Frequently Asked Questions

Often Asked Questions About Pelvic Floor and Lymphatic Therapies

Pelvic floor therapy is a type of rehabilitation done by a trained therapist, either an occupational therapist or a physical therapist, that focuses on treating conditions related to the pelvic floor muscles. The pelvic floor muscles are a group of muscles that provide support to the bladder, uterus, and rectum, as well as control the functions of urination, defecation, and sexual activity.

Pelvic floor therapy typically involves a combination of exercises to improve the strength, flexibility, and coordination of the pelvic floor muscles, myofascial release and soft tissue manual techniques, posture and biomechanical training, and may also include biofeedback. It can be used to treat a variety of conditions, including urinary and fecal incontinence, pelvic organ prolapse, pelvic pain, sexual dysfunction, and constipation.

Everyone would benefit from seeing a pelvic floor therapist who is experiencing pelvic related symptoms. This could be pelvic pain, incontinence (urinary or fecal), menopausal issues, postpartum symptoms, or sexual health concerns. Incontinence, pain and pelvic floor disorders are common problems many people suffer from that significantly affect an individual’s ability to function in daily life, but you don’t have to. I can help. I know these are all sensitive issues and encourage you to take advantage of our free consultation service to find out how I can help.

In general, pelvic floor therapy can help people who experience discomfort, pain, or dysfunction in the pelvic region. It is important to note that every individual’s symptoms and needs are unique, so a qualified healthcare provider can help determine the most appropriate treatment option for you.

Pelvic floor therapy can treat a wide range of symptoms including:

  1. Urinary incontinence: Pelvic floor therapy can help women who experience urinary leakage during activities such as coughing, sneezing, or exercise.
  2. Fecal incontinence: Pelvic floor therapy can help women who experience accidental bowel leakage or have difficulty controlling their bowel movements.
  3. Pelvic organ prolapse: Pelvic floor therapy can help women who experience a bulging sensation or pressure in the vagina, as well as discomfort or pain during intercourse.
  4. Pelvic pain: Pelvic floor therapy can help women who experience chronic pelvic pain, which can be caused by a variety of conditions, including endometriosis, vulvodynia, and interstitial cystitis.
  5. Painful intercourse: Pelvic floor therapy can help women who experience pain during intercourse, which can be caused by a variety of conditions, including vaginal dryness, vulvodynia, or vaginismus.
  6. Menopausal symptoms: Pelvic floor therapy can help women who experience menopausal symptoms, such as vaginal dryness, pain with intercourse, or urinary urgency/frequency.

I do not process health insurance directly, but I do provide a ‘superbill’ which you can submit for direct reimbursement of services paid through your ‘out-of-network’ plan. As an out of network provider, I am able to practice in a way that is not restricted by insurance companies. Which means you get higher quality of care than your average clinic with one-on-one treatment by a trained pelvic floor therapist, with 60-to-75-minute sessions. More quality time with your therapist per session means better results in less visits, getting you back to doing what you love sooner without interruption from pain and other symptoms.

Telehealth is a virtual offering and therapeutic interaction using audio/video communication. So much information can be obtained and shared through secured online video sessions. I can see how you move and breathe, then visually guide you through assessments and optimal movement patterns. I can verbally ask vital questions to acquire a detailed health history. With that information, I can start providing education of your condition and develop a supportive home program tailored to your goals and unique situation. This can all be successfully done remotely with the advanced and secure technology we have available as clinicians.

There are many variables to each individual case. I expect positive changes after the first session and can better assess what can be expected after that initial visit. Since I am able to spend more time with clients and I focus on implementing home programs as soon as possible, I find the amount of treatment sessions have lessened by 68% from when working in the outpatient clinics under health insurance restrictions.

You do not need a physician referral to get started with an occupational pelvic floor therapist in California. Some insurance plans require a physician referral in order to be reimbursed. Check with your plan administrator if this is a concern.

Yes! Occupational Therapy is an eligible expense and you can use your HSA debit card to pay for your visit.

The initial visit is a chance to hear from you what has been going on, your health history (symptoms, diagnosis, birth history, surgical history) and identify factors that may be contributing to your current symptoms. I will look at your movement patterns, posture, assess soft tissue, and breathing techniques.

