Virago FAQs

Frequently Asked Questions

  • What is Pelvic or Women's Health PT?
  • How quickly will I see relief?
  • How many visits will I need?
  • Do you have appointments that are convenient with my schedule?
  • How soon can I return to activities that I enjoy?
  • Can I choose Virago as my physical therapy provider even if my doctor recommended another facility?
  • Common misconceptions about Pelvic PT
  • Some signs you may need Pelvic Floor PT

The term Pelvic or Women's Health Physical Therapy is a very unfamiliar term. It's probably safe to say that over 75% of my Women's Health patients start their evaluation with a statement saying they didn't know what Pelvic PT is and they aren't sure how it will help them. Many patients never knew that physical therapists are trained in evaluating and treating pelvic floor dysfunctions. Virago PT is passionate about helping women of all ages enjoy active, healthy lifestyles, by restoring confidence and dignity in pelvic, bladder, bowel and sexual dysfunction, without relying on medications or surgery. We provide conservative treatment options for many conditions that patients may be unaware that there is hope.

For many conditions, you will see improvement in just a couple of visits! Patients with incontinence are taught a self-help exercise on their very first visit and often come back on their second visit exclaiming they already see a difference. Most patients who have pelvic pain have an immediate reduction in their symptoms with each visit. Long term relief from pelvic pain and improvements in pelvic floor strength and support are seen progressively over the course of several weeks. The patients' consistency with their home exercises and adherence to the plan of care will determine the level of improvement seen in many conditions. Your physical therapist will provide education on body mechanics, posture, and symptom management that will provide for a more thorough and comprehensive physical therapy experience.

It is recommended that most patients have treatments, initially, twice a week to establish the "dos and don'ts" of posture, body mechanics, and movement restrictions. In addition, the patient will also receive manual therapy that will provide, in many cases, moderate to significant relief in pressure, pain or inflammation. Usually after 3-4 weeks of treatments twice weekly, and the patient is being compliant in their home program and performing daily pelvic and core stabilization exercises, they may be able to drop down to once a week. Some pelvic conditions are significantly improved or abolished within 4-6 weeks.

Although Mary's physical therapy career has spanned almost 16 years, Virago is a newly established private practice that will initially offer limited hours. Treatment hours will be offered during early mornings, late afternoons, early evenings and weekends. The need for additional time slots will be re-evaluated with continued growth. Virago will make every effort to accommodate its patients with flexibility and unparalleled one-on-one skilled care.

This can be a difficult question to answer as the rate of healing is different for each individual. However, it is usually advisable that patients can return to their normal activities so long as it does not exacerbate their current symptoms. Certain activities such as high impact running, jumping and deep squatting are stressful to the pelvic floor with underlying weakness and dysfunction. It is encouraged for patients to limit and/or refrain from further straining the pelvic floor and possibly progressing their condition. Mary will help to tailor every patients' appropriate level of activity based on their level of dysfunction.

Every patient has the right to choose their health care provider. It is encouraged that if you choose to seek care from a facility that was not recommended by your doctor, that you notify your doctor of your intentions.

Your therapist can provide your doctor with a brochure and a letter summarizing your initial evaluation. Doctors often refer to facilities that they have fostered relationships with and may not be aware of new and upcoming practices or practices that tailor to a specific demographic.

  • Pelvic PT is only for women after childbirth. Only a very small percentage of my patients are post-partum. Almost 85-90% of my patient population is between the ages of 18-90 whom are experiencing a wide variety of problems from incontinence, constipation, abdominal pain, sexual dysfunction, SI/lower back pain, and vaginal or rectal pain.
  • If you are experiencing urine leakage, you need kegel exercises. Despite popular belief, urinary incontinence is a failed system. Not just a failed muscle. Proper pelvic floor function is achieved with coordination from the abdominals, hip muscles, diaphragm and low back muscles. Patients need a strong yet flexible muscles that tighten and relax when needed. Patients with a tightened and irritated pelvic floor may have just as much difficulty as a patient with a weak pelvic floor. Virago PT will correctly identify what you need to achieve success as design a specific and tailored program specific for you.
  • If a patient has had or is planning to have surgery then Pelvic PT won't help. Not true! Physical therapists work closely with your team of health care professionals to design a program that will be successful. Many times, surgery is indicated to resolve or fix an anatomical problem that cannot be corrected with conservative treatment alone. However, optimal outcomes after surgery are best achieved with improved muscular control and function. Appropriate physical therapy intervention prior to and after surgery improves therapeutic outcomes and reduces the need for future surgery.
  • Physical Therapists performing a vaginal or rectal exam is not normal and NOT conventional. Quite the contrary! Although not all therapists are trained in pelvic physical therapy, it is a specialization. Just like any other muscle in the body, the pelvic floor is a group of muscles, that can become tight, shortened, stretched, or weak. The only way to truly assess these muscles is via a gloved finger to assess the integrity of these muscles. An although "unconventional" to some, there is a strong anatomical basis for the exam. Physical Therapists are trained in external and internal examination techniques, and current medical research supports these techniques in the treatment of this population.

