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Episode 38:

It's Time to Get Real about Pelvic Health

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Sex shouldn’t hurt, and incontinence isn’t normal. In this fascinating conversation with Physical Therapist, Kari Melby (PT, MPT), we get really real and learn a lot about pelvic health & how physical therapy can help. In the “You Want Me To Do What?!” section, Nicole & Shanna talk with their good friend Kim about her personal experiences with Women’s Health PT. Kim is the epitome of No B.S. and shares openly about how PT has helped her. What’s even better, she gives advice on going to see a pelvic health Physical Therapist and what you can expect.

Episode Recap:

Interview with Kari Melby, PT, MPT  - 2:29

“You Want Me To Do What??” section - 59:50


  • Kari has had a passion for pelvic health physical therapy (PT) since she first learned about it in physical therapy school. She now teaches courses on pelvic floor physical therapy to Physical Therapists that want to specialize in this type of PT.

  • Women’s Health PT (more commonly called Pelvic Health PT) involves the assessment & treatment of the muscles, organs and nervous system in the pelvic region.

  • Pelvic Health PT is different from a typical gynecological visit in some key areas:

    • The initial examine focuses on assessing the muscles not the organ system

    • Treatment tables typically don’t have stirrups

    • Prior to doing the examine, the patient is given lots of education from the Physical Therapist on what to expect during the examine

    • Assessment & treatment is more gradual with the pace of progression being set by the patient’s comfort level

  • Common diagnoses seen by Pelvic Health Physical Therapists:

    • Urinary incontinence

    • Urinary urgency & leaking urine

    • Pain during intercourse

    • Pain during a pelvic exam

    • Pain using a tampon

  • Other diagnoses/symptoms that a Pelvic Health Physical Therapist can help with:

    • Pressure & heaviness in the pelvic floor region

    • Chronic constipation

    • Fullness in the rectal or vaginal region

    • Painful bladder syndrome

    • Fecal incontinence/accidental bowel leakage

    • Pain from endometriosis

    • Pain from Irritable Bowel Syndrome

  • While each treatment plan is specifically designed for the individual, the Physical Therapist will address both internal and external aspects of the body.

  • Pelvic Floor Physical Therapy is covered by insurance if physical therapy is part of your insurance plan.

  • If you think pelvic health PT can help you, here are some recommendations to get going:

    • Find a pelvic floor Physical Therapist near you and call them to ask if you need a referral from a doctor

    • If you need a referral, go to your doctor and ask for the referral. Advocate for yourself

    • If you don’t need a referral, go to the Physical Therapist and be open about what you’re experiencing

  • Kari’s recommendations for taking care of your pelvic floor health:

    • Make sure you are breathing correctly - aka diaphragmatic breathing

    • Make sure you are maintaining proper posture

    • Don’t clench your glutes and abs. Muscles should have tension & mobility, not tightness.

    • Do a pelvic brace or core brace before doing something like jumping, heavy lifting, coughing, etc.

    • Do not hover over the toilet when going to the bathroom

    • Do not do ‘just in case’ peeing

  • Kim (our special YWMTDW guest) gives her advice for going to a pelvic health Physical Therapist based on her experience:

    • Be Real

    • Don’t sugarcoat what’s going on with you

    • If you go to a Physical Therapist and don’t like them, find a new one