SHEFit Physical Therapy specializes in women’s health and pelvic floor therapy with a focus on pregnancy and the postpartum period. We are San Diego’s premiere physical therapy clinic and your top local resource for pregnancy, pain, bladder issues, diastasis recti, core weakness, sexual dysfunction, and fitness during/after pregnancy. If you want to be fully prepared for pregnancy, birth, and recovery, we are your dream team!

1.What is pelvic floor physical therapy?

Pelvic floor physical therapy (PFPT) focuses on addressing a variety of issues that are related to the pelvic floor – a group of muscles that are housed inside the pelvis. Symptoms may include dysfunction of the bladder, bowel, and reproductive system, as well as pain in the pelvis, vagina, rectum, abdomen, back, and buttocks. Pelvic floor physical therapy employs a mix of movement training, strength and coordination work, massage, stretching, myofascial release, education, and lifestyle guidance to help resolve these issues.

Pelvic floor Physical Therapists are specialized PTs who have extra post-doctoral training and experience in these areas.

2. What is prenatal pelvic floor PT?

Prenatal pelvic floor physical therapy (PFPT) focuses on addressing the physical changes that occur during pregnancy and how they affect the pelvic floor. It includes treatment for conditions like pelvic pain, incontinence, sciatica, hip pain, and more. Our goal is to help you feel strong, comfortable, and prepared for childbirth.

2. Why should I see a pelvic floor PT during pregnancy?

Pregnancy puts unique stress on your body, particularly your pelvis, hips, and lower back. Our PFPTs can help alleviate discomfort, improve posture, reduce pain, and help you prepare for labor and delivery by strengthening your core, pelvic floor, hip and back muscles and teaching you proper body mechanics so you can remain comfortable until your delivery day!

3. What conditions do you treat during pregnancy?

We specialize in treating a range of prenatal conditions, including pelvic pain or discomfort, diastasis recti (abdominal muscle separation), bladder leakage (incontinence), bladder pain, hip and lower back pain, sciatica, pubic symphysis dysfunction, pain with walking or standing for long periods, vulvovaginal heaviness or pressure, hemorrhoids, posture changes, and more.

Our therapists also specialize in fitness/athletics during and after pregnancy, and birth preparation – preparing you to use your pelvic floor and core to have the smoothest labor possible and avoid unnecessary interventions and damage to your pelvic floor!

4. What will my first appointment be like?

Your first appointment will involve a thorough discussion of your  concerns and goals, medical history, any pregnancy-related discomfort or symptoms you are having, your birth plan, and any other reasons for seeking our help. Your PT will perform a thorough evaluation of posture and movement patterns, which may include breathing, squatting, core activation, and other functional movements. If your PT thinks it prudent we may also do an intravaginal pelvic floor assessment, but this may be deferred or declined based on clinet comfort.  Based on this assessment, we’ll develop a personalized plan tailored to your needs, and send you home wiht some initial steps to start moving toward your goals immediately!

5. Should I start PT now or wait until postpartum?

YES! Every woman should do at least a few visits during pregnancy for a few reasons. First, we want to prepare your body for the changes of pregnancy in order to maximize your fitness, minimize your prenatal aches and pains, and prepare your pelvic floor for birth. If we stay AHEAD of the changes in your body, you are much less likley to experience back pain, bladder issues, sciatica – all those nasty things your friends complain about!

Second, we do BIRTH PREP! There is much we can teach you to help you make labor easier, faster, and less damaging to your pelvic floor! We can teach you how to use your core and pelvic floor effectively during labor, reduce your risk of severe tears, help you cope with labor pains, and be an active conductor of your birth experience. We want to help your labor go smoothly and prevent damage to the pelvic floor, vs. just fixing it afterward!

6. How does pelvic PT help with labor and birth preparation?

Strengthening your pelvic floor and learning good coordination can help you during labor and delivery! Learning how to both engage and relax your pelvic floor muscles helps to maximize your comfort and effectiveness during the pushing phase of labor while reducing the risk of perineal tears and damage to the pelvic floor. Additionally, learning how to align your body and move efficiently can make labor smoother and more manageable.

In a birth prep session we provide research-based advice to help you prevent perineal tearing and empower you to use positions and techniques in labor that will help reduce pushing time and keep you in control, minimizing unnecessary interventions. We coach you with hands-on feedback on the best way to PUSH, with or without an epidural, to maximize your power and minimize perineal damage. We practice with you in a variety of positions so you know the nest options for YOUR body, and can ask for those preferences in the delivery room!

