Pelvic floor problems are common at every stage of a woman's life, and most respond well to physical therapy.
1 in 4US women has at least one pelvic floor disorder, and the share rises with each decade of life.
Pregnancy and after birth
Pregnancy
Many women have pelvic, hip, or low back pain during pregnancy, and want to prepare the pelvic floor for delivery.
Postpartum recovery
After childbirth it is common to have weakness, a feeling of heaviness, or pain with movement, whether the birth was vaginal or by cesarean.
Diastasis recti
Abdominal separation after pregnancy often affects core strength and how the trunk manages pressure.
Bladder and bowel
Urinary incontinence
Leaking with coughing, sneezing, laughing, or running is one of the most common reasons women seek pelvic floor PT.
Pelvic organ prolapse
A feeling of pressure or bulging in the vagina is often manageable with pelvic floor training and pressure management.
Urgency and frequency
Needing the bathroom often, or waking at night to go, can involve bladder habits and pelvic floor patterns that respond to retraining.
Pain and recovery
Pelvic pain
Persistent pain in the pelvis, tailbone, hips, or lower abdomen frequently involves tight or overworked pelvic floor muscles.
Painful intimacy
Pain with intercourse, or with tampon or exam insertion, is common and is a routine part of pelvic floor care.
Post-surgical recovery
After cesarean, hysterectomy, prolapse repair, or other pelvic surgery, guided rehabilitation helps restore strength and confidence.
How it works
How a virtual visit works
Most of pelvic floor physical therapy is education, breathing and pressure management, and guided movement. That is why it translates so well to video.
Discovery call
15 minutes, free, by phone
A short call to hear what is going on, explain how visits work, and check insurance or pricing. No pressure to book.
Evaluation
60 minutes, by video
Dr. Shalem takes a full history, watches how you move and breathe, and guides a self-assessment so she can see how the pelvic floor is working.
Your plan
Same visit
You leave the evaluation with a plain-language explanation and a short home program, usually a few minutes a day.
Follow-ups
45 minutes, every 1 to 2 weeks
Progress checks, program updates, and techniques you can do yourself, for as long as they are useful.
For a video visit you will need
A phone, tablet, or laptop with a camera
A private room
A mat or towel
About an hour
Your physical therapist
Dr. Elana Shalem, DPT
Doctor of Physical Therapy, University of St. Augustine for Health Sciences, Miami
Dr. Shalem focuses on women's pelvic health: pregnancy and postpartum recovery, bladder and bowel symptoms, pelvic pain, and recovery after surgery. Visits are one-on-one and unhurried, and she explains what she is seeing in plain language.
She is licensed in Florida, Hawaii, Maryland, New York, California, Oregon, and Montana, and sees patients by video in all seven. In the Miami area she also offers visits in your home.
Also licensed in Maryland, New York, California, Oregon, and Montana, where visits are private pay by video. Send a message or call 786-273-9151 to book in those states.
Questions
Common questions
Does pelvic floor physical therapy work over video?
Much of pelvic floor PT is education, breathing and pressure management, movement retraining, and a home program, and all of it works on camera. During the evaluation Dr. Shalem guides a self-assessment so she can see how the pelvic floor is coordinating.
An internal examination is not possible by video. If a hands-on assessment would change the plan, she will say so and help you find local care.
Do I need a referral?
It depends on your state and plan. In Florida, no referral is needed to start. In Hawaii, TRICARE Select members do not need a referral, and TRICARE Prime members need one from their primary care manager. Not sure? Ask on the discovery call.
What happens on the discovery call?
A 15-minute phone call. You describe what is going on in as much or as little detail as you like, Dr. Shalem explains how she would approach it, and we confirm insurance or pricing. If it is a fit, you book the evaluation.
What should I wear, and do I need equipment?
Comfortable clothes you can move in. A mat or towel, a small pillow, and a chair are all that most visits use.
Is the visit private?
Visits run on a HIPAA-compliant video platform, and only Dr. Shalem is on the call. Choose a room where you can close the door for the hour.
Can I keep seeing Dr. Shalem if I move?
Yes, if you move within the seven states where she is licensed: Florida, Hawaii, Maryland, New York, California, Oregon, and Montana. Care continues by video; only the billing details may change.
Do you see patients in person?
Yes, in the Miami area, where Dr. Shalem offers in-home visits. Everywhere else, visits are by video.
Start with a free 15-minute call.
Tell us what is going on, hear how Dr. Shalem would approach it, and decide from there.