Pelvic Health Physical Therapy

Pelvic health physical therapy is an intensive and essential component of Houston Methodist’s pelvic floor rehabilitation team. Houston Methodist has the only board-certified, residency-trained pelvic health specialists in Houston.

Pelvic health physical therapy focuses on the musculoskeletal component of pelvic floor dysfunction. Physical therapy treatment restores postural dysfunction, skeletal misalignment and muscle dysfunction, which contribute to loss of bladder and bowel control and sexual function, leading to complex pelvic pain.

The pelvic floor rehabilitation team is led by a highly specialized group of doctoral-level educated physical therapists. These expert physical therapists use an array of tools and equipment to ensure optimal treatment, including: 

  • Perineal biofeedback
  • Rehabilitative ultrasound
  • Percutaneous tibial nerve stimulation (PTNS)
  • Transcutaneous electrical nerve stimulation (TENS)/Interferential (INF) electrical stimulation (for pain reduction)
  • Functional electrical muscle stimulation (muscle stimulator)

Bladder and Bowel Problems (Female and Male)
The following conditions are common in both women and men:

  • Urinary or fecal incontinence
  • Urinary retention
  • Urinary or fecal urgency or frequency
  • Pelvic organ or rectal prolapse
  • Interstitial cystitis/painful bladder syndrome
  • Constipation/difficulty voiding
  • Post-prostatectomy/neobladder
  • Incontinence/prolapse surgery
  • Pregnancy and postpartum
  • Female athlete-related incontinence

Various physical therapy treatment options are available to treat these conditions:

  • Individualized and accurate exercise for pelvic floor muscles, muscle strengthening, relaxation and coordination (biofeedback, electrical stimulation, ultrasound etc.)
  • Bladder/toilet training
  • Deferment techniques
  • Pelvic floor relaxation and coordination techniques to decrease urgency and improve bowel/bladder emptying
  • Electrical stimulation to ease bladder urgency and/or increase muscle tone
  • Nutritional and lifestyle counseling
  • Manual therapy techniques to decrease bladder/bowel urgency, pain and constipation.
  • Tailored home exercise prescriptions for pelvic girdle and abdominal muscles

Female and Male Sexual Pain, Perineal Pain and Chronic Pelvic Pain
The following conditions are common in women and/or men:

  • Vaginal, penis or rectal muscle spasm and/or surrounding soft tissue tightness
  • Pudendal neuralgia or pudendal nerve entrapment
  • Scar pain from surgery or painful episiotomy
  • Interstitial cystitis
  • Vulvar and vaginal pain or burning
  • Abdominal and pelvic girdle (sacroiliac joint , coccyx, pubic symphysis etc.) pain
  • Pain with urination and/or defecation
  • Testicular and groin pain

Click here for more information on causes, symptoms and additional treatment for pelvic pain.

The following lists evidence-based physical therapy treatments for these conditions:

  • Manual (hands-on) therapy to improve joint and tissue mobility and decrease pain
  • Electrical stimulation for pain and/or muscle relaxation
  • Tailored exercise prescriptions and modification
  • Appropriate self-care and comfort measures
  • Sexual education and modification of positioning
  • Postural and movement impairment alterations
  • Appropriate use of dilators at home
  • Bracing and taping to maintain appropriate pelvic and spinal alignment for pain reduction

What to Expect on the First Visit
The first visit will be a one-hour evaluation that will help determine the most appropriate treatment approach for your condition. The session will begin with a subjective interview in a private room, where you will be given the opportunity to discuss your symptoms and goals of treatment. Your physical therapist will then provide you with education relevant to your condition as well as the pelvic floor anatomy. After the subjective interview, the physical therapist will assess your posture, spine/pelvic girdle alignment and gait. Your therapist will also screen for muscle strength and coordination deficits that lead to compensatory movement strategies and may contribute to your condition.

The visit continues with an objective assessment of internal pelvic floor muscles. This is performed by insertion of the finger in the vagina or rectum to determine resting muscle tone, symmetry, strength and coordination. Digital palpation is the current gold standard for the assessment of pelvic floor muscle coordination and strength. Biofeedback and electrical stimulation are used during follow-up visits, if deemed appropriate for your condition.
At the end of the session, your physical therapist will discuss their findings and diagnosis, treatment plan and therapeutic expectations/prognosis with you in detail. You will also be given a specialized home program to supplement your treatment sessions.

Frequency and Duration of Treatment
How often and how long you will receive pelvic floor physical therapy is highly variable and will be based on your diagnosis, compliance with attending treatment sessions and home program, and the duration of your symptoms before initiating therapy. Plan to be seen one to two times on a weekly basis for about 4 to 12 weeks.

At Houston Methodist, our mission is to offer pelvic health physical therapy in a thoughtful environment to improve your quality of life while maintaining dignity.

Houston Methodist combines the expertise of urogynecologists — specialty physicians trained in the areas of urology and gynecology — as well as traditional gynecologists and colorectal surgeons to provide the most advanced care available for women and men with problems related to the lower urinary tract and the pelvic floor. The Center for Restorative Pelvic Medicine at Houston Methodist Hospital is the first of its kind in the Greater Houston area and is one of the few centers in the country that offers a single-center location for the diagnosis and treatment of complex pelvic-floor disorders. 

If you are a physician and would like to refer a patient to the Center for Restorative Pelvic Medicine for pelvic health physical therapy, download our referral form here.


Houston Methodist provides pelvic health physical therapy at the following convenient locations: