How Do You Know if You Need Pelvic Floor Physical Therapy

Let’s clear up the mystery of knowing if you need pelvic floor physical therapy!

Quite often here is limited understanding of what the pelvic floor muscles do and whether these muscles might be a problem.   The pelvic floor muscles are located inside the bones of your pelvis and sit like a hammock inside you.  On top of this hammock you have all of your organs:  bladder, bowel, uterus/prostate.  These organs are supported by the muscles.  The muscles and the organs communicate with each other and work together as partners, so if you have problems in one area (such as your bladder control) you will have problem in the other area (the pelvic floor muscles).  Pelvic floor dysfunction presents itself as pain, bladder, bowel or intimacy problems.

This is a checklist of some common symptoms you may be experiencing that can indicate you have pelvic floor muscle dysfunction.

If you have any of these then you know you need pelvic floor physical therapy:

*Pelvic Pain:  Any pain from the abdomen/spine through the pelvis/groin.  This includes mid and lower back pain, SI joint pain, pubic bone pain, groin pain, tailbone pain, abdominal pain.

*Lower Back Pain: This pain gets its own bullet point because research has shown us that people with persistent lower back pain typically also have underlying pelvic floor muscle dysfunction.

*All bladder and bowel issues can also have an underlying problem with pelvic floor muscle dysfunction.  This could be fecal smearing, unexpected loss of gas, urinary incontinence, urinary urgency, painful urination, poor urinary stream, getting up at night to pee.

*Intimacy related struggles:  pain with penetration, pain with erection, pain after intimacy, poor intimacy response, inability to orgasm.

*Pelvic organ prolapse, pelvic heaviness, vaginal and pelvic pressure

*Pelvic muscle weakness, whether you can perceive it or not, is usually happening.  The muscles are commonly stiff, tight, have trigger points and operate slowly and deficiently.  Hence, the laundry list of symptoms here!  Kegels are often not the solution to the problem and, in fact, can make things worse.  So, seek expert care from a pelvic PT if you have any of these symptoms.

If you are interested to learn more about these muscles, here is a link to an article that briefly covers pelvic floor muscle anatomy.

If you know you need pelvic floor physical therapy, what should you do?  Call us and we can help!

Well, we are here to help you!  We provide wholistic and comprehensive care to get you results!  Our compassionate, patient-centered treatment will identify underlying issues that are contributing to your problem and will treat each of these things.  This is key to your success!  By providing numerous assessment and treatment methods we can get your symptoms to improve.  We have a lot of techniques to help you improve such as:

  • Myofascial release
  • Trigger point release
  • Joint mobilization
  • Movement pattern restoration
  • Muscle firing and recruitment re-education
  • Strength and conditioning
  • Trigger point dry needling
  • Self-care education and modification of habits/behaviors that contribute to your symptoms
  • Instruction in optimizing nutritional healing to promote relief of symptoms
  • Postural correction and alignment

If you are pregnant or postpartum the pelvic floor muscles and the rest of your body change dramatically during this experience.  Unfortunately in our region of West Michigan pelvic floor physical therapy is not routinely suggested to a pregnant/postpartum person, even though we know that it helps improve how you feel!

At Purple Mountain Physical Therapy we provide a  comprehensive pelvic health physical therapy treatment program special for pregnant and postpartum women!  If you would like to read more about what we do, here is an article we wrote that details one of our postpartum patient’s experiences with us!

Purple Mountain Physical Therapy located in Grand Rapids, Michigan is a specialty pelvic health clinic that serves women and men who have any pelvic condition.  If you are still wondering “how do I know if I need pelvic floor PT?” then give us a call!  We offer a free phone consult to discuss your condition.  Call 616-516-4334 to schedule your free consult.  No problem is too simple or too difficult for us!  We commonly help people who have failed to get results from other interventions.  The men who come to us often have experienced years of pain and/or bladder & intimacy issues that have proven very frustrating, anxiety producing and depressing.  The women who come to us may also have pelvic pain or could be pregnant, struggling with postpartum recovery, have longstanding pelvic floor dysfunction that shows up as urinary incontinence, constipation, pelvic pressure, painful intimacy, “mommy tummy” or weakness in their back.  If any of these resonate with you, give us a call to schedule your free phone consult:  616-516-4334.

Tailbone pain and How Pelvic Floor PT Can Help You! Plus Some Self-Care Tips!

A common problem that we treat is Tailbone Pain! Pelvic Floor PT is the solution you have been looking for!  It works!

Coccydynia is the worst! You can’t sit!

Coccydynia means that the tiny bone at the very end of your spine, located just above your anus, hurts!  And, boy, can it be a bugger!  This is a very common problem and we treat it all the time.  We help both women and men who experience coccydynia and they can experience complete resolution of their pain by getting the right pelvic floor PT to treat it!  If you are dealing with tailbone pain that is persistent, don’t get frustrated and go from provider to provider looking for answers that they don’t have.  Call us today at 616-516-4334 and let’s get you feeling better!  Read on for more information about this condition and some tips to help yourself.

What Causes Tailbone pain? Is Coccydynia permanent? How will Pelvic Floor PT Help?

We treat tailbone pain (Coccydynia) by providing expert pelvic floor PT to both men & women.  No, it is not permanent!  We know it is persistent and you’ve probably had your pain for a while, but it will get better with the right treatment.

Sometimes the cause is trauma (you fell on it, your labor & delivery strained it).  Other times the cause is pelvic floor dysfunction, specifically spasm of pelvic muscles that attach directly to the coccyx.  And still other causes of tailbone Pain (Coccydynia) for which pelvic floor PT is warranted are misalignment of your pelvis and low back, postural strain or constipation.  When you work with us we conduct a thorough evaluation to discover the multiple things contributing to your pain so that we can treat all of these.  We provide wholistic care, which means that our treatment is directed anywhere from your jaw to your knees because we know that fascial tension or restrictions in areas far away from the coccyx will pull on the coccyx and contribute to your pain.

Both Men & Women Can Have Tailbone Pain & Benefit from Pelvic Floor PT

It is common to experience persistent tailbone pain (Coccydynia) and to benefit from pelvic floor PT when postpartum and sometimes during your pregnancy.  Women often come to us and report that when they sit down or stand up they experience excruciating tailbone pain in the midrange of moving.  This is because the injured tailbone and pelvic floor muscles are experiencing stress with the positional changes.  They also report they cannot sit, they must sit on their side or shift their weight because of tailbone pain.

How Pregnancy & the Postpartum Period Might Contribute to Tailbone Pain

When pregnant your entire pelvis and abdomen are changing, which alters the pressure and pulling within the pelvic floor and all of the pelvic joints.  The tailbone experiences changes as your posture changes and the uterus and baby grow. For some women, this causes the pelvic floor to spasm or may strain the joint between the coccyx and the sacrum (the bone above the coccyx that it attaches to).  Because numerous pelvic floor muscles attach directly to the tailbone, if you have spasms or stiffness in these muscles it will tug on your tailbone and cause you pain.  The tailbone needs to be able to float and move freely, when this cannot happen and you sit down, you will sit right on that stiff and sore area.  During labor and delivery a woman may experience trauma to her tailbone, which is a common reason why we treat women when postpartum for coccydynia.  Pelvic floor PT is a crucial component to getting your pain resolved.

For men who have tailbone pain (Coccydynia) and come to us for pelvic floor PT we commonly discover considerable myofascial restrictions, pelvic floor dysfunction and hip, leg and low back tightness or lack of joint mobility that are contributing to their pain.  They may have constipation and a history of straining to have a bowel movement, which might strain their coccyx.  The coccyx needs to be able to freely move backward when you have a bowel movement and if everything is stiff, you might not get that motion and, therefore, cause strain to the tailbone.  High quality pelvic floor PT will address the stiffness, muscle guarding and loss of joint mobility in the coccyx, hips and entire abdominal, low back and pelvic complex.

What should I do if my provider says I should get my tailbone surgically removed?

Dr. O’Keefe recalls years ago working closely with an orthopedic surgeon who recommended surgical removal of the coccyx when a person had coccyx pain.  Please, if this has been recommended to you, first come see me or a very experienced pelvic health PT so you can receive quality and effective treatment for your coccydynia.  Surgeons perform surgery, so that is what they will offer you, but it often does not work to relieve your pain.  A tailbone that persistently hurts may be a bit of a mystery to your provider, but it is not a mystery to Dr. O’Keefe and other experienced pelvic health PTs.  We can help you!

Will Pelvic PT help my Tailbone Pain? Do I really Need it?

Let’s use an analogy:  Your knee hurts everytime you bend it, the joint is stiff and the muscles are tight.  Do you need treatment to your knee? Treatment that addresses your knee joint mobility, your muscle strength and flexiblity?  Yes, you do.

With coccydynia the joints around the coccyx (tailbone) are stiff and the muscles are tight.  There is imbalance in the pelvis and your hips, abdominals, back and thigh muscles are probably throwing off your tailbone.  You need pelvic PT to figure this stuff out and to treat it.  There are several pelvic floor muscles that attach directly to the coccyx and we find that our patients who went somewhere else to get their tailbone pain treated and who did not get better, did not get the right kind of hands-on treatment to the muscles that attach to the coccyx.  We have numerous gentle techniques we use to help ease your problems.  Some of them involve myofascial mobilization, or trigger point release, dry needling, postural correction, visceral mobilization, joint mobilization, myofascial stretching and pelvic floor release techniques.  And our patients tell us they feel so much better after a pelvic floor PT appointment, it is all so helpful!  If you’d like to read a research report summarizing treatments and evaluation for coccydynia, here’s a paper.

Here are some tips for Self-Care for your Coccydynia:

  • Watch your standing posture and figure out what positions bother your tailbone & adjust accordingly. It may be that having your head down, looking at your phone (even when you are standing up), worsens your tailbone pain.
  • When sitting, a cushion can help. I’ve had people use a cushion that’s the shape of a donut. Other people say that rolled up towels under their sit bones on the right side and left side help. Another cushion that can work is V shaped.
  • Sitting up tall often bothers the tailbone, so while we don’t recommend slouching the reality is that you often have to weight shift to get the pressure off of your tailbone and the posture doesn’t look fantastic, but it is necessary for the moment.
  • Take breaks often when sitting
  • Manage your constipation and avoid hard stools, which can aggravate the tailbone come BM time.
  • Try to massage the area adjacent to your tailbone. Sometimes applying gentle pressure here can release some of the tension.
  • Some activities should be avoided if you know they might aggravate your tailbone. Common things that patients tell us bother their tailbone include bike riding, motorcycle riding, horseback riding, lots of squats & lunges and gardening. The up/down movements of gardening and squats/leg workouts can bug a tailbone.
  • Play with ice or heat and see if either helps you.  If you use either one, limit it to ten minutes.
  • Practice diaphragmatic breathing because your tailbone will respond to the gentle rhythm of your abdomen and ribcage moving.
  • Work to drop and release your pelvic floor.  This can be very tricky and nearly impossible to do before getting good quality pelvic floor PT to release your muscles. But, if you can practice on releasing your pelvic floor it can help you.

I specialize in treating tailbone pain using effective pelvic floor PT methods! Because there are numerous pelvic floor muscles that attach directly to the tailbone as well as pelvic joints around the tailbone, the quality, hands-on, gentle treatments I offer help resolve your condition.

Purple Mountain Physical Therapy, located in Grand Rapids, Michigan, is a specialty pelvic health physical therapy clinic. We help women and men with pelvic floor dysfunction, bladder, bowel and sexual health problems recover so they can live an active life! Our program for pelvic pain, including coccyx pain, SI joint pain, pubic bone pain and low back pain, is comprehensive and results oriented! We have been exclusively focused on pelvic health for over 20 years and offer a level of expertise and wholistic care that you won’t find elsewhere! If you are wondering if we may be able to help you, call 616-516-4334 to talk to Dr. Maureen O’Keefe, DPT. We can discuss your symptoms and condition and determine if pelvic floor PT may help you!


Dr. Maureen O’Keefe, DPT

What’s holding you back from getting Pelvic Floor PT? All of your concerns addressed here!

We help women and men overcome their pelvic condition, naturally and wholistically, without pain medications, so that they can get back to an active life and have a smile on their face again!

You want results.  You feel uncertain about what pelvic floor PT is and, actually a little intimated by it.  You are also hesitant because your problem is personal and you don’t want to waste your time going to someone who doesn’t know how to help you.

This is your validation that you deserve to feel better and to get rid of your pelvic problem.  And that you have found the right place to receive your pelvic floor PT and help you!   What’s holding you back?

If your hesitation is that you don’t know where to go and who can help you.  Then. Stop. That. Excuse. Right. Here.  We offer expert pelvic floor PT treatments.

At Purple Mountain PT we specialize exclusively in providing wholistic, effective and expert care for pelvic floor PT. We treat all pelvic conditions that women and men experience.

When you choose Purple Mountain PT you are choosing to be proactive, to address your nagging problem and to get results.  You don’t want to waste your time, going to someone who doesn’t know how to help you.  We also understand you might feel nervous because your condition is in a private area and pelvic floor PT sounds a bit intimidating.  Rest assured, our patients tell us that their appointments are helpful, comfortable and educational, that they feel heard and understood.  In contrast to your fears and anxiety, we can assure you that your time with us will be uplifting, informative and encouraging!  Our pelvic floor PT is comprehensive, meaning a lot of our treatment occurs far away from the pelvis, such as at your shoulder blades or your thighs.  We also include lifestyle, exercise, nutrition, stress management and other wholistic interventions because these help you get results!

How can we say with confidence that we are the right choice for your pelvic floor PT?  Because our patients tell us that all the time.

If you give us a try, you will know within the first phone call if you think I may be able to help you. At your first visit you will receive an education and in-depth evaluation that is different from anything you have had with any other provider.  We’re not just making this up, our patients tell us this.  These are the types of things we hear from our patients:

I was hesitant to come to pelvic floor PT.  I didn’t know what to expect, now I wish I had come sooner because I could have felt better long ago!

I’ve gone to a chiropractor and pelvic PT for months and still have problems, I decided to try you because I like that you specialize in this.

I went to someone else, but they didn’t explain it like you.

You are my third PT and the first one to help me feel better.

My other provider never treated all the things you are treating.

At my other provider I felt like my appointments were too short to really treat everything I needed.

My other provider didn’t seem to know what my problem was and gave me a sheet of exercises to do that I knew wouldn’t help me.

I went somewhere else and they didn’t examine things nearly as in depth as you and didn’t ask me the questions you asked.  I can tell you know what you are doing here.

You get the idea.  I understand why you may be skeptical that pelvic floor PT could help you, especially if you’ve already gotten care that didn’t work.  But, many of our patients have been in your shoes and have found that by choosing Purple Mountain PT and getting wholistic and expert care, they finally feel hopeful and can see they will get better.

You will receive your pelvic floor PT care from someone who knows how to get you results!

Dr. O’Keefe has devoted her life and her curious mind to learning and treating pelvic floor conditions and all pelvic problems.  She has treated just about every pelvic condition you can imagine.  Pelvic floor PT is a path forward for you, proven in research to help you get better.  We have invested more than 2 decades into learning, studying, treating, teaching and post-graduate education focused on pelvic problems and wholisitic healing.  If you are wondering how qualified and what expertise Dr. O’Keefe has, here’s a glimpse:

  • Doctor of Physical Therapy Degree with a capstone project on physical therapy indications in pregnancy, exercise in pregnancy and a focus on pelvic conditions
  • Masters of Physical Therapy Degree with a research project on the movement patterns of individuals with total knee replacement and a heavy focus on orthopedic injuries and clinical rotations working in busy orthopedic clinics.
  • Bachelors Degree, biology major and chemistry minor with research project on blood transfusion.
  • Division I volleyball player, athlete and exercise enthusiast.
  • Certification in dry needling.
  • Tons of post-graduate education taken all over the country specific to pelvic problems.  This includes:
  • Advanced training in pregnancy and postpartum recovery, diastasis recti, birth preparation, exercise in pregnancy, pelvic girdle pain in pregnancy and postpartum and more.
  • Advanced training specific to male pelvic health & pelvic floor dysfunction including prostate conditions, chronic prostatitis pain, post-prostatectomy recovery, male erectile dysfunction, male pelvic floor dysfunction, male pelvic pain, testicular pain, hernias and more!
  • Advanced training & treatments in all bladder conditions including overactive bladder, urinary frequency and urgency, urge incontinence, stress incontinence, nocturia (getting up at night to pee), urinary retention, neurogenic bladder, neobladder post-cancer.
  • Advanced training and treatments for interstitial cystitis.  In fact, the specific treatment methods we use were researched in a 6 clinic nationwide NIH study and because they worked, the guidelines for treating IC include this exact treatment you will receive!  Here is a link to the guidelines!
  • Advanced training and treatments for painful sex, vulvodynia, provoked vestibulodynia persistent genital arousal disorder, penile pain, anorgasmia and more!
  • Advanced training and treatments for all spine conditions.  Sub-specialty in spine problems including completing a post-graduate spine certification program that was one year in length.
  • Advanced training and treatments for all orthopedic pelvic problems including SI joint dysfunction, pubic pain, sports hernia, hip labral tears, sciatica, low back pain, neck and thoracic problems, hamstring pulls, coccyx pain and more!
  • Advanced training in pelvic floor dysfunction, core, diaphragmatic breathing and coordination of these muscles to control intra-abdominal pressure and optimize bladder control and reduce pelvic organ prolapse
  • Advanced training in pelvic organ prolapse, cystocele, urethrocele, hypermobile urethra, rectocele, rectal prolapse, uterine prolapse.
  • Advanced training and treatment methods for Pudendal neuralgia, sciatica, posterior femoral cutaneous nerve injuries, obturator nerve injuries and other pelvic nerve injuries.
  • Advanced training and treatments for myofascial mobilization and fascia release.
  • Advanced training and treatments for chronic pelvic pain, chronic pain syndromes, pain neuroscience education and overlapping pain conditions.
  • Advanced training and treatments for visceral mobilization.
  • Advanced training and work experience in busy orthopedic and rehabilitation clinics, including serving as the spine specialist for failed low back syndrome, working with athletes, treating individuals with spinal cord injury, neurologic conditions, post-stroke recovery, burns and complex trauma.

You don’t settle for anything in your life, why settle for pelvic problems, a less active life and less than high quality pelvic floor PT treatment?

Do you know there is treatment for:
**Stress incontinence: you don’t have to lose pee everytime you laugh!
**Urge incontinence: you don’t have to rush to the toilet and fear losing pee
**Urinary frequency: you don’t have a small bladder! You need treatment!
**Pelvic Organ Prolapse: this is a biggie! Ladies, if you have any prolapse you can optimize the pelvic region to provide better support to the area.
**SI Joint pain: This hurts! We know your pain and we can help it!
**Gluteal tendinopathy: Does your glute hurt? We can check you out and help you figure out why. If it is tendionpathy we have a treatment program for that! If it’s something else, we know what to do to help you!
**Pubic pain: This. Is. Frustrating. To. Have. & I can help you!
**Pudendal Neuralgia: The monster of pelvic pain. It can get better!
**Sciatica: ‘nuf said. It hurts. PT helps.
**Endometriosis: The long, painful, lonely road. PT helps endo pain!
**Interstitial Cystitis: Beastly bladder condition & I specialize in treating it!
**Recurrent urinary tract infections: You probably have pelvic floor dysfunction and we can get that better to reduce your risk of another infection
**Vulvodynia: Yep, we know you are suffering silently. We specialize in helping this. It’s awful & can get better!
**Painful sex: Sex shouldn’t hurt! There’s treatment for this!
**Painful cesarean scars or other scars: We can address this and get rid of that pain! Wouldn’t it be great if your clothing didn’t hurt your scar?
**Pelvic muscle spasms: Ouch. Yep, they feel just like you imagine. & I can help them go away.
**Pelvic Floor Dysfunction: All those muscles “down there” not quite working right? I can help that.
**Constipation & straining: Believe it or not, the pelvic muscles and involved in this problem and I can help you! Take care of it so you don’t give yourself a prolapse.
**Pregnancy related pelvic girdle pain: My specialty!!
**Postpartum recovery: Again, this is my jam! I love to help you get back to feeling strong and confident as you recover.
**Birth trauma injury: I have seen them all & I can help you!
**Chronic prostatitis pain: PT is the way out of this problem!
**Testicular, penile or vulvar pain: PT works! I can help you!
**Persistent Genital Arousal Disorder: This. Is. Awful. I know it and I can help you!

Purple Mountain Physical Therapy, located in Grand Rapids, Michigan, is a specialty pelvic floor PT clinic.  We help women and men with pelvic floor dysfunction recover so they can live an active life! We have been exclusively focused on pelvic health for over 20 years and offer a level of expertise and wholistic care that you won’t find elsewhere! If you are wondering if we may be able to help you, call 616-516-4334 to talk to Dr. Maureen O’Keefe, DPT. We can discuss your symptoms and condition and determine if pelvic floor PT may help you!


