At PT of Wimberley, we know that you want to be an independent woman, or man living a strong, active life. To do that, you need to become free from persistent pain, regain strength, and heal properly. You have been told incontinence is simply a part of life, surgery or medication is the only option to help your injury, or that your discomfort is here to stay. Whatever your story is, you have been left feeling like you are at the end of the road with nowhere else to go.
We believe your body was designed to be healthy.
We understand your physical limitations have left you feeling hopeless. We get it. We are pelvic health specialists who have helped thousands of people just like you overcome limitations and regain a life of freedom.
Here is how to get started: 1 Schedule an Evaluation. 2 Follow Your Treatment Plan. 3 Overcome Your Limitations.
So, schedule your evaluation today! And join the thousands of men and women who have overcome their hardships and are living strong, healthy, independent lives.
Most people don’t realize the physical discomfort they experience can actually be treated and overcome. At PT of Wimberley, we have helped thousands of patients learn how their bodies function and what it takes to get their bodies back on track. So you can stop worrying about your discomfort and live with a renewed sense of relief.
We work with patients in a pretty intimate area of the body, so it is understandable to have questions — lots of questions. If you have a concern that’s not addressed below or need additional information, please call our office at (512) 847-3300 (Wimberley)
There is no question too small or too strange. We want people to understand that our staff is very knowledgeable and helpful and have a passion to help our clients get the care they need and deserve. We tend to keep emails short and sweet and will likely be encouraging you to make an appointment because honestly, it’s very hard to answer private, anatomical questions without actually seeing what is going on. Also, we love meeting people in person so we can best educate on the specifics to each person’s needs.
Pelvic Floor Physical Therapy (or Pelvic PT) is a specialized type of physical therapy that treats bowel, bladder and sexual dysfunction through the musculoskeletal and neuromuscular system on the inside and outside of your body. Basically, there is a bowl of muscles between your hips, holding up your organs: your bladder, rectum and uterus, if you have one. Lots of things can go wrong with those muscles and the nerves that feed them, and when the muscles and nerves aren’t happy, everything else can go a bit haywire, too. Muscles can be too tight, too weak, in spasm, full of scar tissue, taking up the slack for other parts of the body that aren’t carrying their fair share, or not engaging fast enough — all things that make it hard for them to do their job properly. Instead of accepting these changes and dysfunction as people’s “normal”, we pelvic floor physical therapists use our hands to work on the muscles, tissues and nerves that need it, empowering you to heal yourself as we use our clinical expertise and work together with your body to resolve those “down there” problems.
I like to remember that the pelvic floor is:
So while these muscles are intimate, together, we will be looking up and down the kinetic chain trying to help your body be more efficient throughout your daily movements to decrease the demand at the pelvic floor muscles. We will be addressing your feet all the way up to rib mobility, position of your cervical, thoracic, lumbar spine, pelvic position and TMJ, in addition to internal pelvic exams. It is all connected. You are fearfully and wonderfully made.
No. You no longer need a referral from your medical doctor to see a physical therapist. Texas physical therapists have “direct access” and you can just call to make your appointment. It is easier if you have seen your medical provider and they are aware of these concerns and issues that you have as they will need to sign off on your PT plan of care within 10 business days of your initial evaluation, or we can no longer see you until a prescription is signed by a MD (gastroenterologist, gynecologist, urologist, primary care). If you did get a referral script, please bring it with you to your first appointment or you can upload it as part of your intake paperwork.
According to the TPTA (please visit their website for more questions):
Referral is no longer needed to evaluate and treat patients.
A disclosure form must be given to patients who are treated by a physical therapist without a referral. The form shall include language in which the patient acknowledges that physical therapy is not a substitute for a medical diagnosis by a physician, nor is it based on radiological imaging, that a physical therapist cannot diagnose illness or disease, and that such services might not be covered by a patient’s health plan or insurer.
NOTE: Although you can see your PT without a referral, some insurance companies will *only* reimburse you if you received a referral from your medical doctor. Please contact your insurance company prior to your first visit if this is a concern.
*The only exception to this rule is if you have never had a gynecological exam. In that case, we do ask that you visit your gynecologist before starting pelvic floor physical therapy as we will not be able to provide a patient’s first internal examination.