To assess strength and tone of your pelvic floor muscles and evaluate tissue, I may perform an internal pelvic floor muscle exam. I also may use s-EMG to capture your muscle activation and coordination in real time. I will thoroughly explain what is involved in these procedures and you can decide if this is right for you.

Following the evaluation, we will work together to develop a plan of care based on examination findings and come up with goals you would like to work towards in therapy. I may provide manual treatment and have you complete beneficial exercises. I will assign a few things for you to work on at home and provide you with important educational materials regarding your condition to support your symptom relief and wellness.

Internal manual work is accessing the muscles, connective tissue, circulatory/nervous system, and pelvic organs from inside the pelvis. This gives us a great advantage to be able to address the body from all angles. An internal exam can be quite helpful to access the muscles, connective tissue, nervous system, and pelvic organs from inside the pelvis, but this decision is always left up to you to decide.

You always have the option of having or not having an internal exam. An internal exam can be quite helpful to access the muscles, connective tissue, circulatory/nervous system, and pelvic organs from inside the pelvis. This gives us a great advantage to be able to address the body from all angles. However, this can be overwhelming for some and that is okay. If you are not comfortable with internal manual work, I have plenty of other tools to assess your muscle activation such as surface EMG biofeedback. I will find the right approach for your body to make the positive changes needed in your life.

The transition through menopause presents many challenges that can often be helped with pelvic rehabilitation and wellness techniques, when applied can often help mitigate symptoms which interfere with the normal functions of everyday life. I strive to network with the best wellness professionals to create a team approach that will support your healing and promote optimal wellness for you. Due to the variety and intensity of the symptoms, I encourage you to book our ‘free’ consultation service to discuss your individual circumstances.

You can be seen soon after delivery if you are well enough and cleared to resume light activity. However, internal PF work will not be considered until you have your doctor/medical provider clearance, this is usually at the 6-week postpartum period.

During Manual Lymphatic Drainage (MLD) sessions, a gentle massage technique is used to encourage the movement of lymphatic fluid in specific areas of the body. When skillfully applied, this therapeutic form of soft-tissue mobilization dramatically enhances lymph drainage within the superficial and deep systems of the lymph vascular network. By doing this, your therapist is able to reduce swelling and discomfort, improve circulation, immune function and help prevent disease. MLD effectively reduces traumatic and post-surgical edema, and can provide symptomatic relief of migraine headaches, fibromyalgia, rheumatoid arthritis, scleroderma, stress, fatigue, and more. MLD also induces detoxification, pain reduction and promotes general relaxation.

If you are feeling well then do come to your therapy session. We will focus on external PF work, biomechanics, reducing pain and swelling, and wellness strategies.

Biofeedback is a treatment intervention used to help clients learn to coordinate their pelvic floor muscles. These muscles aid in bladder, bowel and sexual functioning. Biofeedback is a painless intervention using special sensors, and a computer monitor. This form of biofeedback is referred to as surface electromyography (s-EMG) biofeedback and will be performed in the office with guidance from your pelvic floor occupational therapist. Biofeedback along with other forms of treatment/exercises are used as appropriate for each client.

Myofascial release is a therapeutic technique that consistently provides safe, gentle, and effective treatment for fascial restrictions resulting from imbalances due to trauma, inflammatory responses, surgical procedures, releases muscle tension and poor posture. Fascia is uninterrupted connective tissue from head to toe. It is a highly complex biological dense fabric that holds us together, covering muscle fibers, bones, nerves, blood vessels and cells. When fascia is tight or strained, it can feel like tremendous pressure pulling or squeezing around any given body system, immediately causing pain, discomfort and dysfunction. Applying a sustained, gentle pressure will resolve painful restrictions. MFR treats the entire mind and body system and through treatment you will feel your entire body release tension and be more comfortable.

Contact

Dr. Holly Mulvaney
OTD, OTR/L, MLD-C, CLT
16935 W. Bernardo Dr., Suite 140
San Diego, CA 92127
Ph: 858-888-9676
Em: Hello@ascendwomenshealth.org

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