Not every woman needs pelvic floor therapy. But if you pee when you sneeze or awkwardly run to the bathroom after laughing fit, this is a telltale sign that your pelvic floor needs a little lovin'. The pelvic floor is like a hammock of sorts, that extends from your tailbone to your pubic bone. Like any other group of muscles in your body, the pelvic floor can contract and relax. Also, like other muscles in the body, the pelvic floor can become either chronically tight and overly contracted or invariably weak and over stretched. Either spectrum can lead to problems of related to the pelvic floor.

Think of the pelvic floor as a basket holding all of your valuable organs up and keeping everything taut and supported. Between all the sedentary activity and the gravity dependent, heel-wearing we do as women, it's hard to please our pelvic floor. Here are some warning signs you may benefit from the services of Virago PT.

  • You pee when you cough. Or laugh. Or sneeze. Or exercise. Urine should stay in the bladder until it is voluntarily released. If you are experiencing pre-mature leaking or dribbling during these situations, then you are a candidate for pelvic physical therapy. This could be a sign that your pelvic floor is weak, and requires strengthening. Doing Kegel exercises alone won't fix this problem. Tightening the pelvic floor pulls the base of the tailbone to the pubic bone, the same position as when the pelvic floor is lax and weak. Kegels won't stop the pee and can make the incontinence worse.
  • It hurts to urinate or you have been diagnosed with IC (interstitial cystitis). Sit much? At work? In the car? At home? Yeah, everyone can relate. We as women also wear heels and carry a tremendous amount of stress. This all leads to tight pelvic floor muscles. Over time, this can create chronically tight, lumpy connective tissue. This is the stuff that connects muscles and organs and holds it all together in a nice tight bundle. Tight connective tissue can lead to pulling on other organs and structures in the pelvic floor and lead to chronic bladder pain with urination, chronic low-grade lower abdominal pain. Tight connective tissue can lead to pain in the groin, thighs, lower back and hips.
  • Sex is painful. Tightness in a muscle can be exacerbated by irritation. Sex can be the cause of this irritation. Physical Therapists are trained and experts in detecting abnormalities in normal tissue function. A trained physical therapist can detect with just a light touch of the finger any abnormality to the normal resting tension of the pelvic floor.
  • Urinary Tract Infections are the Norm. There is a clear link between reoccurring infections "down there" and dysfunction of the pelvic floor. These problems arise as incontinence or "falling organs". Reoccurring infection increases with increased pressure on the valve between the bladder and the ureter. The ureter is the connecting pathway between your kidney and the bladder. It's a lot like reflux of the ureter - bacteria can move from the bladder to a more sterile environment of the ureter and kidneys. Chronic UTI's can be important just as much as pressure from falling organs on the valve connecting the bladder to the kidneys. This is where Pelvic Floor Therapy shines!
  • You're pregnant and you have pain. The ankle is connected to the leg bone. The leg bone is connected to the thigh bone. The thigh bone is connected to the pelvic bone. The pelvic bone is connected to the tailbone. The tailbone is connected to the low back. Everything is so closely related that any dysfunction in one area leads to dysfunction in another. During the normal stages and progression of therapy, it is normal to feel discomfort but not pain. The increase in ligament laxity hormones increase during pregnancy. You want to do all you can to create a space of comfort and support for the growing fetus during pregnancy. Pelvic Floor PT can help you make healthy adjustments as your belly grows and your gait changes - like keeping weight in your heels or pulling in your lower ribs while untucking your pelvis.