Pelvic Health and Rehabilitation

Our Physiatrists or Physical Medicine & Rehabilitation (PM&R) physicians are board-certified specialists, many with fellowship subspecialty training in areas including interventional pain medicine, and are experts in diagnosing and providing non-operative treatment of conditions that affect muscles, joints, bones, and nerves of the pelvic floor.

Musculoskeletal and interventional pelvic pain treatments

Nerve blocks:  Chronic pelvic pain can be treated with this minimally invasive procedure. Medications are injected into specific nerves in the body to block pain signals and alleviate pain. This injection takes about 20 minutes and has the potential to provide pain relief for several months.

Pelvic floor trigger point injections: If muscle fibers in the pelvic floor become tight due to stress or injury, this can cause a “muscle knot” or a raised bump or nodule. These trigger points can cause tenderness and pain. Trigger point injections are effective for inactivating the trigger points and providing pain relief. 

Botulinum toxin injections: Botulinum toxin (Botox) contains a neurotoxin that temporarily relaxes specific muscles. This is an effective treatment for pelvic muscles that are contracting or spasming painfully. The Botox is administered directly to the muscles that are causing pain. This procedure takes about 20 minutes and typically provides pain relief for about three months.

Our Physiatrists utilize an interdisciplinary team approach when indicated and oversee care when referring to other members of the rehabilitation team.  

NewYork-Presbyterian’s physical therapists offer a full array of evidence-based therapy to treat your pelvic health condition. We work closely with you and your referring physician (physiatrist, gynecologist, urologist, urogynecologist, gastroenterologist) to design an individualized treatment plan that meets your specific personal needs.  We offer extensive education about your anatomy and the many things that may be influencing your condition, including your diet, postures, and behavioral habits. During your one-on-one session(s), your therapy may include:

• Extensive education 
• Self-management techniques to reduce symptoms 
• Hands-on work – soft tissue mobilization, myofascial release, trigger point therapy, scar massage,  and internal and external manual therapy
• Muscle re-education, which may include stretching and/or strengthening
• Neuromuscular education for pelvic floor muscle strengthening and relaxation
• Postural re-training 
• Bladder and bowel retraining
• Nutrition and dietary recommendations
• Electric stimulation 
• Biofeedback – an approach used to optimize your awareness of the muscles of your pelvic floor. Various methods may be utilized, including the use of internal or external sensors and computerized visual images

When it comes to your care, it is important to be seen by clinicians who are experienced and knowledgeable. NewYork-Presbyterian boasts a team of highly trained pelvic health therapists including some with advanced certifications from accredited medical organizations including:

• Board Certification in Orthopedics and Pelvic Rehabilitation (OCS, PRPC, WCS)
• Pelvic Rehab Practitioner Certification (PRPC)
• Certificate of Pelvic Health (CAPP-Pelvic)
• Schroth Method for Scoliosis treatment
• Certified Manual Physical Therapist (NAIMT) and (NAIOMT)
• McKenzie Mechanical Diagnosis and Treatment Certification (Cert. MDT)
• Certified Orthopedic Manual Therapy (COMT)
• Biofeedback Certification