Dr. Maureen O’Keefe, DPT

SI Joint Treatment in Grand Rapids

Do You Need Expert SI Joint Treatment in Grand Rapids?  Are you looking for more than run-of-the-mill care that doesn’t work?

We offer comprehensive SI joint treatment right here in Grand Rapids, so you can finally feel better again.

We offer expert care to evaluate and treat your SI joint and pelvic condition.

At Purple Mountain Physical Therapy we have more than 20 years’ experience helping people overcome SIJ problems.  We treat individuals with SI joint issues who often have already been to other providers and still hurt.  Many of our patients are pregnant and worried that they may not be able to walk or function in their third trimester.  Give us a call if you know you need high quality care!

You Need Comprehensive SI Joint and Pelvic Care that Includes Evaluation and Treatment of Your Pelvic Floor Muscles

Did you know that your piriformis muscle, which many people who have SI Joint problems are familiar with, is part of your pelvic floor?  There are additional pelvic floor muscles, also, that influence your SI joint.  That’s why our treatment program will check these muscles for you and determine if they are problematic. We find that SI joint problems rarely are happening in isolation.  Some people with SI joint dysfunction also experience hip pain or bladder control problems. We’ve found some of our patients also have gluteal tendinopathy, a separate tendinitis condition, going on at the same time as SI joint dysfunction. We will figure this out with you and develop a customized treatment program for you.

We Provide You A Detailed & Comprehensive Evaluation and Treatment Plan That is Probably Different than You’ve Had Before!

SI joint pain can be debilitating and we offer a comprehensive treatment program that helps move you forward.  Your SI joint problem is in your pelvis, which is our expertise! Our comprehensive care includes assessment and treatment of the SI joint, hips, pubic bones, low back and all associated muscles, nerves, tendons and ligaments, including the pelvic floor muscles.  Pregnant women, we’ve got you covered!  We know how to help you navigate SI joint dysfunction, pelvic girdle pain and low back pain.

The Importance of a Proper SI Joint Evaluation

Research and years of experience have taught us that there are specific tests and measures that need to be done to evaluate an individual with SI joint dysfunction.  We will evaluate your joints and your muscles, as well as your ligaments, fascia and nerves.   We look at your posture and alignment, from your feet to your knees and hips upto your shoulders and neck.

Your muscle spasms, tightness and misalignment will improve

By providing a combination of specific, graduated exercises and advanced manual therapy methods to optimize alignment, reduce trigger points and muscle guarding we help you feel better.  We don’t just tell you to stretch it out!  In fact, many of our patients have been told to stretch their problem, which can aggravate an SI joint condition when not done carefully.  By restoring your boney alignment, using methods that balance your pelvis and SI joint, you will feel things are in place again!  Addressing underlying pelvic floor muscular problems is sadly often overlooked, but is necessary to recover from SI joint dysfunction. A typical patient with SI Joint Dysfunction comes to us with a considerable amount of pelvic floor dysfunction.  Once we treat these muscles, in conjunction with everything else provided, the condition will begin to heal.

For more information on SIJ physical therapy, here is an article that may be of interest

If you are suffering from SIJ syndrome and are frustrated with lack of progress, come give us a try.  We want to make sure we are a good fit for you, so call us at 616-516-4334 to get your questions answered.  We promise to give you expert, compassionate care that is designed to help you feel better!


Dr. Maureen O’Keefe, DPT

Get Your Annual Pelvic Floor Wellness Checkup!

Would I benefit from an Annual Pelvic Floor Wellness Checkup? 

Calling all women and men!

  • It is common for our pelvic floor muscles to not be working correctly (pelvic floor dysfunction). An annual pelvic floor wellness checkup will screen you for this issue.
  • Do you wonder if your spine, hip and pelvic joints and muscles and bladder/bowel function are optimal?
  • Do you have a family history of pelvic conditions and want to be proactive about your health?
  • Did pregnancy change your body in ways you never imagined and now you wonder if things are working right?
  • Did you previously have some pelvic pain or urinary incontinence and you are uncertain if things are working top notch?
  • Did your dad have prostate or bladder problems and you want to do everything you can to avoid the same thing?
  • Are you wondering if the exercises you are doing are bad for you, might cause an injury or could cause a pelvic organ prolapse?

At Purple Mountain PT we offer Annual Pelvic Floor Wellness Checkups.  Why do we offer this? 

We are all familiar with scheduling a checkup with our family doctor, OBGyne or dentist.  But, none of these providers are specialists in the musculoskeletal system, which includes your bones, muscles, nerves, ligaments, and tendons. And, thus, these things don’t get a proper checkup.

Pelvic Health Physical Therapists are musculoskeletal experts of your pelvis!  None of your other providers examines what we assess in our annual pelvic floor wellness checkup. 

Your musculoskeletal system, and keeping it strong, flexible and healthy, is the specialty of all physical therapists.  We have doctoral level degrees in the musculoskeletal system.  This is our jam! We are nerds in this department.  Pelvic health physical therapists take this up a notch and zero-in on the musculoskeletal system of the spine and pelvis.   The pelvic system that we specialize in helps to:

  • Maintain urinary control
  • Get your bowel movements out!
  • Maintain pelvic organ support
  • Provide for circulation in the pelvic region
  • Keep you sexually healthy and functioning properly.

