting a certain treatment modality? Or were you hooked up to biofeedback or electrical stimulation of some sort because that was the only treatment being offered?
Did you leave your sessions with a better understanding of your anatomy, how your lifestyle contributes to your symptoms, or things to work on between sessions? How about why you’re experiencing these symptoms in the first place?
Were your individual goals discussed in order to create a plan tailored to your specific needs?
Why are “pelvic floor PT” and “PT” in quotes??
The only people who can provide you with pelvic floor PT/physical therapy are physical therapists.
If your care was provided by anyone other than a licensed physical therapist, you were not actually provided with physical therapy.
This term is protected in order to protect you. It’s the same reason that the only people who can call themselves MDs are people who went to medical school. It’s the same reason your dentist had to go to dental school and can’t just be a person who likes teeth.
It can be incredibly frustrating to spend time and money on self-care while being mislead about what’s actually being provided.
Being hooked up to biofeedback or electrical stimulation and left in a room is not physical therapy.
Can your PT utilize these tools as part of their plan of care?
Sure.
Is this the only treatment provided by physical therapists?
No.
Biofeedback and electrical stimulations are tools, just like a hammer. If you started a home improvement project and the only tool you had was a hammer, you wouldn’t get all that far with the exception of a VERY select few projects.
PT is no different. We can use tools, but it’s incredibly rare that a single tool is enough to get you where you’re going.
What can pelvic floor PT actually look like?
Every practice functions a little differently, but generally here is what you should expect from a PT visit:
Time spent talking to your physical therapist about the specifics of your symptoms, with more time for follow up questions. Also a discussion about your priorities, goals and lifestyle.
A physical exam targeting your specific complaints. This may include anything from watching you walk or run to a pelvic exam, based on PT recommendation and your comfort level.
Some forms of hands on treatment and assessment.
Exercise performed together as well as personalized homework.
Continuous reevaluation and progression or modification at each visit. PT is a living, breathing thing. It changes and grows with you as your body changes.
TL;DR
If you’ve received PT provided by anyone other than a licensed physical therapist, you haven’t actually had physical therapy.
Biofeedback and electrical stimulation may be PART of your PT care but should never be all of it.
If you’re being left alone in a room hooked up to a machine at every visit for the whole visit, consider this a red flag.
PT should include continuous conversations about your goals and progress. It should include hands on work and/or assessments, exercise performed in session and homework to practice between visits.
More than anything, you should expect to see progress. It may not be at the rate you’d have hoped and it may not be linear, but you should see changes. And you should be able to discuss the rate of these changes with your PT so you have a clear idea of why you’re progressing at the rate you are and what you can expect moving forward.
Have questions about pelvic floor physical therapy and what you should expect from a visit at our office? Call us today at 512-766-2649 or shoot us a message here to get started.
This post was written by Dr. Rebecca Maidansky, PT, DPT, owner and founder of Lady Bird Physical Therapy. Rebecca is a pelvic floor physical therapist in Austin, TX and founded Lady Bird Physical Therapy in 2019. She is the creator of Birth Preparation and Postpartum Planning, Baby Steps Fitness and the head writer and editor of The Pelvic Press.
Rebecca is a passionate writer and vocal advocate for pelvic health and the importance of improving access to perinatal care. She believes strongly that many common pregnancy pains and postpartum symptoms can be eased or even prevented with basic education and care.
She created this blog to help all birthing people manage common pregnancy pains, prepare for birth and recover postpartum.