Meet Michelle Cortese: Pelvic Floor Physical Therapy

Hi there!

My name is Dr. Michelle Cortese, and I’m a loud and proud pelvic health physical therapist.

If you’re not familiar with pelvic health physical therapy, buckle up! I’ll give you a little primer about what it is and what I do in my clinic.

What I treat:

• Do you pee your pants when you bust out laughing because your kid does something adorable? I got you.

• Are you avoiding sex because it hurts? Let’s talk.

• Do you skip going to the movies because your tailbone hurts so badly you can’t sit that

  long? We really need to change that.

• Are you pregnant and dealing with changes in your body and want to prepare for getting

  that baby earthside? Let’s tackle that!

There are also plenty of things that you may not realize are directly related to your pelvic floor. If

you have constipation, low back pain, TMJ dysfunction, pelvic organ prolapse, hip pain, difficulty

with scars (C-section, hysterectomy, episiotomy/natural tearing during delivery, etc.), sciatica,

pudendal nerve pain, or issues during or after pregnancy, pelvic floor physical therapy may be

just what you need!

What happens in pelvic floor physical therapy?

So now that you know what I treat, you might be wondering how the hell I treat that stuff. You can expect a wide variety of treatments. And patient education is my jam. I love to talk about anatomy, so I’m going to get out my pelvic floor model and show you exactly what you have going on down there.

I may suggest that we do an internal assessment (yes, that means assessing your pelvic floor

muscles either through your vagina or rectum, depending on which of those you have and on

your symptoms), but obviously only with your consent. I’ll look at how your back and hips are

functioning, see how you’re breathing (are you breathing, really?), or watch how you lift something.

Pelvic floor treatment is MORE than kegels!

Sometimes, you need to learn how to relax your pelvic floor muscles rather than strengthen them. Even if your main symptom is leaking urine, it may be because your pelvic floor muscles are always “on” rather than because they lack strength. That’s why a thorough pelvic floor assessment with a qualified physical therapist is so important. It’s such an important part of determining what is causing your symptoms.

You’ll also probably get some homework. That homework might be kegels if that’s what you need. But you’ll go home knowing how to do them properly (remember that internal assessment?) and that you know how many, how often, and in what positions you should be doing them. Or I might prescribe you the “anti-kegel,” a pelvic floor dropping/relaxing exercise that teaches you to be aware of tension in your pelvic floor and gives you the tools to address that. You’ll also almost always get some breathing exercises to do at home. I

mean, I named my practice Breathe Physical Therapy; surely you guessed that I think breathwork is important?

Have more questions about your pelvic floor or about whether pelvic floor physical therapy might be able to help you? Hit me up, I’d love to chat!