The importance of the pelvic system cannot be overstated!  With so many important things going on in the pelvis, an annual pelvic floor wellness checkup with an expert pelvic physical therapist can catch early problems before they become big issues.

What if you don’t exactly have a pelvic condition that needs treatment, but you have some questions or concerns and want an expert assessment?

This annual checkup is for you!  Our pelvic health wellness checkup program was developed because patients asked us for this!  If you’ve been on our website you’ve seen that we offer pelvic floor specialty physical therapy care to treat individuals with bladder, bowel, pelvic pain and sexual conditions.   Over the years we have heard MANY times from patients (both men and women!) that they wished they had gotten looked at years before meeting us with their condition.  These are the things we’ve heard:

I wish I had known about you years ago because I think I have had pelvic floor problems going back decades.

Can my daughter come and get checked by you just to see if she is ok down there?

My best friend and I have commiserated that we both have had urinary incontinence since having our kids, but she doesn’t know where to go to get checked.

So, ask and you shall receive!   We offer an annual pelvic floor wellness checkup program just for you!  If you would like to read some additional material regarding the importance of pelvic health physical therapy, here’s one resource.

Who is this Annual Physical Therapy Checkup for?

This is for all women and men who want to be proactive about their pelvic health, want to avoid bladder, bowel and sexual pain problems and want to keep their pelvic floor, core, spine and hips in tip-top working order.  If you have a suspicion that things might not be working right, either in your abdominal muscles, your back, hips or pelvic region, then this is for you!

Every person on this planet has pelvic floor muscles. These muscles are crucial to your quality of life because if they aren’t working optimally you can have urinary or bowel incontinence, overactive bladder, waking up at night repeatedly to urinate, pain with intimacy, trouble with arousal, back pain, hip pain, SI joint pain, tailbone pain and many other problems.

What does a pelvic floor wellness checkup involve?

This is an annual check up of your strength, conditioning, flexibility, posture, coordination of your core muscles, your abdominal wall integrity and function, low back, hip, pelvic muscles and joints.

  • We will talk to you to determine any concerns you may have and answer all of your questions. Patients tell us this education is perhaps the most valuable part of seeing us.  It is common for us to hear “I had no idea that I was doing this wrong all these years.”
  • We will establish your baseline at present, so you know where you are starting and we can compare this year over year to make sure you are staying strong, flexible and healthy.
  • Correcting issues early on is always easier than waiting until symptoms worsen.
  • We want to learn about your history and any risk factors that you may have for pelvic floor dysfunction. For example, often I hear from women that their mom had a prolapse and they don’t want to get one, what can they do to prevent one.  Or, I hear from men that their dad always had back pain and then developed prostate problems and they want to be proactive about their health.  I also hear from people that they’ve “always had a small bladder” or that in high school they “always leaked urine when playing” their sport.
  • Our pelvic floor wellness checkup is particularly important for individuals who have a prior history pelvic pain or incontinence, even if you are currently not experiencing symptoms.
  • For women we cover pregnancy and postpartum considerations. For men we cover prostate considerations
  • We will conduct a thorough wellness screen of your abdominal, pelvic, low back and hip control, strength, flexibility and asymmetries.
  • We will review your exercise routine and provide you with exercise and behavioral suggestions for keeping your core and pelvic floor strong and healthy.

Still not sure if you would benefit from a pelvic floor wellness checkup?  No problem, we love to talk to you and answer your questions beforehand to determine if we are a good fit for you.  Call us with your questions or to schedule An Annual Physical Therapy Wellness Check Up with Your Pelvic Physical Therapist today contacting us at  616-516-4334.


Dr. Maureen O’Keefe Continue reading

Postpartum Pelvic Floor PT in Grand Rapids

Postpartum Pelvic Floor PT in Grand Rapids

What does Postpartum Pelvic Floor PT Treat?

If you are postpartum and wondering what postpartum pelvic floor PT in Grand Rapids would do for you, read on!  We thought it might help you to hear of one woman’s recovery story with us.   If, after reading this, you feel postpartum pelvic floor PT could help you, Contact Us

Here’s a story of one woman we helped.  Her problems:  pelvic and perineal pain, pelvic floor dysfunction with bladder and bowel control problems,  postpartum recovery following severe pelvic trauma with labor and delivery and pelvic reconstructive surgery.

Like all new moms, this woman was impressive!  She worked full time, was in love with her baby, struggled with sleep deprivation and wanted to get back to being athletic.  When we met, she was 6 months postpartum with problems of bladder/bowel control and pelvic instability, pelvic pain, pelvic floor weakness and diastasis recti abdominus (split abdominals).  She experienced inner thigh and pubic pain with walking, exercising, moving in and out of positions when picking up her baby and when driving and moving her foot from gas to the brake.   This pain was her dominant concern, but she also wasn’t happy to have embarrassing and unexpected loss of gas, problems with bladder control, a weak abdomen and a diastasis recti abdominus (split abdominals) as well as knee pains.  Before I met her, when her baby was 4 months old, she had pelvic surgery to correct a serious injury from her labor and delivery.  She had been referred to me by her urogynecologist surgeon, but had tried two other pelvic floor PTs prior to her surgery and before finding me.  Neither of the prior pelvic health PTs could help her pain and she had been told that she needed to get in shape, but she found herself unable to exercise because of pain.