Honestly, most people have been doing the “kegels” and not making any progress in their daily life concerning pain or dysfunction. The pelvic floor was never intended to simply activate and rest on demand. It’s much more complicated than that. And that will be part of our job to allow the system to work together (resting and activating) while you’re moving and living your life.
And, 30% of people do the kegels incorrectly and put them at risk of worsening their condition. Learning the correct form and providing you with a tailored training program will help you recover much faster.
We do offer an online option of learning some habits that may prepare you for pelvic floor PT. These are education topics that are usually brought up in treatment sessions if they pertain to your care. But as a working mom of 3 young kids, I understand that importance of learning what I can, when I can, so this online Teachable format was created (which is not covered by insurance):
There are several classes to choose from:
Dress in comfortable clothing that you can move in because there is a short orthopedic assessment where we will assess your range of motion and ask you to do a variety of motions (e.g. squat, lunge). If you did not complete the intake questionnaire(s) online, or emailed back the completed paperwork, then anticipate the initial paperwork taking 30 minutes to complete upon arrival, prior to your appointment time. There is a lot to unpack concerning these sensitive matters, and the paperwork must be able to accommodate people that have all types of pelvic dysfunction. You can print the forms out and bring in the completed forms to your evaluation. If you are printing them out, please also bring a form of payment, and a list of your medications, vitamins, supplements, as well any other types of treatments you may be taking undergoing at this time. Also bring the name and contact information of your medical provider (e.g. ob-gyn, urologist, proctologist, gastroenterologist, primary care physician), and a referral if you have one.
Internal pelvic floor muscle examinations are the gold standard for understanding pelvic dysfunction. Think about it: you wouldn’t go to a dermatologist and ask the doctor to assess your skin through your clothes, or a PT to address your hurt shoulder without letting them look and touch your shoulder. Pelvic floor physical therapists have specific, high-level training to assess the muscles, nerves and connective tissues that make up the pelvic floor, and we do this by performing an internal exam of the vagina and/or the rectum, depending on what area we need to assess. Stacy has extra certification of PRPC (Pelvic Rehabilitation Practitioner Certification) indicating many years of experience (beginning in 2013) and has passed a Herman and Wallace examination indicating competency of pelvic floor dysfunction. You’re in safe hands. However, not everyone is comfortable with an internal exam, and your job is to let us know what those boundaries are so we can determine if it’s appropriate to proceed. Discomfort, pain, fear, or simply not wanting it are all perfectly acceptable reasons. Again, “No” is a full sentence. Just let us know. There are several conditions that can be treated successfully using external techniques if you don’t wish to have an internal exam, but it is not gold standard treatment.
Before any external or internal exam, your therapist will show you on a model of the pelvis and the muscles and structures we will be assessing. You will be asked to provide consent before any assessment or treatment, and most importantly, you can change your mind at any time. Your PT will step behind a curtain for you to undress from the waist down and lie on the treatment table, covering yourself with the sheet provided. There are no stirrups or speculum involved in pelvic floor physical therapy. We use clean, non-latex gloves and first observe your pelvic floor muscles externally, assessing tissue quality and health, as well as muscle coordination. The internal exam involves inserting one gloved, lubricated finger into the vaginal canal or rectum, in order to access and assess the front and back portions of your pelvic floor muscles. I am examining the strength, endurance, muscle tone, coordination, connective tissue and tissue quality of these areas. While we talk you through the entire physical exam, you will provide feedback about any areas of discomfort, altered sensation, or limited mobility. We can stop at any time, and we may not even perform the internal exam on your first visit, depending on your comfort level or our time constraints.
NOTE: If you have never had a gynecological appointment (for women), you will be asked to get one before we do any internal work. Similarly, men who have never visited a urologist or proctologist may be asked to see one before we do any internal work. We ask this because it’s important to provide you with the best, most complete care possible
and there may be necessary tests or treatment to be completed by an MD before a physical therapist provides treatment. Please ask for a referral to a medical doctor should you need one.
ASAP. We will not perform internal assessments until cleared by physicians around your 6 weeks appointment after a birth or surgery, but there is so much we can work on in the meantime. What does your scar and pelvis position look like? How are you breathing, especially when moving? Do you have any orthopedic pains or difficulty with your everyday activities from feeding baby, lifting, bed mobility? Let’s help you address those things so that way when you see your doctor on your follow up visit, you can spend your precious time on other concerns that are best suited for that doctor (meds, hormones, birth control).
