Pelvic Health Physical Therapy: The Future is Bright and Diverse

In recent years, more and more people are seeking education and resources about their reproductive health. A research study revealed that persistent pelvic pain is a common complaint among young patients, and it is estimated that pelvic floor dysfunction will rise by 35% in the next 12 years. (1) This means that the demands for pelvic health professionals (OB-GYNs, pelvic PTs, urogynecologists, midwives, doulas, etc.) will greatly increase as well. So, what does this mean for the future of pelvic health professionals, especially pelvic health physical therapy?

I believe that in order for our profession to keep up with increasing demands that 3 key things will need to take place. The first will be educating the community and population on signs and symptoms of pelvic floor dysfunction/ disorders. The University of Iowa conducted a study of over 25,000 adult women that attended their primary care clinics and found that at least 32% had at least one pelvic floor disorder (PFD) diagnosis. This consisted of women who may or may not have even been initially seeking care for pelvic floor dysfunction/disorders. (2) Many women may also be underreporting due to lack of education, feelings of shame, or other reasons which makes the prevalence of PFD even greater in the primary care setting.

With the establishment of high prevalence, it is important for pelvic health providers to get into the community and begin educating the masses on what PFD is and interventions/resources available for treatment. Pelvic health physical therapists go through extensive education with certifications, classes, and patient care in order to provide quality care to patients. But simply providing care to those who seek it is not enough, especially in communities with underserved, underrepresented, and low socioeconomic standing. Hosting free educational seminars, providing short yet informative pamphlets in local stores, or even starting with early education in health education high school courses can be a great start to increasing pelvic floor health awareness.

The second important thing that needs to take place is furthering the education all PT/PTA/SPT/SPTAs on the importance of pelvic health as well as screening/ examination techniques to detect pelvic floor dysfunction. The average DPT curriculum provides a brief overview of the female/male pelvic floor anatomy and physiology. In my program, I was fortunate enough to have 2 guest clinicians give 1–2-hour lectures on male/female anatomy and some basic exam items for specific diagnoses like pelvic organ prolapse. But even with this, I did not feel competent enough on how to screen for pelvic floor disorders or when to refer the patient back to an OB-GYN or pelvic health therapist. While I understand the current DPT curriculum is already very dense and packed with tons of information, I believe that the same amount of time and effort should be given to learning about the pelvic floor as any other musculoskeletal system like the cervical spine or shoulder. This will not only help with more detailed patient education but will help make current and future clinicians more competent and well rounded.

The last thing that will need to take place is increasing inclusivity, diversity, and equity of pelvic health PT. In 1977, Elizabeth Noble founded the Section on Women’s Health of the American Physical Therapy Association, now known as the Academy of Pelvic Health Physical Therapy (APHPT) (3). Just recently, in 2011 and 2018, is when the APHPT began to recognize member who treated male pelvic health disorders and changed the name of the academy respectively. The push towards the inclusivity of more gender identities aside from women is a step in the right direction for the APHPT. With this, it is important to recognize that more education and research needs to be conducted on Black people, Asian people, Hispanic people, LGBTQIA+ people, and more’s pelvic health. By increasing the diversity of not only knowledge, but increasing the diversity of clinicians serving these communities, this can help to alleviate knowledge gaps and make patients more comfortable with treatment knowing that the clinician serving them is aware and well versed on their specific circumstances and unique determinants of health. 

Another aspect that needs to be improved upon not only in pelvic health PT, but physical therapy in general is equity. Insurance complications, lack of financial resources, and lack of reliable transportation can make physical therapy extremely inaccessible to a lot of people/communities. And unfortunately, the current state of the U.S. health care system does very minimal to alleviate barriers to access. The responsibility to get patients the care they need and deserve then falls on future and current clinicians to provide. This can be as simple as volunteering at health screenings once or twice a month and providing education and HEPs for patients that are unable to consistently attend sessions, or as impactful as hosting pro bono clinics especially in areas with a low volume of physical therapy clinics that treat pelvic health patients.

Overall, the growth that the Academy of Pelvic Health Physical Therapy has made in the last 54 years is extremely commendable and does not go unnoticed. The 5 pillars of community, research/knowledge, practice & advocacy, education, and operational excellence as well as the incorporation of the IDEA committee and volunteer leadership shows the dedication that the Academy has to increasing the awareness, education, and diversity in the pelvic health field. With the trajectory that the APHPT is on, there is no doubt that the future of pelvic health physical therapy is bright and diverse.

References:

1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8781482/

2. https://medicine.uiowa.edu/content/study-data-25000-women-finds-least-32-have-pelvic-floor-disorder

3 https://www.aptapelvichealth.org/about

Author:  Elizabeth Meretighan, SPT, APTA x NABPT PH1 Scholarship Recipient

Author Bio: I am Elizabeth Meretighan, a 3rd year Physical therapy student at Emory University from Inglewood, California. I received my B.S. in Health Sciences, Magna Cum Laude, from the illustrious Howard University in 2021. I have thoroughly enjoyed learning about the physical therapy profession and can’t wait to further my knowledge and education in the years to come. My passions, aside from physical therapy, include traveling, dancing, and weightlifting.

Author: Elizabeth Meretighan, APTA x NABPT PH1 Scholarship Recipient

Author Bio: I am Elizabeth Meretighan, a 3rd year Physical therapy student at Emory University from Inglewood, California. I received my B.S. in Health Sciences, Magna Cum Laude, from the illustrious Howard University in 2021. I have thoroughly enjoyed learning about the physical therapy profession and can’t wait to further my knowledge and education in the years to come. My passions, aside from physical therapy, include traveling, dancing, and weightlifting.