Her Goals:

  1. Get pregnant again and be healthier before the pregnancy, down the line.
  2. Get the adductor (inner thigh & pubic bone) pain to go away. “It prevents me from doing every other exercise.”
  3. Regain the strength of the pelvic floor and muscle control.

We got to work right away with a comprehensive postpartum pelvic floor physical therapy evaluation.  This included a detailed assessment of her:

  • Load transfer ability:  This was impaired, she could not shift weight from one leg to another and keep her pelvis and low back in stable.
  • Strength: Poor all around, she was deconditioned, had weakness in her glutes, pelvic floor and abdominals and low back.
  • Abdominal wall integrity: Disrupted by a diastasis recti abdominus that caused ineffective and abnormal load transfer through her legs, pelvis and core)
  • Pelvic floor integrity & coordination: Integrity of the multiple layers of the pelvic floor was intact, but coordination was impaired and deficient, poor timing and firing of the muscles noted)
  • Postoperative healing: She was doing well, but the vaginal tissues were fragile and needed to be treated delicately and carefully.

Her Plan of Care Included Hands-On Treatments and Graded, Specific and Careful Exercises to Promote Stability, Strength and Coordination

We worked together at each visit, with a very careful and coordinated plan to progressively help facilitate her recovery.  I provided a good amount of hands-on manual therapy to her abdomen, low back hips and thighs and internally to her pelvic floor.  Together we worked to optimize her muscles and her fascia, to improve her pelvic stability, to advance her strength and conditioning and to restore her pelvic floor, breath and core muscle coordination, timing and strength.  If you may benefit from postpartum pelvic floor PT in Grand Rapids, we can offer the same expertise to you!

At Her 5th postpartum pelvic floor physical therapy appointment, she was feeling better!  Less pain!  Less Worry!  Hope and optimism were born!

She arrived with a smile and noticeably less stressed.  She reported this was because she was feeling better and seeing that we were making progress.  Her postpartum pelvic floor physical therapy program was different than the other two physical therapists had recommended and it was detailed, systematic and progressive.  She was feeling improvements and this gave her confidence that she was getting the help she needed.  By this fifth appointment she reported “every now and again I get twinges of pain in my inner thighs or my abs, but it goes away.  It doesn’t happen often.  My walking is pretty good.  Standing on one leg still hurts a little; I have to sit down to put on shoes and pants.  It is unstable and some pain in the proximal adductor.”  This difficulty with standing on one leg is something that women with pelvic instability can experience.  We perform a comprehensive evaluation to determine what are the driving factors with balance, pelvic stability, muscular control and motor coordination.  Then, once we know what is causing this pain and problem, we devise a program to systematically address all of the contributions to it.  In her case, we provided a postpartum pelvic physical therapy program customized to her post-operative precautions and designed to optimize both her post-operative and her postpartum healing.  The results of pelvic floor physical therapy are born from the wisdom and experience of a good pelvic health physical therapist to design an effective and comprehensive treatment program.

Not all pelvic health physical therapy is the same!

For this woman we were challenged to develop a pelvic health recovery program that gave a “Goldilocks” effect.  You remember the childhood 3 Little Pigs tale, with Goldilocks finding the “just right” bed and porridge?  We needed to evaluate and treat her with the “just right” methods of physical therapy.  Enough to stimulate pelvic recovery, coordination and strength while also reducing pain and instability.  Too fast, too aggressive or the wrong exercises and treatments and she was at risk for a huge flare up and possibly adverse healing.  Too little or the wrong exercises and treatments and she was at risk for physical therapy not helping her, having no response and thinking “this doesn’t work and I’m never going to get better.”  If you might benefit from postpartum pelvic PT in Grand Rapids, we are here to help you.  Contact Us

We’ve Seen This Before & We Can Help You!

I had seen this condition before, many, many times over the years.  By working with so many other women and having advanced training in pregnancy and post-partum pelvic floor physical therapy, I knew how to best help her.  She and I worked together in partnership to step-by-step get her to achieve her goals.  One advantage she had in coming to see me was my experience with helping women with these types of complicated cases.  I am an avid reader of clinical research and participant in professional societies and ongoing clinical education, because of this I can offer my patients clinical expertise.  For example, in this woman’s case she had a diastasis recti abdominus, which is split abdominal muscles.  In the last ten years there has been a lot of research, debate and clarifications on how to best treat this condition.  Having kept up with all of this, I was able to offer her the most current and effective methods to resolve her diastasis recti abdominus.  There are many published articles about DRA, here is one that surveyed pelvic health physical therapists to learn what their current practices were to treat this condition.

At 6 Months After Starting Pelvic Floor Physical Therapy She Was Roller Blading!

To help someone recovering after pregnancy and surgery requires expertise.   At 6 months after starting physical therapy, she returned with happiness reporting “I’m feeling ok!  I feel fine doing my core exercises (this is an improvement!).   I went roller blading and felt good.  I feel some soreness in my inguinal region, not like it was before, it is mildly sore, same as my abs.  My knees and back have felt better.  I’m doing all of the exercises you gave me and some extra squats throughout the day and my knees are fine.”  You can see this is a huge advancement in her activity tolerance.  Rollerblading?  That was absolutely out of the question when I first saw her, she would have had pelvic pain, possibly knee and low back pain also, possibly loss of gas or urine.  And, here she was able to roller blade without anything more than some soreness that was normal post-workout soreness!   Her success with roller blading was a huge win and a reflection that all of our pelvic floor physical therapy had correctly addressed her myriad problem.

