Lack of Access to Pelvic Floor Physical Therapy
There is a huge gap in access to pelvic floor physical therapy. We will get asked these questions by patients almost daily: “Why didn’t I know this type of therapy existed earlier?” or “Why is it so hard to find someone that specializes in this type of therapy?” or “Why didn’t my provider refer me sooner?”. The answers to these questions come from a number of reasons we are going to explore… and these are not the only reasons. At V Strong Physical Therapy in Armonk, NY, we are committed to raising awareness about this type of care.
1. Lack of education in physical therapy curricula
Pelvic floor rehabilitation is commonly overlooked and not nearly enough providers are specialized in this kind of care. According to Origin’s ‘Our State of Pelvic Floor Physical Therapy’ Report is Hot Off the Press’, 40 M Women need pelvic floor PT, but there aren’t enough providers to treat them. A majority of the population lacks the educational awareness, “As critical as the pelvic floor is to the core bodily functions and overall quality of life, there simply isn’t enough room in the PT curricula to cover the complexity of evaluating and treating this area of the body. That means that the majority of entry-level physical therapists lack adequate knowledge of the pelvic floor.” This held true for Dr. Victoria’s education, which did not consist of much pelvic floor content. All of the training for pelvic floor rehabilitation is offered through continuing education courses, taken outside of the PT curricula. If more content was put into the PT curricula, more entry-level providers would have a better foundation and would be more inclined (and less fearful) to go into the field.
2. Lack of referrals from OBGYNs to pelvic floor physical therapy
One study looked at 173 attending and resident OBGYNs and how often they recommended pelvic floor PT to prenatal and postpartum patients. They found that 19.8% ALWAYS recommended pelvic floor PT, 43.8% SOMETIMES recommended pelvic floor PT, and 36.4% NEVER recommended pelvic floor PT! Basically, over a third of OBGYN physicians do not recommend pelvic floor PT to prenatal and postpartum patients (and these are not the only patients that would benefit from pelvic floor PT!). “Among those who reported not counseling women regarding pelvic floor dysfunction, the most common reason cited was lack of time (39.9%) followed by lack of sufficient information (30.1%).” Due to the demands of high volume OBGYN clinics, there is not enough time for providers to even discuss these issues with patients. Let’s explore lack of sufficient information, or education, next.
3. Lack of pelvic floor rehab education in OBGYN training
Current data has highlighted that in fact there is a lack of adequate education and training in the OBGYN field on pelvic floor rehabilitation- impacting the level of care of patients. The study previously mentioned found that “This lack of time and educational resources may be the reason that residents were less likely than attending physicians to discuss pelvic floor dysfunction during prenatal counseling. Expanding resident education regarding pelvic floor disorders early in residency, as well as improving patient educational materials may help to improve counseling during visits with limited time.”
Another study in 2021 surveyed 274 residency programs on education of pelvic floor dysfunction and urogynecology. They found that “Resident education in non-surgical techniques to treat urinary incontinence, however, was lacking in approximately 50% of programs. The survey suggests that the basic foundation may be in place to provide residents with adequate exposure to diagnostic and therapeutic measures for dealing with pelvic floor disorders and urogynecology. There are, however, many aspects which need attention in our educational objectives for resident education. A broader focus on the non-surgical management of incontinence needs to be encouraged“.
Residency programs have a larger focus on surgical intervention, but we need to focus on educating residents more on non-surgical intervention – and the gold standard is pelvic floor physical therapy. Why put yourself at the risk of surgery when there are less harmful techniques that you can try first?
Summary
Two of the biggest reasons there is a gap in access to pelvic floor physical therapy are EDUCATION and TIME. There are other reasons we will be diving into, stay tuned! As the best pelvic floor physical therapy clinic in Armonk, NY, in Westchester, NY, we are committed to our patients and helping them achieve their goals.
Read more about our V Strong Physical Therapy program, and how pelvic floor physical therapy can benefit you!
https://vstrongphysicaltherapy.com/about/