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What IS Pelvic Physical Therapy and Why Doesn’t EVERYONE Know About It?

Tracy Sher shares her personal experience in the pelvic physical therapy field.

True story –

During graduate school (Northwestern shout out) for physical therapy over 15 years ago, I distinctly remember turning to a friend in class and stating emphatically,
“Mark my words, I will NEVER EVER do what the therapist is doing in that video. NEVER. Why are we even seeing this in class?”.
You may wonder what happened in that video that lead to my bold statement. Why was I so shocked at the time? Well, that was essentially my first exposure to learning about pelvic physical therapy. I had no idea there were highly skilled specialists who performed internal vaginal and rectal musculoskeletal evaluations and treatments for women and men.  I didn’t know at that time that the scope was even larger than that. And I certainly didn’t know I would end up spending my career focusing in this area and embracing it with such enthusiasm. After a wonderful clinical internship in women’s health and the professional influence of great mentors (thank you!), it was clear that this was the right path for me; and the need for this type of therapy was very evident. I tell my patients about the video story sometimes and we laugh about ‘never say never’, right!?
Here I stand today, stating without hesitation, that this type of specialized work, is very rewarding, challenging, and vitally important to people all over the world.  Pelvic physical therapists are musculoskeletal experts in the areas associated with the pelvis (sacrum, sacroiliac joints, coccyx), including vulvar and vaginal, penile and scrotum, colorectal regions. Most importantly, as physical therapists, we are trained to assess the musculoskeletal system and body as a whole as well (not just small bits and parts). We can still treat necks, shoulders, knees, etc., but some of us have such a high volume of patients needing pelvic health care that we focus in this area exclusively (and still treat the person as a WHOLE).  It is also common for pelvic physical therapists to take post-graduate advanced classes to study GI, reproductive/sexual, orthopedic, neurologic and dermatologic “systems” (and more) to understand the complexity of how this all impacts an individual’s function and movement. We are interested in how systems operate together. Many of us are lucky to work with a network of specialized physicians, midwives, sex therapists and educators, fitness professionals and others in associated fields. A patient once told me (and we hear this type of thing often):
“Having endometriosis, painful intercourse, and constipation at the same time is tough. I feel crazy having to go to so many doctors for each thing  – GYN, GI, and Colorectal.  This is the first time I’ve been to someone who’s looked at all of these issues in a bigger picture at the same time, connecting the dots, and coordinating care with these doctors”
Depending on the type of physical therapy practice, the assessments styles and environments can vary. There are some fantastic therapists who focus on orthopedics and sports and do assessments without touching the pelvic floor internally; or some who focus on chronic pain conditions;  while others focus heavily on assessing the pelvic floor muscles and associated areas in private treatment rooms first and then transition to daily functional activities or athletic moves later. There are lots of options. The exciting part is that we can offer hope with conservative treatment! You may see us in private clinics, outpatient hospital facilities, nursing homes, gyms, and other settings. Here’s a sampling of the types of conditions we treat (from my clinical website) The list shows some conditions for women and men and we also treat pediatric bowel and bladder issues:
pelvic PT conditions

Sample of some of the conditions treated by Pelvic PT. From

Here’s a great 3D video by about the pelvic floor anatomy and bony landmarks. We love this stuff! “The BioDigital Human Platform simplifies complex health concepts through the power of visualization. Our platform reveals anatomy, health conditions, and treatments in interactive 3D, demystifying what goes on below the skin through friendly visuals” has a fantastic female reproductive tutorial (and male) on their website. Want to see more about pelvic anatomy? If you would like access to the Pelvic Global anatomy images, look into becoming a Global Pelvic Health Alliance Member!

Best Articles on Pelvic Physical Therapy. All in One Place! Thanks to My Wonderful Colleagues for These Contributions!

Elle Magazine explains treatment for pelvic pain:  Let WHO Put WHAT WHERE? Finding a cure for pelvic pain Pelvic Global blog post by Jessica Powley Reale:  Misconceptions of Pelvic Physical Therapy Excellent Article by colleagues, Stephanie Prendergast and Liz Rummer, at Pelvic Health and Rehabilitation Center What’s the Patient’s Role During Pelvic PT? The French Government Wants to Tone My Vagina Even Oprah’s talking about it: Physical Therapy for Your Lady Parts. Pelvic Physical Therapy for Men with Pelvic Pain – 2 Case Studies, APTA Another great one by Pelvic Health and Rehabilitation Center: The Role of the PT in Treating PN (Pudendal Neuralgia)
Here is a great article about how physical therapy can help with urinary leakage during workouts: 
Side note: If a doctor’s office has an employee doing pelvic floor biofeedback (and/or electrical stimulation) as the ONLY treatment to every patient, regardless of the condition  (painful intercourse, urinary leakage, bladder pain), you may not be getting the full spectrum of care.