Free Discovery Visit if you wonder if postpartum pelvic floor physical therapy might help you!

This story gives you a glimpse into one woman’s experience of postpartum pelvic floor physical therapy.  This woman had an unfortunate and complicated case and was able to get back to an active life and achieve her goals.  Many women we help are fortunate to have fewer problems.  But, most postpartum women do experience some challenges to their recovery. Even when they are feeling fine they don’t know exactly which exercises they should be doing.  Or, they may experience some urinary leakage from time to time and don’t know how to get that to go away.  If you wonder if postpartum pelvic floor PT in Grand Rapids could help you, we offer a free Discovery Visit.  This would be an opportunity for us to meet so I can answer your questions and get a sense of what is going on with you.  I could then tell you how and what I may be able to offer to help you reach your goals.  If you are interested in this, call 616-516-4334 and mention this articel and the Discovery Visit and we can find a good time to meet!  Contact Us



Dr. Maureen O’Keefe, DPT




Stress Incontinence Treatment in Grand Rapids

If you have stress urinary incontinence, we provide expert physical therapy solutions so you can resolve this problem and get back to doing all the things you love!

Why do I lose urine when I laugh so hard?

Urinary incontinence is often not simple and can be very frustrating. Because the human body is a complex system and there are several types of urinary incontinence, women often don’t understand which type they have and aren’t aware of effective remedies to solve it. We can’t tell you how many times women have come to us saying “I’ve been doing my Kegels and they aren’t working.” Well, our answer to them is #1, maybe Kegels won’t help you and, in fact, they might worsen your incontinence and #2 maybe you aren’t doing the Kegels properly, a very common finding. Our skilled pelvic physical therapy stress incontinence treatment in Grand Rapids includes an in-depth examination to determine what is causing your leakage, what the status and function of your pelvic floor muscles are and what needs to be done to recover your bladder control. Maintaining continence is a complex coordination of your body managing your intra-abdominal pressure and keeping your bladder’s ability to fill urine, store urine and empty at the appropriate time. For your treatment we will discover the contributing factors in your incontinence and we will treat each of these. One professional society that is laser focused on pelvic health and urinary incontinence is AUGS. AUGS has published a brochure about stress incontinence that details treatment options.  You can see on the brochure that pelvic floor physical therapy is a proven and recommended treatment for stress incontinence.  Here’s the brochure:

Stress Incontinence Treatment Works so you can jump again!

Stress urinary incontinence is the involuntary loss of urine with activities such as coughing, laughing, jumping, sneezing and raising our voice. While most of us have heard about stress incontinence, many people think is “normal” after you’ve had a baby. It is never normal to be leaking urine. Recovery of your urinary control is possible and with skilled physical therapy you will receive expert care and a customized treatment program to help you get back to walking, running, and exercise without incontinence. If you are losing urine it is likely that your muscular strategies from breathing, to abdominals, back muscles and the deep core, including your pelvic floor, are ineffective. With stress urinary incontinence, in particular, we typically find deficits in several components of coordinating these muscles together so that you can properly manage your intra-abdominal pressure changes.

Seriously, I can’t even laugh anymore??? Why won’t my stress incontinence get any better? So, here’s the deal, with each laugh there’s increased pressure generated in your abdomen. This pressure places a downward force on your bladder. Your bladder and urethra support structures should be able to keep everything in place. Your pelvic floor muscles should respond to all of this by activating and improving the support to the bladder and effectively “shutting the door” to the urethra, so no urine can escape. When this goes awry, instead what happens is a mixed-up response of any one of these things. Maybe your abdominal wall has a diastasis rectus abdominus, causing goofed up intra-abdominal pressure. Maybe you have a hypermobile urethra, so it can sag and bounce ever so slightly as you chuckle, leading to a drip, drip, drip of urine. Maybe your bladder has dropped a bit because its support is compromised. Maybe your pelvic floor muscles don’t pre-activate anymore, meaning they don’t turn on when they are supposed to. Maybe your pelvic floor muscles have deconditioned, they’re just tired and not responding. Like they’re on vacation, only they’re not, they’re supposed to be working.

Recovery from stress incontinence is more complex than simply doing Kegels. Continence is a coordination of all of your core muscles managing your intra-abdominal pressure.  At Purple Mountain PT Dr. O’Keefe provides expertise at determining how you can best recover from your stress incontinence.  Our stress incontinence physical therapy treatment program is detailed, systematic and customized to your body’s findings and it is right here in Grand Rapids.  We evaluate your breathing, abdominal wall, back muscles, hip girdles and pelvic floor and teach you how to coordinate muscular control of all of yoru core muscles to facilitate the return of continence.  This includes how to engage your pelvic floor, addressing speed, power, pre-activation, coordination, and release; this is a lot more complex than simply “do a kegel”.

At Purple Mountain PT we are experienced physical therapists with proven experience helping many people overcome their stress urinary incontinence. This is a passion of ours, it is what we do and what we’ve done for 20+ years. We are devoted to pelvic health and getting women back to being active and dry “down there.” Come give us a try and in your first visit we promise we will educate you about your own body’s performance and help you begin the process of recovery. If you would like to learn more about our stress incontinence treatment in Grand Rapids and how you can be evaluated, contact us today.


Dr. Maureen O’Keefe, DPT specializing in pelvic health, pelvic floor dysfunction, bladder, bowel and sexual health.