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  • Writer's pictureNicole Cozean

Should Pelvic PT Hurt?

"What if pelvic PT is painful" Is a question that we get a lot. The short answer is that pelvic PT should never hurt - we can't treat pain with more pain. This is especially true if you're already dealing with chronic pelvic pain.

With these conditions - interstitial cystitis, vulvodynia, chronic prostatitis, endometriosis, dyspareunia, or other diagnoses - the nervous system is already upregulated and primed to expect pain.

One of our main goals in physical therapy is to "downregulate" the nervous system and let it realize it's 'safe' so it stops reporting painful signals to the brain.

Causing more pain is directly counter to this goal.

So, what should you do if you're experiencing significant pain with physical therapy?

Speak Up! Never be afraid to tell your pelvic PT that you're experiencing pain during the session. Some discomfort is expected, but the discomfort should dissipate during the session and over time. After most sessions, you should be experiencing some relief and a change in how your body is feeling. If you're consistently experiencing pain either during or after your session, you need to let your pelvic PT know.. Never be afraid to speak up!

If you are consistently experiencing pain with your sessions and either 1) aren't comfortable talking about it with your physical therapist or 2) don't notice a change after you bring it up, you may need to find another physical therapist for a second (or third) opinion.

Remember, physical therapy should never hurt - we can't treat pain with pain.


At PelvicSanity, we support patients beyond the walls of our own clinic in Southern California. We offer an Out-of-Town program, remote consultations, and a Facebook support group for patients called Finding Pelvic Sanity.

Nicole Cozean

Dr. Nicole Cozean is the founder of PelvicSanity Physical Therapy in Orange County, CA. PelvicSanity treats patients from all over the world with remote consultations and the Immersive Out of Town Program. She also runs Pelvic PT Rising, training other pelvic PTs to better serve patients.

Named Physical Therapist of the Year, Dr. Nicole is author of the award-winning book The Interstitial Cystitis Solution and the first PT to serve on the ICA Board of Directors, Her passion is helping those with pelvic health issues - regardless of where they live - find lasting relief.

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