Initial evaluations are 60 minutes with the therapist, after 30 minutes of paperwork for you to complete and followed with 10-15 minutes for scheduling subsequent sessions. Follow-up sessions are 60-75 minutes, with 15-30 minutes with the pelvic PT and the rest of the session with our talented team, working on your specific exercises/stretches for carryover into our daily exercises and movements. Our goal is for these first months with each other to increase ease of activating your correct muscle groups in the right order so when you are doing everyday activities, you don’t have to think about these muscles for the rest of your life. We use biofeedback, muscle energy techniques, manual therapy, tactile and verbal cues, neuromuscular re-education, home exercise programs, breathing patterns and TENS units to supplement your therapy sessions.
Appointments always includes one-on-one time with a licensed Doctor of Physical Therapy for 15-30 minutes and then an additional 30-45 minutes in the gym (totaling about an hour) with our skilled team members who are trained in pelvic rehabilitation, following your specific treatment plan. Our sessions are movement based, so there is carryover from these sessions into healthy habits in your daily life, whether that be decreasing pain or increasing strength. These exercises are specific and individualized as there is no cookie cutter approach to pelvic health.
Yes. Menstruation does not affect pelvic floor muscle treatment in any way and can often decrease the discomfort you may normally experience during your period. If you do not wish to have any internal work done during this time, please let me know. Also, many sessions will not include internal treatments anyway. There are many other body parts that affect the pelvic floor and by helping them be more efficient, it can decrease the demand at the pelvic floor muscles, so they can respond naturally.
Yes. If pelvic floor muscles are tight, in spasm, or uncoordinated, it can make it difficult for the body to welcome a pregnancy and allow for implantation. Pelvic floor PTs spend increased time with our patients and we can often pick up on muscular imbalances and circulatory or nervous system issues that may be a contributing factor to your current inability to conceive. Our treatment also often costs much less than current fertility options on the market while empowering you with a much deeper understanding of your personal anatomy and function. Once you no longer feel comfortable with internal treatments, usually due to pregnancy or implantation, then we respect your decision and will follow our treatment plan externally.
Yes! Low back pain, round ligament pain, pubic symphysis dysfunction, sacral misalignment, pelvic pain or sacroiliac joint dysfunction are all common conditions affecting pregnant women. There is so much we can accomplish externally and if warranted clinically, we can gently assess the muscles, nerves and tissues internally as well. We will also work on posture, core stabilization, strengthening and lengthening of your muscles. Depending on your knowledge and experience, we may also discuss appropriate birthing positions and exercises that will make labor and delivery easier for your body. So whether you have aches and pains to address or simply questions or concerns about how to protect your pelvic floor during labor and delivery, a few visits during pregnancy can be a great introduction to the amazing support that pelvic health therapists offer women at this wondrous and powerful stage in life! If you are pregnant, I usually recommend at least 4 sessions before having the baby so we can cover birthing positions, spinal and rib mobility for optimal space for baby and breath and to prepare tissue for c-section or vaginal delivery. After the baby is born, I recommend at least 4 more sessions (depending on the level of your new issues) so I can walk you through your recovery and look at each system again (getting feet, pelvis, hips and ribs back in place), getting proper activation of muscle groups that ‘quit’ working when you were pregnant, scars from episiotomy or c-section. I have had a c-section and 2 VBACs and have a strong passion for setting yourself up early for healing, and understanding pressure management and correct muscle activation so you don’t cause any harm in this precious time of your life.
*Please also be sure to tell us if you are pregnant or suspect you may be pregnant even if it is early on in your first trimester.
If you currently have an active infection or a flare-up, it is best to hold off on coming to your appointment until it has cleared – we absolutely don’t want to risk transmitting a localized infection to another part of your body or making your symptoms worse by working on the tissues in that area. If you need a referral to an MD to seek treatment, please don’t hesitate to get in touch with that MD.
If I identify what may be an active infection when we are working together, I will stop any external or internal treatment for that day and work on other parts of the body as per your treatment plan (posture, breathing, core strengthening). We will resume sessions when the infection or flare-up has cleared. Please know that you will need clearance from your MD to resume treatment unless you have already been prescribed appropriate medication.
