What is the pelvic floor?

The pelvic floor is a group of muscles that create a sling from the pubic bone to the tailbone. Interwoven between bones and connective tissues, they function to support pelvic organs (bladder, rectum, intestines and uterus in women ), maintain continence, enhance sexual appreciation, and improve core strength and stability for back support.

When pelvic floor muscles are functioning at an optimal level, they work with the diaphragm, deep abdominals and back stabilizer muscles to provide support and stability with dynamic movement as you participate in your activities of daily living.

What is pelvic health physical therapy?

Pelvic health is a specialty practice in physical therapy, and it means your therapist is trained to treat conditions related to pelvic floor dysfunction. This may include performing myofascial release to the pelvic floor muscles or teaching you how to strengthen and use them properly for improved function (ie resolution of symptoms such as incontinence or pain).

Having “strong” pelvic floor muscles and doing kegels is not enough to maintain continence and core stability. In fact, sometimes pelvic floor muscles can be too active causing pain and dysfunction. Often this occurs because the other core muscles are weak or uncoordinated and the pelvic floor is compensating to improve pelvic stability and alignment.

Functional training of the pelvic floor muscles allows them to appropriately co-activate with other muscles in a balanced manner to provide optimal pelvic alignment and muscle function. Sometime pelvic floor rehabilitation means down training the pelvic floor muscles and up training or strengthening other muscles such as the diaphragm, glutes, hips and abdominals.

Do you treat men and/or transgender/non-binary folk?

Yes!! Pelvic health is often misnomered as "women’s health," but all people have a pelvic floor and anyone can suffer from pelvic floor dysfunction. At Connect NW Physical Therapy & Wellness, we treat all pelvic floor issues for any person. Check out our

What happens during the first visit?

The initial evaluation is all about developing a clear understanding of the problem you are experiencing in order to reach an accurate diagnosis. Your therapist will spend time talking with you about your current and past medical history and listening to how the problem developed. In order to gain as much information about potential causes of the problem, your therapist will ask you specific questions that may shed light on the source of the issue.

After a thorough review of your history, your therapist will perform a physical evaluation. This may include assessment of movement patterns, posture, tissue and joint integrity and application of specific diagnostic tests and measures to rule in and rule out possible culprits of your pain or dysfunction.

With pelvic floor dysfunction, an internal pelvic floor assessment is often the most direct and effective assessment and treatment approach. Direct pelvic floor assessment may include external observation and palpation of pelvic floor muscles and/or internal vaginal or rectal muscle assessment.

Direct pelvic floor assessment is used to identify correct contraction and relaxation function of the muscles, trigger points and muscle spasm, weakness or organ prolapse (dropping of the bladder or rectum). Internal vaginal or rectal examination is different than a pelvic or prostate exam from a physician. It is performed to look at the musculoskeletal components of the pelvic region.

During direct pelvic floor assessment you will be comfortably draped under a sheet with your legs supported with pillows. The therapist will use one gloved finger to assess the pelvic floor muscles.

If direct pelvic floor assessment is not an option for you, there are other external pelvic floor assessment methods including use of biofeedback. Additionally, dysfunction in other parts of the body such as the hips or back may be contributing to pelvic floor issues and will also be addressed.

Do I need a referral from my doctor?

Washington state is a direct access state meaning you are not required to have a referral to get physical therapy treatment, HOWEVER, most insurance companies DO require a referral in order for the service to be covered.

If you are a private pay client and do not plan on sumbitting a claim to your insurance, then you do NOT need a referral. If you plan on using insurance, please check with your insurance provider to determine whether or not you need a referral for physical therapy.

Do you take my insurance?

We are in-network with Kaiser, Premera, Regence, HMA, and Blue Cross Blue Shield. For all other insurance providers, we are out- of- network.

What does it mean to be out-of-network (OON)?

As an out-of-network provider, Connect NW Physical Therapy & Wellness is not contracted with your insurance company. Some insurance companies have out of network benefits, and we are happy to provide you with a superbill to submit to your insurace for reinbursement. If your insurance is out-of-network, you will pay at the time of service and Connect NW Physical Therapy & Wellness will provide you with a receipt/superbill to submit.

If I am OON will I pay more for physical therapy?

This depends on your insurance plan. If you have a high deductible plan, sometimes you end up paying LESS with an out-of-network provider than you would with an in-network provider. Typically, if you are seeing an in-network providers and you have not met your deductible you are responsible for paying the billed or insurance contracted amount which can be anywhere from $150-$300 for a 30-45 minute session.

As an out-of-network provider, we are able to offer a private pay cash rate. At Connect NW Physical Therapy & Wellness, you will always receive 60 minutes of one-on-one hands on treatment with your physical therapist, and you will always know the cost per session.

What are your private pay rates?

• Initial Evaluation (60 min): $175
• Follow ups (60 min): $150