Looking for specialists for pelvic instability and pelvic pain? There are different types of specialists where you can go to when you have pelvic instability. Think of a pelvic floor trainer, pelvic physical therapist, pelvic exercise therapist, sexologist, psychiatrist, gynecologist, colorectal surgeon or stomach, liver and intestinal specialist. These specialists will focus on helping you and will be there for you when you need it. You can also do a lot yourself. Think of doing different pelvic floor exercises. These pelvic floor exercises can strengthen or relax your pelvic floor. This depends on what you need. A combination of the 2 goals is often the most effective for pelvic instability. This way you become more aware of your pelvic floor muscles and you strengthen your pelvic floor at the same time. 

 

Choose for your recovery and take a look at my pelvic floor exercises page. These exercises are professional and are specially prepared for you. If you’re looking for pelvic floor exercises or go to the exercises page. If you’re
looking for products for your pelvis and go to the Pelvic Store. 

 

You can do a few things when you’re experiencing issues in the pelvic area. You can go on a discovery. My composed tips and exercises are a good first step. But if your pelvic pain becomes consistent, a good next step is to go look for a specialist. Your search often begins at the doc or physician. They can refer you to e.g. a pelvic physical therapist, pelvic floor trainer, pelvic exercise therapist, sexologist, psychiatrist, gynecologist, colorectal surgeon or a stomach, liver and intestine specialist. For more information see my article about all the pelvic floor specialists.

 

The doctor and pelvic instability 

In the first instance, you could go to the doctor, but keep in mind that a referral isn’t needed for a pelvic physical therapist or pelvic exercise therapist. But it’s still a good idea to visit the doctor first if you’re experiencing issues with your pelvic instability. It’s especially recommendable to visit the doctor if you’re experiencing pelvic pain or urinal or fecal incontinence next to your pelvic instability. If you experience more issues apart from a nagging or painful feeling in the pelvis then it’s always smart to discuss your problems with the doctor. 

 

What questions will the doctors ask with pelvic instability? 

Firstly the doctor will ask you a lot of questions about your pelvic instability. You can expect to hear the following questions when you visit the doctor: 

• • Why do you think you’re having pelvic instability? 
  • Where do the issues like pelvic instability come from? 
  • Did the pain in the pelvis get caused by the pelvic instability? 
  • Why do you experience pelvic instability? 
  • Since when do you think you have pelvic instability? 
  • On which moments do you experience your pelvic instability issues? 
  • Is your pelvic instability limiting you in your daily life? 
  • Are you maybe expecting? Pelvic instability gets caused by pregnancy. 
  • How does the pelvis feel during menstruation? Or are you in the menopause? 
  • Do you work? How do you experience working with your pelvic instability? 
  • On which moments of the day are the issues the worst? 
  • Do you experience less or more issues after some efforts? 
  • Are you still working out? 
  • Can you go to the toilet easily? How does urinating and pooping go? 

These are probably the most common questions that you can expect to hear from your doc. Try to answer them beforehand. This way you’re prepared for when you go to the doc, but the doc also gets a better image of your pelvic issues. 

The doctor would also like to know the consequences of your issues. How is the continence? Your feces can also be examined, next to your blood and urine. Are they different from a healthy person’s? For example, you could be having thin and fluid-like or firm feces and maybe this is a consequence from the pelvic issues or your eating habits. After making some conclusions, the doctor is able to initiate the next steps. You could be referred to a pelvic physical therapist or pelvic exercise therapist, stomach-liver-intestine specialist, colorectal surgeon or maybe being sent to a specialized pelvic floor center, where often all disciplines are located under the same roof. You can also continue your search after the doctor’s conclusions. Look for the right pelvic floor exercises or pelvic floor tips and get to it! 

 

What is a pelvic physical therapist? 

The pelvic physical therapist is a physical therapist specialized in (pain) issues in or around the pelvic girdle. This is a follow up education after the physical therapist education has been finished. This means that pelvic physical therapists possess extra knowledge. The pelvic physical therapist is there for everyone, because everyone possesses a pelvis. So women, men and children can go there. If you experience issues in the groin, lower back, abdomen, genitalia, incontinence or you have other pelvic area issues then their office is the place for you. 

 

What pelvic issues do you have when you’re visiting a pelvic physical therapist? 

You can go to a pelvic physical therapist if you experience pain or other issues in or around the pelvis. Think of pelvic pain or pelvic instability. The issues in your pelvic girdle can also cause you to get fecal or urinal incontinence, organic prolapses or sexual issues. You can go to a pelvic physical therapist will all of the issues mentioned above. A pelvic physical therapist can also help you if you’re having issues with a weakened or an overactive pelvic floor muscle. This pelvic floor is pretty complicated. I will briefly tell you something about the pelvis. 

 

Information about the pelvis and the pelvic floor 

The pelvis itself is made out of several bones. Bones that are attached to each other and to joints through a lot of ligaments and muscles. The pelvis protects a variety of crucial organs, like your bladder, intestines, uterus or prostate. The genitalia like the penis and the vagina are also included in the pelvic area. There is a large group of muscles located in the pelvis, this muscle group supports all of these organs and keep them in place. These are the pelvic floor muscles. 