7. Do you offer pre/postnatal fitness aside from physical therapy?

Our docs know pelvic rehab, but we also know fitness, strength, and performance! Unlike most clinics and hopsital programs where the PT will teach you kegels and send you on your way, our aim is to actually get you back to ALL the things you love! We have heard too many stories of clients who have seen another PT only to be cut loose then their insurance runs out, even though they still cannot run, jump, lift heavy, or get back to their sport. Our PTs are 100% confident in exploring beyond the boundaries with you – pushing past those outdated limitations you may have been given like “you can’t lift more than 10lbs with prolapse” or you “can’t do crunches with diastasis”. We will work with you as long as it takes to get you back to the physical activities you love.

8. When postpartum should I start therapy?

We recommend coming in for your first postnatal visit around 3-4 weeks postpartum; you do NOT have to wait until your 6 week check up! If you have questions or concerns sooner we are happy to help – you can book a video visit or come in for body work as soon as you need! One of our goals in prenatal PT is to equip you with the knowledge to manage those first few weeks on your own – that’s why we recommend everyone do a few visits during pregnancy!

9. I don’t have any current problems – should I still do pre/postnatal PT?

Absolutely. Every woman should do at least a few visits prenatally (see the reasons above!) to prevent pain and pelvic floor dysfunction or diastasis recti, maximize strength and fitness, and prepare to have the smoothest possible birth experience with the leas amount of damage to the pelvic floor. An ounce of prevention is worth a pound of cure!

Similarly, every woman should have a pelvic floor and core assessment postnatally. Even if you have no immediate symtpoms there is trauma from birth – either to the vagina or to the lower abdomen, or sometimes to both! Our job is to spot any red flags early and help you recover smoothly without any of the side effects like bladder problems or pain rising up down the road.

Clients always tell us they wish they had come in sooner to prevent their problems, vs. waiting until they could no longer function to seek help.

10. How does pelvic therapy help with chronic pain conditions like endometriosis?

Chronic inflammatory conditions often set off a fight-or-flight response in your body, which triggers muscle sapsm and tension in your pelvic floor. Over time, this muscle tension can generate pelvic pain, as well as irritate the nerves in your pelvis which generates more pain! Believe it or not, the tension in your pelvis may spread to impact other areas like your neck, hips and back. As pelvic PTs, we help address any myofascial (muscle + fascia) and nerve tension that may be contributing to your symptoms through gentle release techniques, as well as teaching you to release this tension at home so that you can overcome your symptoms and get your life back! We may also refer you to other trusted resources and providers to tackle related causes that traditional medicine has been unable to fix.

11. Can you treat other parts of me besides the pelvic floor? (My hip, knee, shoulder etc…)

All phyiscal therapists are experts in general injury rehab, and we are no exception. In the course of your care with us, we are happy to help with your knee, shoulder or hip pain! In fact, we are one of the few pelvic health providers who will treat you as a WHOLE PERSON, addressing any and all body parts that need attention. Did you know that your jaw, neck and back pain migh actually be related to your pelvic floor? Did you know that your diastasis recti might actually be connected to your shoulder pain? Yes, the whole body is connected – nothing works in a vacuum by itself! We want your whole body to work well and be well, so that you can achieve whatever goals you have in mind for your life!

12. What training do your PTs have beyond typical PTs?

Our DPTs KNOW pregnancy and the pelvic floor. All our DPTs are required to complete extensive post-doctoral study in pelvic floor and pregnancy prior to being hired at SHEFitPT. Clinicians must have over 2 years of experience specifically in pelvic floor therapy before even being considered for an interview! Unlike other clinics where your PT may have just taken a one day course or a few online classes, you can rest assured that every doctor you see at SHEFitPT has extensive training and experience and is 100% qualified to help you!

13. What is different about SHEfitPT compared to other clinics?

At SHEFitPT pregnancy and the pelvic floor is not an add-on service or and after thought – it is WHAT we do and WHY we exist. Our doctors are not simply dabbling in pregnancy and the pelvic floor and seeing primarily sports injuries or post-op patients – all our doctors are highly specialized and experienced in pregnancy and the pelvic floor, and it is in fact our primary professional passion!

