Frequently Asked Questions

+ What is a pelvic physical therapist?

A pelvic physical therapist is a state licensed physical therapist (PT) who has an advanced degree in physical therapy, but also has specialized training specific to working with the pelvis and pelvic floor muscles. These therapists are able to examine the pelvic floor externally and internally as well as the abdominal, lumbo-pelvic and hip regions.

Their advanced skills enable them to work with clients with pelvic pain, bladder and bowel issues as well as sexual dysfunction. Many Pelvic Physical Therapist’s also go on to receive advanced training in male pelvic health, pregnancy and postpartum care, athletics and more.

+ Can men have pelvic floor dysfunction as well?

Yes, we treat men and women. We have a vast diversity of patients at Pelvic Forward PT that all benefit from our services. A few examples of commonly seen cases among men include prostatitis, testicular/perineal pain, athletic injury or conditioning, nerve dysfunction, abdominal pain, post surgical pain or rehabilitation, and various bladder dysfunctions. If you have any further questions, please feel free to call our office at 828-738-2332.

+ How does the pelvic floor cause bladder and bowel problems?

The pelvic floor is a hammock of muscles that holds all the pelvic organs and is critically involved in their function. For example, when your pelvic floor is too tight, weak, or incoordinated this may result in the inability to store urine or in some cases cause bladder area pain. Problems with the pelvic floor can also cause an overactive bladder symptoms including urinary urgency and frequency. Pelvic muscles that are weak or not functioning well with the rest of the core may cause urinary and/or fecal/stool incontinence. In some cases, constipation may be a result of muscles being tight and not moving in the right directions.

+ Is it normal to have pain with sex?

It is not typical to have pain with sexual intercourse nor is it something you should live with or suffer through. When muscles in the pelvic floor are tight or short, have tender areas, or don’t move properly sex may be painful or impossible to engage in. At times these muscles may also become thin, which also contributes to pain. At Pelvic Forward PT, we will assess your pelvic floor muscles, tissue and address any impairments that can be eliciting your pain.

+ Isn’t it normal at my age to pee a little when I cough or sneeze? I’ve been doing it forever.

The answer is No. It is not normal for anyone to leak urine at anypoint in the lifespan. There are likely reasons that you are experiencing leakage which we can treat. And it is never too late to begin addressing them! In fact don’t wait for things to get worse or turn into a new problem. We can help you move beyond pads and back to the things you love.

+ I have had these pelvic problems for so long. Do you think you could still help me?

Many patients have come to Pelvic Forward PT after trying various medical interventions with limited or partial success. We work to identify the root cause of your problem by addressing all musculoskeletal and neuromuscular dysfunction instead of just one piece of the puzzle. We have had success with patients who reported issues that began decades ago, yet they never knew the right help was out there. It’s never too late to get the care and treatment you deserve to improve and move forward.

+ My medical doctor told me to do kegels but I do not know if I am performing them correctly. How can I tell?

Kegels, or more specifically, pelvic floor muscle contractions, can be an effective method to reduce some pelvic floor symptoms, however, they are not appropriate for everyone and many individuals (~50%) perform them incorrectly. We have expert training to complete a full body evaluation and pelvic floor examination to determine the best treatment plan for you, including how to perform the appropriate exercises and activities to address your symptoms.

+ Can I see a physical therapist without a referral from a medical doctor?

North Carolina is a Direct Access state for physical therapy. This means anyone can refer themselves directly to our office.

+ Can I file for reimbursement with my insurance?

We will provide you with the itemized receipts and diagnostic code information at your request to self-file. If you are interested in exploring your out-of-network benefits, contact you insurance company and ask about coverage for "out-of-network physical therapy in a private outpatient office." Some insurers have other internal requirements, so if you plan to seek reimbursement get your information first.

+ Is an internal examination necessary?

An internal examination does not have to be performed at your first or any other visit. We are able to evaluate and treat you externally. However, by having an internal exam we are able to gather a wider range of information. Directly palpating the muscles and other structures that may be affected gives us the most thorough understanding of what’s causing your symptoms. We understand that the reason you may be visiting our office is because you have difficulty with gynecological exams. We will focus on making you as comfortable as possible throughout the session and will only perform components of the internal examination with your consent.

+ Should I cancel my appointment if I am on my menstrual cycle?

We ask that you still come to your appointment even if you are on your menstrual cycle. In fact sometimes it can even help us find issues that are more present during that time. We can still perform internal work, or we can work externally, if you prefer

+ How is payment and insurance handled?

Pelvic Forward is a cash-based business meaning an out-of-network provider for private insurance companies. We have strived to keep pricing very reasonable to prevent cost from inhibiting the care many individuals need. The approximate rate of $90/hour for treatment sessions has been selected due to being comparable to many insurance company copayment amounts for outpatient therapy. Clients are offered a detailed receipt that allows them to apply their payment to flexible spending accounts or toward their out-of-network deductibles.

Cash payment also allows for a higher standard of care unrestricted by insurance requirements. A key example is my ability to conduct a 2-hour evaluation specific for your needs to collect a maximum amount of information to allow for the minimum number of follow up treatment sessions to meet client goals. In my experience this approach to care allows a client with any pelvic health issue to have a very efficient rehabilitation experience, and eliminates the need for extraneous sessions often dictated by insurance companies.

Please note I am not able to treat Medicaid patients due to the special requirements of this insurance entity.

+ What payment methods do you accept?

We accept cash, personal checks, credit cards, and HSA accounts.

What Questions Do You Have?

I’m here to help. Give me a call at 828.738.2332 or email me at amanda@pelvicforward.com. I am happy to answer any questions you might have.