Where Does a Licensed Physical Therapist (Masters/Doctorate level) Go For Specialized Pelvic PT Training?

When physical therapy graduate students ask me how to get into this specialized area of work, I direct them to two main educational tracks of postgraduate study (and there are other organizations and groups to discover): Pelvic Global Academy! We offer live courses and online courses coming soon! American Physical Therapy Association: Academy of Pelvic Physical Therapy Herman and Wallace Pelvic Rehabilitation Institute Find a Pelvic Health Professional – Physicians, PTs, Nurses, Sexuality Experts

Why Doesn’t Everyone Know What Pelvic Physical Therapy is and How Can We Change This!?

To Physicians, PAs, Nurses, Fitness Professionals – please consider referring your patients and clients to a licensed physical therapist who understands this specialty field and can complement your care. To Physical Therapists and patients, please share this with friends, family, and your healthcare providers so that there’s awareness of this conservative type of care. Here’s a directory of pelvic health professionals. **If I missed anything, please let me know!    Tracy Sher, MPT, CSCS  Private Practice Owner in Orlando, FL; International Speaker/Faculty. Passionate about treating pelvic pain and all pelvic floor disorders – bowel, bladder, sexual function. Secretly hoping to be a circus clown or rock, paper, scissors champion someday. Connect with Tracy on LinkedinCheck out Pelvic Global on Facebook or Twitter @pelvicguru1 If you are interested in more pelvic health education, please see our online platform, Pelvic Global Academy for some amazing courses.


  1. Debra Goldman on December 28, 2013 at 12:43 pm

    Tracey, what a wonderful gift! Putting this all together, so succinctly and fun to read. It’s as if you read my mind, thinking about new marketing ideas for the new year.
    I would like to add and recommend the coursework taught by the Barral Institute. I have just completed Level 3 of Peripheral Nerve Manipulation and it has added so much to my manual therapy skills and the outcomes of my patients. It is especially amazing for all of the nerves of the pelvis. Plus, they keep their underwear on!!
    Happy New Year to my favorite Pelvic Guru and all the wonderful therapists I have been meeting at conferences in the past few years.

    • Pelvic Guru on December 28, 2013 at 12:49 pm

      Debra! Thanks so much for your feedback and recommendation! The next step with this article is to add a PDF handout that we can fax or take to physicians’ offices…right?

      Do you have to take Levels 1 and 2 through Barral to take the Peripheral Nerve Course?

      • Debra Goldman on December 29, 2013 at 10:11 am

        You do have to start with Level 1 but then I went to 3 because it was in my area, NYC. I plan on completing 2 another time. The Barral Institute has West Palm, Fl as their US base- so easy for you! Lol
        To be able to palpate the pudendal, obturator, inguinal, femoral nerves ( among others!) in such a gentle and effective manner is among the best work I have ever learned. I am getting really good results with my pain patients, even a very stubborn post-op pudendal surgery . I also am learning the Visceral work which I started with Ramona and Gail.

      • Debra Goldman on December 29, 2013 at 10:14 am

        Also-yes to a PDF. That would be awesome!
        Tracy? Why does the reply face icon look sad and confused??

      • Pelvic Guru on December 29, 2013 at 1:07 pm

        Thanks for the info, Debra. We actually some gentle “dermoneurmodulation” (a Diane Jacob’s term) and indirect mfr strategies in the Pudendal Neuralgia course Loretta and I teach. It would be interesting to see how these relate.

        Want to join us in Boston in March? 😉

        I’m not sure why the faces sometimes look grumpy or silly – it’s random. 🙂

  2. Evelyn Hecht, PT, ATC on December 29, 2013 at 12:29 pm

    Thank you for your enthusiasm in promoting our amazing speciality of pelvic physical therapy! To underliine the importance of our detailed assessment and “not one treatment fits all”, my practice, EMH Physical Therapy in NYC, recently had three patients present with the same complaint of urinary stress incontinence.
    The first patients’ symptom was due to traditional pelvic muscle weakness, the second was due to muscle/fascial adhesions of the hip adductor and levator ani and the third was due to the uterus literally sitting on top of the bladder.
    The first patient received strengthening of pelvic/core, bladder retraining and manual and biofeedback for up-training; the second patient received down training and manual therapy to release and lengthen her tight myofascia and the third patient required visceral mobilization techniques to reposition the uterus off the bladder and to release abdominal adhesions.
    As a Pelvic PT since18 years, I see a huge boom in in the last 3 years, as more patients spread the word and research is proving our efficiency in healing pelvic floor dysfunction.
    I applaud you and all of our colleagues for their passion and committment!