Second to our specialization and expertise, we provide unparalleled individualized care. Unlike other clinics where you will spend 20 minutes with a PT and then be passed off to an aide or tech, who will “supervise” you (and 2 other patients) doing a long list of random exercises or sitting on machines. With us you will be hands-on with your doctor of PT for the full hour session! This allows us to accomplish so much more in your time with us, and achieve your goals much faster!

Third, we take a holistic approach to your pregancy and pelvic health. Unlike other clinics, we do not give you a one-size-fits-all protocol of kegels exercises, and we do not limit ourselves to the one body part on your referral. Our doctors complete a full-body assessment to find all the factors contributing to your problem – your pelvic floor does NOT live in a vacuum and we want to address any factors that may be holding you back! We also want to help you move past any other injuries or issues that are bothering you – chronic knee pain keeping you from running, shoulder pain with lifting the car seat, back pain with holding the baby – we are here to help you as a WHOLE person, not just a pelvis!

14. I’m not pregnant – can you still help with my bladder or pain issues?

We understand the vast variety of concerns of both birthing and aging women, and we can help! If you are many years beyond birthing, or not even considering it, but are experiencing common pelvic floor concerns such as pelvic organ prolapse, urinary leakage, painful intercourse, pelvic/low back pain, or core dysfunction, we can help you too! Call us to discuss your personal conerns and decide if we are the right fit for you.

15. Do I need a referral from my doctor to see a physical therapist?

You do not need a referral to see a pelvic floor physical therapist. We always recommend informing your medical provider (obstetrician or midwife) before starting therapy and asking if they have any specific precautions or concerns with your pregnancy, but you do not need permission to come see us! We will send a copy of your evaluation to your preferred medical provider to ensure they are in the loop about what we are doing in PT, and are always happy to communicate on specific concerns if needed.

16. How many sessions will I need?

The number of sessions needed varies widely depending on your specific concerns and goals. Most patients see improvements after just a few sessions, but if you are pregnant we want to support you through your entire pregnancy AND postpartum recovery, whatever may arise – we are by your side for the long haul! For non-pregnancy related concerns, more complex or longstanding issues may require extended care over months or even years. You should see continued progress over time, though it may not always feel like the same rate of improvement and the frequency of visits may fluctuate. Our goal is always to bring you to best possible outcome where you have achieved your goals and are living a full and satsifying life, however long that takes! Your therapist will provide you with specific recommendations for a treatment plan after your evaluation.

17. What can I expect during treatment?

Treatment may involve a combination of manual therapy, massage, movement training, coordination and awareness training, exercise, postural training, and breathing techniques. We’ll guide you through exercises that strengthen the pelvic floor and synergistic muslce groups, improve posture, and alleviate discomfort. We’ll also teach you ways to support your body during activities like standing, walking, lifting, jumping running, or whatever else YOUR live demands!

19. I’m having trouble with bladder leakage—can therapy help?

Yes, pelvic physical therapy is highly effective in treating urinary incontinence at any stage of life, inlcuding during pregnancy. In fact, it is the first line recommended treatment for bladder leakage! We will guide you through pelvic floor exercises to help strengthen the muscles that control bladder function if they are weak, as well as mobilize them if they are stiff, and retrain them if they are uncoordinated or unresponsive. It’s a lot more interesting than just kegels! We involve a whole-body approach that address contributing factors in your core, glutes and diaphragm to really get you leak-free with ALL the activities you desire.

20. Do you take insurance?

Pelvic floor therapy services at SHEFitPT will be covered under your out-of-network insurance benefits.  We are out-of-network for most insurance plans, however we are in-network for Tricare West. Please call our office for details on how we can help with insurance reimbursement.

21. Will there by homework?

Yes! One of our main goals is to empower you to take care of your body at home. We’ll provide you with exercises, stretches, releases, and ideas that are safe, effective, and easy to integrate into your daily routine. We’ll also make sure to adapt exercises as your pregnancy progresses to ensure they remain safe and beneficial.

22. Do I need to wait until after delivery to see a physical therapist?

Not at all! Prenatal pelvic health therapy is designed to help you during pregnancy. In fact, it can reduce the likelihood of experiencing postpartum complications like pelvic floor dysfunction or back pain. We encourage patients to begin therapy as soon as they experience discomfort during pregnancy.

Still have questions? Call us at 858-247-2660!

*SHEFit Physical Therapy proudly serves San Diego County through our offices in Pacific Beach and Mission Valley. We accept all major credit cards, HSA/FSA cards, and Tricare Insurance. Please see our Pricing page for detailed pricing information.