WOMEN'S HEALTH PHYSICAL THERAPY
You don’t have to live with pelvic discomfort or urinary leakage. Customized treatment for pelvic pain or dysfunction is now available.
What is Women's Health?
If you experience urinary leakage, pelvic pain or dysfunction, you are not alone. Pelvic floor dysfunction is a common condition experienced by women. It can result from pregnancy, childbirth, surgery, chronic constipation, and aging. Physical therapy may help. Kim Fletcher, DPT, is specially trained in Women’s Health Physical Therapy and is dedicated to working with women on treating musculoskeletal and pelvic dysfunction in a private, one-on-one setting.
Do I need a referral from a doctor?
Yes. Although your insurance may allow you to attend physical therapy without a prescription or referral, it is required that you have a provider managing your overall health care. Many conditions involving the pelvis can be medical in nature and require ruling out a more serious condition before coming to the clinic. It is also helpful to have a medical provider with whom we can coordinate care and discuss your health as a team
What will we do on my first visit?
First, we will talk. We will review any forms that you bring in, and you will have the opportunity to share your history and concerns. The exam will be discussed with you so that you can have any questions answered right away. Your exam may include general movement like bending forward and backward, observing how you move your body, and specific tests of your joints, muscles, and nerves. If you come to the clinic for pelvic rehabilitation, an assessment of your pelvic muscles internally (through the rectum or vaginal canal) may be valuable, and you have the option to choose or refuse any part of the process with which you don't feel comfortable. This portion of the exam will be thoroughly explained to you after your history is taken and you will have an opportunity to ask questions.
What is biofeedback?
Your therapist may use surface EMG (electromyography), a form of biofeedback. This includes placing small sensors on your body so that you and your therapist can get a better idea of how you are coordinating your muscles. Biofeedback means that you will be able to get information about how your muscles are working. This will be displayed as a graph or bar on a computer screen.
I have my period, should I reschedule?
It is usually not necessary to reschedule if you are on your cycle, so you are welcome to keep your appointment. However, if you are uncomfortable keeping your appointment, please call to cancel as soon as possible so that we may fill your time slot.
Do you do Internal Work?
Yes. If appropriate and indicated based on findings from your initial evaluation continued internal muscle work may be completed as part of your treatment.
Will my insurance cover this?
Most insurance companies will cover physical therapy for pelvic rehabilitation. Please check with your insurance company or our billing department if you have any specific concerns.
Physical therapy treatment can help the following:
- Stress incontinence (urine leakage with coughing, sneezing, jumping, lifting etc)
- Urge incontinence (strong sudden urges)
- Pelvic organ prolapse
- Dyspareunia (Pain with intercourse)
- Pelvic Pain
- Vaginismus (painful spasms with Penetration)
- Vulvodynia (chronic pain around the vulva)
- Post-Partum Pain
- Levator ani Syndrome
- Diastasis Recti
- Pregnancy Related Pain
- Pudendal Neuralgia (Pelvic nerve pain)
- Post-surgical scar pain Coccyx/tailbone pain
Physical Therapy Treatments:
- External and Internal Examination Techniques
- Pelvic Floor muscle Training
- Internal and External Trigger Point release
- Surface EMG
- Manual Therapy for the Pelvic Floor and Hip Musculature
- Joint Mobilization
- Patient Specific Exercises Targeting the Pelvic Floor Musculature
- Instruction in Vaginal Dilator Use
Forms to bring for your first appointment
- Consent Form
- Urinary Incontinence Questionnaire - Please fill this for out for urinary leakage only
- Pelvic Pain and Urgency/Frequency Patient Symptom Scale - Please fill this form out of you experience pelvic pain with or without urinary leakage
- Bladder Diary
A Moscow native, Kim returned to the Palouse following graduation from EWU with a Doctorate in Physical Therapy. After working many years as an outpatient orthopedic physical therapist she sought further education to allow her to better serve patients with pelvic dysfunction, pregnancy and postpartum.
- B.S. University of Idaho 2004
- Doctor of Physical Therapy Eastern Washington University 2007
- Pelvic Health Related Education
- Pelvic Floor Level 1, Herman and Wallace
- Pelvic Floor 2A, Herman and Wallace
- Pelvic Floor 2B, Herman and Wallace
- Pelvic Floor Capstone, Herman and Wallace
- Pudendal Neuralgia and Nerve Entrapment, Herman and Wallace
- Pediatric Incontinence and Pelvic Dysfunction, Herman and Wallace
- Physical Therapy Treatment of the Pediatric Pelvic Floor Patient: birth to 18 years, SOWH APTA
Special interests in the area of pelvic health include pregnancy and postpartum, coccyx dysfunction, incontinence and pelvic pain. Outside of work she enjoys spending time with her 2 children, playing hockey and golfing with her husband.