Why is pelvic floor health important?

In the early months of 2020, physical therapist Khushboo Joshi was busy tweaking a telehealth version of her new private practice as a means of providing pelvic health services to women living in places that lacked easy access to care.

In March 2020, that place became Joshi's own home.

A physical therapist for 18 years, Joshi opened her own private practice upon moving to Hinsdale earlier this year. Along with a telehealth site that would allow her to treat women worldwide, she planned to offer in-home visits to patients within a certain radius of her Hinsdale home.

"When shelter in place started, we quickly shifted our focus," said Joshi, who after months of seeing patients exclusively online is now making a slow return to in-home treatment of women's pelvic floor problems.

Joshi specializes in therapies that treat a long list of common conditions, all of which can be controlled and even eliminated by strengthening the pelvic floor. Poor pelvic floor strength is often the root cause of conditions such as bladder leakage, incontinence, painful sex and back pain, Joshi said.

She said the conditions are so common, many women regard them as normal. But she said no woman should have to live with pain or incontinence.

"It's shockingly common and shockingly fixable," Joshi said.

While most women are familiar with their body's core, many think of the core as a cylinder that includes the abdominal and back muscles. In reality, Joshi said, the core is a "pressure regulating system" that includes the diaphragm at the top and the pelvic muscles at the bottom. If one part of the system isn't working, the whole thing is thrown out of whack, Joshi said.

Joshi's patients range from young female athletes experiencing leakage to grandmothers who have spent decades believing that bladder leakage and pain were just normal parts of aging.

"Childbirth is the biggest insult to the pelvic floor," Joshi said. In other countries, such as France, women automatically are prescribed physical therapy after childbirth. As a result, they avoid many of the common problems experienced by women in the United States.

"It really is an American issue," Joshi said.

Before beginning treatment, patients complete an evaluation that helps Joshi assess the issues at hand. Next, when possible, she conducts an internal examination of the pelvic muscles and observes the patient's movements and posture.

Working with the patient, Joshi establishes goals and designs a treatment regimen that often includes exercises and behavioral changes. While success is highly dependent on the patient's adherence to the prescribed treatment, Joshi said most require only four to eight sessions to reach their desired result.

Joshi's services are private pay, but some insurance companies will reimburse patients for her services. And while she doesn't require a doctor's order, she works in tandem with each patient's physician. More information, including prices for services, can be found at - by Sandy Illian Bosch

Author Bio

Sandy Illian Bosch is a contributing writer to The Hinsdalean