The pelvic floor muscle group has a couple of openings. Think of the anus, vagina and the urethra. These are simultaneously being kept closed by the pelvic floor muscles. When you relax, the pelvic floor area allows those openings to open, so the feces and urine can exit. 

 

It’s a very multifunctional area. Because of the amount of tasks that are being put on the pelvic floor muscles and the pelvic area, it’s logical that something can go wrong. The pelvic floor muscles can become too overactive, which means that these muscles are way too tensed up or tightened. But those muscles being too weak is also a good possibility. It can be hard to release urine or feces, you can experience pain during sex or when you try to insert something into the vagina. But you can also have trouble holding back your feces and urine. Another common problem is experiencing pain in or around the lower back, the tailbone, the pubic bone, and in the pelvic floor muscles themselves. 

 

You can see a pelvic physical therapist for all of these pelvic floor issues. But it’s smart to always see a doc first to make sure that you have pelvic instability or other pelvic issues. 

 

What a pelvic physical therapist does with your pelvic instability 

The pelvic physical therapist will mainly focus on getting to the cause of your pelvic issues. If the cause is known then it will most likely be the case that you will have to learn how to relax or strengthen the pelvic muscles. Different tools are often being used during the examination. Those tools can measure the strength and activity of your pelvic floor muscles. You will also receive a ton of advices, like for your eating habits, posture, movement, daily efforts, toilet habits and you will also be given tools like a pelvic brace or other supporting tools. You can tackle down a lot of your pelvic issues when you see a pelvic physical therapist. You can also treat your sexual issues here, but maybe it’s better to talk to a sexologist about it first. Every pelvic physical therapist is qualified to do internal examinations. Click on this link if you want more information about an internal examination. But remember, if you don’t want it, internal examinations won’t happen. 

 

What is a pelvic exercise therapist? 

Pelvic exercise therapists are also qualified and specially educated for treating patients with pelvic pain, pelvic issues and pelvic instability. This study is about the same as the pelvic physical therapist. After a thorough examination and a long but good list of questions, the pelvic exercise therapist will also make their conclusion. The treatment will be composed and your goals will be clear. 

 

What’s the difference between a pelvic physical therapist and a pelvic exercise therapist? 

Generally there aren’t a lot of differences between a pelvic physical therapist and a pelvic exercise therapist, even if they won’t really agree with that. Compared to a pelvic exercise therapist, the pelvic physical therapist will focus more on strengthening your muscles and will make use of fitness tools. A pelvic exercise therapist will focus on your posture and movements. It’s more the case of which of the two will personally be more suitable for you. Pelvic physical therapists are more like pelvic floor trainers and pelvic exercise therapists are more like guiders or tutors with more jovial personalities. This is solemnly because of my own experiences, so maybe you will experience something entirely different. A pelvic physical therapist will also often do more internal examinations than a pelvic exercise therapist. If needs be, run a trial session at both parties so you can make the decision for yourself. As long as you go to a physical or exercise therapist that is qualified as a pelvic therapist. You can often find this back on their website, or otherwise give them a call. 

 

What a pelvic exercise therapist will do with pelvic instability 

The treatments for your pelvic instability will be focused on strengthening or relaxing your pelvic floor muscles, but you will also be given advice on your posture, movement, toilet habits and the capacity of your pelvis. The position of your hips, pelvis and lower back will be an important thing in this process for your pelvic exercise therapist. Posture is an important word for the pelvic exercise therapist. The topic daily life and simulating the daily activities will also be a thing that comes by. This all to give you practical tips that you can apply at home. Being able to cope with your pelvic instability and in the meantime working on your pelvic instability will be the treatment goals at the pelvic exercise therapist. 

 

What questions will a pelvic physical therapist and a pelvic exercise therapist ask? 

When you are going to visit a pelvic therapist, there will probably be quite the list of questions being thrown at you. These are the most common questions that will be asked by a pelvic physical therapist or pelvic exercise therapist at the first meeting: 

• • Since when do you have these pelvic issues? 

• • How did they come to be? 
  • On which moments do you have these issues? 
  • Has a doctor referred you or do you think that you have pelvic instability? 
  • Do you experience pain with moving? 
  • Do you experience pelvic pain during resting? And if you’re sitting or lying down? 
  • How much are you struggling with your pelvic pain? 
  • If you had to rate your pelvic pain with 0 = no pain and 10 = unbearable, how would you rate the pain?  
  • Since when do you have pelvic instability? 
  • When are you experiencing pelvic issues because of your pelvic instability? 
  • How do the pelvic issues or pelvic pain affect your daily life? 
  • Are you maybe expecting? Or are you in the menopause? 
  • How are your menstruations? 
  • Do you still work? How do you experience working with your pelvic instability? 
  • Is the pelvic pain the worst in the morning or at night? 
  • Are you experiencing less or more pelvic pain after efforts? 

• • Do you work out? 

• • How does pooping or urinating go? 

