Pelvic Rehabilitation

U.S. News & World Report Best Hospitals for obstetrics & gynecology

Nationally Ranked in Ob/Gyn

UT Southwestern Medical Center is ranked by U.S. News & World Report as one of the nation's top hospitals for obstetric and gynecological care.

The Comprehensive Pelvic Rehabilitation Program at UT Southwestern offers advanced treatment of a broad range of pelvic conditions, including urinary and bowel dysfunctions, pelvic pain, and prenatal and postpartum conditions.

Our team consists of physical medicine and rehabilitation physicians who specialize in treating disorders of muscles, joints, and nerves, working alongside physical therapists with specialized pelvic health training. Utilizing a unique team approach, we work to ensure positive outcomes for patients, with the goal of reducing pain, increasing function, and restoring quality of life.

Conditions We Treat with Pelvic Rehabilitation

Problems with pelvic pain and function often arise from abnormalities of muscles (including the pelvic floor), joints, and nerves. These changes can be related to injury, surgery, chronic illness, pregnancy and childbirth, surgery, normal aging, or psychosocial factors.

The Comprehensive Pelvic Rehabilitation Program treats the following pelvic issues:

Urinary problems, including leakage, urgency and frequency, incomplete emptying, and pain with urination
Bowel problems, including chronic constipation and incomplete emptying, fecal urgency, leakage, and pain with bowel movements
Pelvic pain, including pain in the lower abdomen, groin, pelvic joints, low back, hips, buttocks, tailbone, and genitals
Pregnancy and postpartum issues, such as sacroiliac joint dysfunction, pubic symphysis pain and dysfunction, back pain with child care activities, and rectus diastasis
Sexual dysfunction, including pain with sexual activity, painful speculum exams, and inability to tolerate tampon insertion

Diagnosing Pelvic Dysfunction

We begin with a thorough evaluation of the patient’s condition. Our physicians and therapists listen closely to our patients to understand their history and symptoms.

The evaluation may include a:

Postural assessment, during which we look at pelvic alignment
Neurologic and musculoskeletal examination, an assessment of the structure and function of the spine, pelvis, and extremities

If needed to confirm a diagnosis, we may recommend radiologic evaluations such as:

X-rays
Magnetic resonance imaging (MRI), including MR neurography, which enables evaluation of the peripheral nerves

Treatment Options

Based on the results of the evaluation, we will develop an individualized treatment plan. Our team uses a variety of techniques, including:

Patient education (pelvic anatomy and function; pain neuroscience education)
Pelvic physical therapy, which can include:
- Bladder retraining
- Bowel retraining
- Neuromuscular reeducation and biofeedback
- Strengthening, alignment, and stabilization exercises
- Support devices, such as sacroiliac joint belts
- Connective tissue manipulation
- Manual therapy, external or internal
- Myofascial release, which involves gentle sustained pressure on connective tissue to release tension and reduce pain
- Dry needling
- Neural mobilization
- Visceral mobilization
- Electrical stimulation
- Home exercise program
Medication management
Nerve blocks and radiofrequency ablation
Trigger point, bursa, and other musculoskeletal injections

Clinical Trials for Pelvic Rehabilitation

As an academic medical center, UT Southwestern regularly conducts clinical trials. These studies help improve understanding of pelvic pain and give our patients access to the latest treatments.

For example, Rupali Kumar, M.D., and Marissa Marcotte, M.D., have an ongoing study about using Qigong to treat chronic pelvic pain.

Search for current clinical trials.