All major credit cards are accepted. It is best to keep a card on file for increased ease. There is a $40 cancellation fee for no-shows or cancellations made with less than 24 hours’ notice because we are still paying our staff regardless of your attendance, and we would like to be able to call people on our waitlist when an appointment opens. It’s kind to respect our time and your time. I really like people to make progress, which usually works best when people attend their PT sessions as planned.
Yes, absolutely. Men also have pelvic floor muscles and can greatly benefit from working with a pelvic floor physical therapist to address a variety of issues, such as hemorrhoids, hernias, erectile dysfunction, bowel or bladder incontinence, scarring or weakness (especially after prostatectomy), painful intercourse or ejaculation, testicular or scrotal pain. These problems can sometimes arise after surgery (e.g. prostatectomy, abdominoperineal resection), injury (e.g. car accident, during intercourse), or activity (e.g. biking, martial arts) and overuse (abdominal exercises). We treat internally (via the rectum once consent is provided) and externally, assessing all of the systems that may be overtaxing the pelvic floor muscles.
Yes, but on a case-by-case basis. I have 3 young children of my own, so I feel confident to encourage moms to bring their children to appointments, but I do NOT have special training for pediatric physical therapy. Parent/guardian must remain in the room throughout sessions. No internal work is performed unless requested by physician. I do not serve primarily neuromuscular conditions or developmental delays (because of my lack of training). I would love to help you manage symptoms of constipation, bowels leaking or staining and bed-wetting. Examples of the treatments to expect from me is similar to adults with looking outside of the pelvic floor. How does your child walk, stand, sit, bend over. We use “tummy massages”, breathing education, stretching and/or strengthening of the abdominal wall to give their organs have something to butt up against and a TENS unit at ankles (TTNS) for urgency and frequency of using the restroom.
From diastasis recti to pudendal neuralgia, from organ prolapse to pain with sex to urinary incontinence — the types of conditions that a pelvic PT can treat are vast and wide-ranging. If you leak when you sneeze, have problems when you poop, or being intimate doesn’t feel so fun anymore, it’s time to talk to a pelvic floor PT. If you had a hysterectomy or a prostatectomy (or any other pelvic surgery), you may also greatly benefit from working with a pelvic floor PT both pre- and post-operatively to help you recover more quickly and with less complications. If you’re thinking that you may need pelvic organ prolapse repair/lifting, I love teaching people that we can probably help you have less symptoms and/or prepare you for only needing the surgery once by better understanding pressure management, specific to you and how you move. Check out our home page for a list of commonly treated conditions, and don’t hesitate to call the office if you have a question about your specific condition.
We have 2 locations. San Marcos and Wimberley TX. I typically work Mondays and Wednesdays in Wimberley, and Tuesdays and Thursdays in San Marcos. I do have shortened hours because even though I have a strong calling walking with people concerning their pelvic dysfunction, but it’s hard to say it here, but I would throw it all away to spend more time with my 3 young children and husband of 15 years. They are my highest calling. The first available slot is at 8am and the last available time is offered at 2/2:30pm. I can stay longer or gladly work through lunch, but only open on a case-by-case basis so I can make sure I have proper childcare and so our office staff can take their lunch break. We appreciate your flexibility and understanding.
I love treating all ranges of adults with conditions that are tired of their pelvic issues and are open to be compliant with our recommendations. People who benefit the most are people who are interested in looking inside and outside of the pelvic floor and are ready to move in a way to decrease the demand at the pelvic floor to increase their quality of life. I have a sweet compassion for healthy intimacy, especially for spouses and for the older adult that has been putting up with this dysfunction for decades. You do not have to have these issues any longer. You are fearfully and wonderfully made.
Appointments are often once or twice a week in the beginning while we begin to rule in or out other systems that can play a part in your pelvic dysfunction. Then the sessions are only once a week, then every other week, and as your symptoms start to improve, we often space out these visits to once every few weeks or months. The typical treatment time frame is 6-12 weeks, for a total of 4-15/20 sessions. For some people it takes less time, for others it takes a bit more, depending on the nature, severity, and length of time of your condition and provided you are diligent in doing your assigned home exercise program and in attending your sessions. Those with bladder leaking conditions, for example, often take only 1-8 weeks to see improvement, but they may need more time for the higher-level activities without symptoms, so continuing to benefit from pelvic floor physical therapy with decreasing frequency for a total of 12-16 weeks. It takes 6-8 weeks for true muscle strength and 8-12 weeks for connective tissue healing.