    • Pelvic Guru on December 29, 2013 at 1:10 pm

      Evelyn – thank you very much for sharing the point that we are doing extensive evaluations and this is not cookie-cutter treatment. We use evidence-based medicine to guide our treatment plans (which is very different than a Cosmo article on Kegels, right!?). I’m sure you’ve made a difference to so many lives in the past 18 years.
      I appreciate your support and valuable input.

  3. tahawur khan on December 30, 2013 at 3:56 am

    hello Tracy. congrats…best article &efforts elaborated by you, ever never,i come across. thanks Dr. Tahawur Khan(Physiatrist)

  4. michellespicka on January 2, 2014 at 12:48 pm

    I said the EXACT same thing in PT school and here I am, 13 years later, seeing only “pelvic” patients! Excellent work and keep up the awesome blog posts. I have referred so many patients to your site for the best information! Thanks again and Happy New Year!

    • Pelvic Guru on January 2, 2014 at 5:54 pm

      Michelle! I bet many of us said the same thing! Thanks for all YOU do…and thanks for sending your patients this way. More good stuff to come in the future. Tracy

  5. Excellent Bodywork on January 2, 2014 at 9:13 pm

    This is an awesome collection of information. Thank you

    • Pelvic Guru on January 2, 2014 at 9:22 pm

      Thanks so much for your feedback. That was the goal and I’m glad it worked! Stay tuned for more…

  6. […] Good first stop:  The Pelvic Guru Explains What PPT Is […]

  7. […] you should see a pelvic floor physiotherapist asap! This is a bit more about what they are and do:…  If you have any pain in your pelvic floor (vulva, vagina, perineum, anus) you should see a pelvic […]

  8. Carl on February 11, 2014 at 2:34 pm

    Fascinating information. Thank you from a happy patient of Her Health Physical Therapy in Columbia, MD. They helped me to regain normal voiding patterns and continance following extensive back surgery recuperation.

    • Carla on February 11, 2014 at 2:35 pm

      Carla that is

    • Pelvic Guru on April 25, 2014 at 1:01 am

      Thanks so much for your comment! So glad you had a great response!

  9. […]… […]

  10. […] example: A 59 year-old male, traveling from out of state, presented to pelvic PT with the chief complaint of  “penis pain” he’s had for 14 years. He also said he […]

  11. […] In order to better understand how physical therapy can help someone with IC, we need to look a little deeper into why the muscles around the pelvis become tender in the first place. At my presentation last night, we spent some time discussing the muscles of the hips and abdomen as well as the pelvic floor muscles. If you aren’t familiar with these muscles already, you can take a quick course by reading Tracy Sher’s article here. […]

  12. Pelvic Floor | The Back Clinic, Inc. on July 13, 2015 at 11:10 am

    […] do you know if you need pelvic floor physical therapy? Read this article about what pelvic floor physical therapy is and what it can do for […]

  13. Life, Love and Loss | Hope and Sensibility on October 25, 2015 at 6:41 pm

    […] What is pelvic physical therapy and why doesn’t everyone know about it? Tracy Sher, MPT, CSCS […]

  14. mlrkbd on March 13, 2016 at 11:44 am

    1982 grad from Columbia University NY
    ‘you wont need to know anything about THAT area. flash card of pelvic floor. Thats all!

  15. Margie Long on April 10, 2018 at 5:37 pm

    Can I get this posting sent to my email? I cannot print from my cell phone.

  16. Catalina Peskin on September 11, 2018 at 1:49 am

    Hi. I loved this article. It has so many useful informations!! I am very interested in knowing more about pelvic floor disorders. I am currently licensed as PTA in FL and CA but I live and practice in CA. Can a PTA get CEU in pelvic floor disorders rehabilitation and can a PTA treat?

  17. Ali on February 23, 2019 at 10:16 am

    I can’t find anyone listed in CT. Anyone? Preferably who takes insurance.

  18. custom physical therapy thousand oaks on November 24, 2020 at 3:00 am

    Physiotherapists’ scope of practice varies considerably across the world, both in terms of the degree of professional autonomy enjoyed and the range of conditions managed.

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