Pelvic Health: Physical Therapy for Every Body

The pelvic floor is a unique series of muscles that require a novel treatment approach. Dysfunction of these muscles can lead to issues in the bowel, bladder, sexual function, as well as pain in the pelvic region. Specialized treatment for the pelvic region, including the pelvic floor muscles, can help you achieve greater comfort and return to your desired function.

Our pelvic health specialists have attained specialized training through additional education and clinical practice to help them address these issues. While this is clearly an area that not all physical therapists chose to pursue with focus and passion, our pelvic health physical therapists have been inspired to provide excellence in this burgeoning field.

Pregnancy and Postpartum Care - Alpine Afternine

Our postpartum care program, Alpine AfterNine,  is there for you in the early stages of motherhood. From birth recovery to chasing toddlers, let us take care of you so you can take care of them.
Pregnancy is a time of discovery, growth, and transformation. During the 40 weeks of pregnancy a woman’s body will undergo both physical and hormonal changes. These changes are normal and natural but they can also lead to dysfunction or pain. We can help with low back pain, pelvic pain, and other pain presentations during pregnancy. We can also provide valuable information on preparations for childbirth such as labor positions, pushing techniques, and other pain relief during the laboring process.

Conditions we treat

Urinary Incontinence
Pelvic Organ Prolapse
Urinary Frequency and Urgency 
Fecal Incontinence
Constipation
Diastasis Recti 
C-section or Perineal Scar Pain 
Pubic Symphysis Dysfunction
Sacroiliac Joint Dysfunction
Coccyx Pain
Pain with sex
Post Prostatectomy Rehab
Nonbacterial Prostatitis or Male Chronic Pelvic Pain
Pudendal Neuralgia and/or Chronic Pelvic Pain Syndrome
Abdominal and/or Genital Pain
This list is not comprehensive. Please contact us to see if we can help you with your pelvic health needs.

Meet Our Team

Clare Antonioli

PT, DPT

Pelvic health Therapist

Janelle Gibson

PT, DPT

Pelvic health Therapist

Dana Solge

PT, DPT, PRPC

Pelvic health Therapist

Treatment Techniques

Rehabilitative Ultrasound imaging (RUSI)

RUSI is an evidence-based technique that trained physical therapists can use to visualize muscles and more accurately assess the origin of musculoskeletal pain and dysfunction. RUSI is a noninvasive tool that utilizes the same safe technology used for monitoring pregnancy, only at different frequencies.

Dynamic real-time (video) images are generated that allow patients to see how their muscles function in action. RUSI may be helpful with the treatment of many different conditions including back pain, pelvic pain, hip and groin pain, post-partum rehabilitation, incontinence, as well as patients who have healed from an abdominal surgery.

Alpine is the few places in Western Montana where RUSI is available as a diagnostic technique.

Surface Electromyography (SEMG) Biofeedback

Surface Electromyography (SEMG) Biofeedback is a helpful form of treatment for various forms of pelvic floor dysfunction. Surface electrodes are placed on the skin to detect the voltage changes within the muscle. This information can be viewed on a computer screen so patients can visualize their pelvic floor function.  While SEMG biofeedback does not directly measure strength, it can allow individuals to visualize muscular activation when they are contracting . This can be used for pelvic floor strengthening to treat urinary and fecal incontinence as well as pelvic floor relaxation training to treat pelvic pain and constipation. SEMG is a noninvasive and safe technique to improve pelvic floor muscle function.
Our pelvic health physical therapy specialists have expanded their careers to help meet the unique pelvic health needs of women and men. Their compassionate spirit and genuine care have infused our pelvic health outreach; Alpine continues to be recognized by doctors and clients as the leader in providing pelvic health services for everyone, regardless of gender or age.

Below is a list of information and frequently asked questions about pelvic health. Click on the topic to expand.

What Should I expect from my first visit?
Your pelvic health therapist will first discuss with you the primary reason for seeking physical therapy services. She will also review key elements of your past medical history. A thorough examination is done for the spine, hips and pelvis as appropriate. Your therapist will talk with you about your condition. 

Notably, pelvic health physical therapists are specially trained in an internal evaluation of the pelvic floor. In the event an internal pelvic floor examination is warranted, she will educate you on why this would be beneficial for treatment. An internal exam allows your therapist to ensure that you are correctly recruiting and activating the proper muscles. Based on the results, your home program is then individualized for optimal results. Additionally, the internal exam alerts your therapist to whether there is over activity or tension present in the muscles. If so, your treatment may require that you start out with relaxation or muscle retraining prior to muscle strengthening.

What is a Kegel?
A Kegel is synonymous with pelvic floor contraction. Its name comes from Dr. Arnold Kegel, a gynecologist whose research in the 1940’s led to the introduction of this set of exercises as an appropriate tool for the treatment of urinary incontinence. Activation of the key pelvic floor muscles is often done incorrectly, which can negatively impact the patient’s condition. Correct activation includes a squeezing and lifting of the perineal muscles inward without over working the gluteal or abdominal muscles. Working with your pelvic health therapist is critical to ensure that your technique is correct and finely tuned, resulting in successful resolution of your symptoms.
Do I need a referal?
This depends on your insurer. Montana allows direct access to physical therapy services, which means you may not need a prescription. Although many insurance companies do not require a prescription or referral for physical therapy, others do. Thus, it’s important to check and see whether this benefit is available prior to starting physical therapy. Our patient care coordinators are here to work with you and your insurer to help sort this out.
Get Started
    1.  To schedule an evaluation, call our Alpine North clinic at 406-541-2606.
    2.  Arrive 15 minutes early for your first session.