A lot of questions about your organs will be asked too because in and around your pelvis are a lot of organs, like your bladder, intestines, prostate and uterus. Topics like menstruation, sexuality, toilet habits, childbirth, urine habits and menopause will be discussed as well. For the rest it’s common that you will have to keep a diary for urinating. You can also already do this beforehand. The pelvic therapist will quickly notice a pattern and will eventually come up with treatment goals. 

 

The physical examinations for pelvic issues of a pelvic physical therapist and pelvic exercise therapist 

After the whole questionnaire during the first session (anamnesis) and meeting, the real work will begin. Now you will be looked at, often during the second session. Your pelvis, lower back, hips, breathing, knees will be looked at and even an internal pelvic examination is possible, however this is always up for discussion. You have control over everything, and keep voicing your boundaries, especially when it hurts. This will give the pelvic therapists a good image of your issues. Both pelvic therapists will also look if a prolapse is present. If there is a prolapse, it’s crucial to know which organ has prolapsed. 

 

The physical examinations for fecal incontinence at a pelvic physical therapist and pelvic exercise therapist 

When there is fecal leakage involved, an anal examination can also take place. The strength of the sphincter is the most important. A small probe, about the size of a tampon, can be used to measure the strength and tension in the pelvic floor. Is there too little tension, or too much? For a pelvic physical therapist or pelvic exercise therapist, this is a crucial element to be aware of. There are also other ways to test the functions of the anus or rectum. Think of a tiny balloon that will be inflated inside of the rectum so the feeling of having to poop gets stimulated. That way the pelvic therapist can see if everything is working as it should. 

 

Tip: Ask for a lot of explanations, because it’s still a lot. The pelvic physical therapist or pelvic exercise therapist will be able to tell you a lot about the pelvis. You are also playing a huge part in further steps, so discuss a lot with each other. 

A lot of pelvic issues that cause your pelvic pain or other pelvic issues often go hand in hand.  A pelvic physical therapist or pelvic exercise therapist can mean a lot to you with these issues. 

 

The examinations aren’t painful, but do tell them if you’re experiencing any pain. 

 

The stomach, liver and intestinal specialist with pelvic issues 

This specialist is located in a lot of hospitals. Like the name says, this specialist is specialized in the stomach, liver and intestinal field. This is ideal for when you experience fecal issues or problems. 

 

The examinations of a stomach, liver and intestinal specialist with pelvic issues 

The stomach-liver-intestine specialist will primarily look at the total functions of your metabolism; like the name says, your stomach and intestines. But because the issues are with the pelvis, the sphincter will also be included. There will be a few examinations again anyway. Think of a manometry (barometer) and an endoanal ultrasound (an ultrasound of the sphincters/circular muscles). 

 

Manometry: An examination of the stomach, liver and intestinal specialist 

This examination is being performed so the specialist can see if your rectum and circular muscles are working properly. It’s a lengthy examination that takes about 30 minutes and consists out of two parts. 

 

Examination 1: The circular muscles. 

For this examination you can lay on your side. A tiny balloon is being placed in the rectum through your anus. Then, a small tube will be placed next to it. You will be asked to tighten up the anus. The strength of the circular muscles is now being measured. This is an easy and painless examination, but if you so happen to feel pain, let the specialist know. 

Examination 2: The rectum. 

This examination is based on the sensitivity and the tension in the walls of the rectum. These will also be measured. The same steps as examination 1 will also be followed here, but now the balloon will be slowly inflated and deflated. The computer will read out all of the results. Again, this isn’t an irritating or painful examination. 

 

Endoanal ultrasound: Another examination of the stomach, liver and intestinal specialist 

This is a crucial examination if you sometimes experience fecal leakage. This examination is focused on the sphincters. It may be an uncomfortable examination, but the circular muscles and sphincters need to be examined as well. Sometimes it occurs that a sphincter got damaged, during childbirth, for example. Even when you’re an elderly and your kids are all grown up, childbirth can affect you for a long time. Getting a tear somewhere during childbirth can still have some effects on your life later on. And as you grow older, the amount of hormones decrease. The pelvic area will function less because of that decrease as well. This way, pelvic issues express themselves easier. With the sound waves of the ultrasound, the circular muscles will become clear and then the specialist can see whether they’re damaged or not. 

 

Visiting the colorectal surgeon 

The doctor will go through a few solutions for you. Maybe one of those solutions will be having to visit the colorectal surgeon. This specialist is specialized in one thing, to restore the anus. A common stomach-liver-intestinal specialist doesn’t perform surgery, they only diagnose. After a diagnose, the colorectal surgeon will be able to help you further. Their work begins after diagnosing your anal issues. This surgeon will also use the details from earlier mentioned examinations. If those details aren’t available, the surgeon will perform the examination themselves. An MRI scan isn’t ruled out either. Anything to be able to get a good image of your issues. 

 

Everything together is a lot, I know, but it’s a necessary path towards your recovery. 

 

And lastly, are you looking for more information? 

Hopefully this information was useful to you! If you’re still looking for some more information, feel free to take another look around on the website. It’s filled with in-depth information, tips, a web shop and also exercises. I still have a lot of articles with lots of information about other symptoms and issues. Feel free to click on the blue words to take you straight to the right page.