Your questions, answered.

The pelvic floor muscles make up a group of muscles located underneath and inside of the pelvis. These tiny but mighty muscles are shaped like a bowl or hammock, and have HUGE responsibilities for some basic human functions, as they support the bladder, uterus, and rectum.

The pelvic floor is attached to the pubic bone in the front and the tailbone in the back, and to the inner side walls of the pelvis. It has multiple layers, including a deep layer and a superficial layer (towards the outside of the body). The deep pelvic floor muscles hold the bladder, uterus, rectum, and abdominal contents. The superficial muscles surround the vaginal opening, urethral opening, anal opening, and clitoris. These muscles are also the important link, connecting our pelvis and our legs!

The pelvic floor acts like a sphincter--it contracts to hold back urine, stool, and gas so that you don’t have leakage, and it relaxes when you need to urinate or have a bowel movement. The pelvic floor provides support to the pelvic bowl, helping to hold the bladder, uterus, and rectum in place. The pelvic floor plays a huge role in sexual function, assisting in arousal and orgasm. The pelvic floor helps to create stability through your trunk and legs and is considered to be part of your “core” muscles. The pelvic floor acts like a sump-pump, helping in the movement of fluid, blood- flow, and lymphatic drainage through the connection between the legs and pelvis.

The pelvic floor muscles can be accessed both externally and internally (through the vagina or rectum) and can be assessed by a trained Pelvic Floor Physical Therapist.

Contact Kim, our Board Certified Women’s Health Physical Therapist if you have any questions!

Your pelvic floor physical therapy evaluation will be with a board-certified Women’s Health Doctor of Physical Therapy. Kim will start by getting to know you, your medical history, and what brought you to PT, in order to better understand your current condition. You might talk about any pain you may be experiencing, your lifestyle, and more specific to pelvic health: your obstetric history, bowel/bladder habits, and sexual function. Kim will then evaluate your overall posture, mobility, strength, balance, and body mechanics. Depending on your history and symptoms, Kim may suggest an external and internal pelvic floor muscle evaluation, which can be performed vaginally or rectally to assist in diagnosis and treatment. Kim will share her findings, discuss recommendations for your plan of care, and answer any questions you have related to you meeting your goals.

Becoming pregnant, having a baby, and starting out as a parent are incredibly complex, major transitions--really, this is the largest transition of your life! While there may be excitement and eagerness, there are so many other feelings mixed in, including anxiety, fear, and uncertainty around having a baby, pregnancy loss or loss of fantasies you've had, parenthood and what it means, losing control of your life, being “good enough,” feeling isolated, disappointed in yourself or confused about your reactions, comparing yourself to images of others and often unreasonable social norms and media portrayals, wanting to create the kind of life for your child that you envision, wanting them to be ok, and keeping your head above water in the process. And having a child, or trying to, brings up all sorts of memories and unresolved wounds from your own childhood. It’s easy to lose yourself in all of it, prenatal and postpartum anxiety and depression are COMMON, and we want to help you take care of yourself physically AND hold onto yourself emotionally. Understanding and investing in your own emotional needs (not just those of your child), learning about your insecurities and stuck points, and building adaptive coping strategies that work for you, will help you feel mentally strong, supported, and help you be the best caregiver you can be for your child and for yourself.

All sessions will last 1 full hour in order to give you the time and thorough treatment you deserve. We don't want you to feel rushed, and we want each and every session to count.

We've all been trained to stay "in-network," and we know it's really hard to get out of the in-network insurance mindset. We've gone through this as clients, patients, and consumers ourselves. We know it can SEEM like more money out of your pocket AT FIRST, but the thing is, in-network can be more of a barrier (your care can get denied at any time, and is usually less personalized, and time-limited) and can ultimately end up costing you MORE money and time (more sessions=more co-pays, medication, and/or further interventions like injections, scans, or surgery that don't even necessarily need to happen at all)! In order for an insurance company to agree to cover your in-network sessions, they have to agree that the services are "medically necessary" which is based on what THEY deem to be the case.

Insurance companies don't know you, your body, what you've been through, your stress, and they certainly DON’T treat the entire human system and how it all interacts. They see diagnoses, isolated to one body part at a time, or they look for meeting the criteria for one mental "disorder". And, they only treat certain diagnoses as worthy of intervention and they do not make the connection between simultaneous issues.

You deserve care that treats you like the complex human being you are, not a list of isolated titles and symptoms, and that focuses on your actual personal needs, so that you can actually heal faster, for the long haul!

Cash-based/out-of-network is how you get it because we can spend the time completely focused on you that we need to assess, synthesize, plan, and partner with you towards repair, and we can use our advanced training as specialists to look at your whole body/mind picture and identify, untangle, and reweave all of the interconnected threads you've got knotted up! And, with full transparency about cost, with NO surprise bills whatsoever. See our Good Faith Estimate information.

Counseling can help clients struggling with major life transitions, challenges in relationships, self-doubt, self-criticism, fear, grief, difficult thoughts, feelings, and moods, and balancing self-care, family, friendships, work, parenting, health, and the list goes on. We focus on figuring out what your values are, whether you're living in sync with your values, how past experiences, upbringing, culture, and biological factors play into how you feel about yourself, expectations you have, and how you see yourself in relationships and in the world. Counseling looks different for everybody because everyone is coming in with a unique combination of circumstances and ideas of what they hope to gain from the process. Sam always aims to de-pathologize discomfort that is culturally and socially deemed "incorrect" or "out of control," normalize, and universalize struggles, highlight your strengths, and most of all, emphasize that you're not broken and you’re not alone! Sam's here to help you sort through what you want, what you need, the difference between the two, and what you’re willing to do to get your wishes and needs met.

Sam and Kim also use a team approach, delivering a unique combination of their skills. If you're working with Kim on a pelvic health challenge, Sam's counseling can supplement and bolster your work.

We start by exploring what’s going on for you now, that sparked your reaching out for support. We’ll talk about a variety of aspects of your history, including where you live, your current family situation, close relationships, social life, culture, schooling, career, family history, trauma, health and medical history, and previous treatment. We’ll talk about the things you want to address in your life and examine what’s contributing to those challenges. We'll explore ways you have coped in the past, what has and hasn't been helpful, and start to identify new coping strategies for practice. The biggest questions Sam emphasizes when beginning with new clients are: “What do you hope to gain from therapy?” and "What would you like to see yourself doing differently?"

We encourage you to wear something you feel comfortable in, that allows you to move around easily. Some suggestions are workout clothes, leggings, and tank tops, while avoiding restrictive clothing like jeans.

Having your period will not impact your physical therapy session, and we encourage you to keep your appointment. Sometimes assessment during your menstrual cycle can provide valuable information about your body and symptoms. As always, if you are uncomfortable with internal treatment at this time, you can ask to focus on other treatment options like your exercises.

Check out our EMDR page for an explanation.