Does Pelvic PT Hurt?


According to popular rumors PT should stand for physical torture, not physical therapy. In pelvic health PT that rumor has escalated to the point that doctors are telling people to go to PT and that they will have “the worst pain imaginable” during treatment. Not only is this not helpful, it’s not true. The goal for physical therapy is never to increase your pain. In addition, you should always leave feeling better than when you arrived.


So why do people expect pain? Several reasons come to mind and some of these may be familiar to you.


  • “No pain, no gain” is still a common phrase that's just outdated and inaccurate. Pain is your body’s way of telling you something is wrong and you need to stop and change what you're doing or how you are doing that activity. Pushing yourself harder to run faster, lift more weight or improving your physical fitness is not pain. It’s hard work. You have to push yourself to see gains, but pain isn’t necessary or helpful.



  • Doctors are telling people physical therapy is painful. Doctors are not performing the treatment so they don’t know if it’s going to be painful or not.


  • Experience tells you it’s going to be painful. Having experiences such as pain with sex, tampon use or gynecological exams can lead you to expect pain with a similar exam. My exam is different from a typical gynecology exam though. I don’t use a speculum, just one gloved finger. I let you set the pace. There is no examination that is required so I’m not trying to force something and you don’t have to bear through a painful exam for me to get the information needed to treat your condition.


  • The unknown can also be scary. Many people are unsure of what pelvic health PT will entail. Fear and worry can lead us to expect the worst. If we’re already having pain, someone “poking around” in a painful area is expected to be painful.


But none of the above applies in my physical therapy sessions. I start with addressing the unknown. We talk about anatomy so you can better understand what I'm going to touch and why. I walk you through each step of the exam before you ever get undressed. Then while doing the exam, I talk you through each step again. We go at a comfortable pace for you. Since I don’t use a speculum for examination that typically takes out 1 potentially scary step associated with pain. Using 1 finger allows me to respond to your body cues more effectively. If I feel or see your body tensing, I know to slow down or stop. If your muscles are tense and painful to the touch, I can adjust how much pressure I’m using to reduce the discomfort you experience.


Repeated painful experiences only work to increase our sensitivity to any stimuli in an area. Our body’s alarm system is on high alert in order to protect us from potential dangers. If my treatment is consistently causing you pain, your body is going to respond by becoming more tense, more guarded and more sensitive. This leads to more pain and more symptoms. So even though pelvic PT can be uncomfortable at times, mentally and physically, it is not painful. You should always leave feeling better than when you arrived.


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