Pelvic Health, Demystified: How Physical Therapy at Riverside Helps People of All Ages and Genders

Pelvic health might sound like a niche specialty—or something only women need to think about—but that’s a misconception Noelle Fillmore, PT is eager to clear up. A physical therapist with Riverside Rehabilitation and Therapy for more than a decade, Fillmore splits her time between home health and outpatient pelvic floor therapy, giving her a full view of how everyday function, comfort, and confidence hinge on a part of the body most people rarely talk about.

“If I had to kind of drill it down,” she says, “I would say it’s a specialized form of physical therapy that’s addressing pelvic floor muscle dysfunction.” That work touches some of the most personal aspects of life—bowel, bladder, and sexual function—as well as pain conditions, low back and sciatic issues, pelvic organ prolapse, and postpartum concerns. And it’s not just for one demographic. “Everybody has a pelvic floor,” Fillmore adds. “Regardless of gender, issues can affect everybody of all ages and diagnoses.”

What Problems Pelvic PT Actually Treats

In clinic, Fillmore most often sees patients for urinary incontinence—urge, stress, or mixed—along with overactive bladder symptoms, constipation or fecal incontinence, pelvic pain (including pain with intercourse), and prolapse. Patterns vary by life stage: pregnancy brings its own set of pains and bladder changes; postpartum may reveal new incontinence, pain, or diastasis recti; and post-menopausal hormone shifts can contribute to prolapse or leakage. But, the common thread, she says, is that everything is connected to each other. “We’re really able to comprehensively treat all those things together.”

That whole-person lens is part of why patients often say, at the end of care, “I wish I’d known about this sooner.” Stigma—and simple lack of awareness—keeps many people quiet. Fillmore addresses that head-on in the very first visit: “One of the things I try to tell my patients all the time when they come in for an evaluation is I’m not embarrassed by anything that we’re talking about, so I don’t want you to be either.”

What to Expect at Your First Visit

A pelvic health appointment isn’t just about one set of muscles. Fillmore begins with a detailed conversation about symptoms, then broadens the assessment. “We’re going to go through more of a broad orthopedic assessment, looking at hips and back and lower extremities,” she explains. Education is central: how the pelvic floor works, why it can become over- or under-active, and how therapy can help.

Treatment plans are individualized. “A lot of people have the assumption that we’re going to just do Kegels, but pelvic floor therapy is way more than that,” Fillmore notes. Sometimes strengthening is part of the plan; sometimes it’s the opposite of what PT professionals want to do. Care can include manual therapy to the pelvic floor or surrounding areas, core and hip work, posture and body-mechanics coaching, and behavioral strategies such as bladder retraining. The goal is simple: match the approach to the real problem, not the stereotype.

Small Daily Shifts That Support Pelvic Health

Fillmore is quick to share a few practical habits that make a big difference. Hydration is first. “Commonly, one, people are probably not drinking enough water,” she advises. “Water is very important for your bladder, getting close to that sixty-four ounces if you can.” For anyone dealing with urgency or frequency, she also suggests taking stock of common bladder irritants. “Carbonation, caffeine and coffee, spicy food, alcohol, those are really common irritants,” she cautions. Tuning into how those affect your symptoms can be eye-opening.

Normal bathroom rhythms matter, too. “Normal urinary voiding intervals are every two to four hours,” Fillmore shares. More often than that may point to overactive bladder; stretching far beyond that often signals dehydration. And yes, she’s a fan of a simple tool with a silly name: “Get a Squatty Potty. It makes a huge difference.”

Tackling the Stigma—and the “It’s Just Normal” Myth

Perhaps the biggest barrier she sees is silence—patients who’ve been told leakage is “normal after babies,” or that pain is “just part of aging.” Fillmore pushes back firmly yet compassionately. “We like to say these things might be common, but they’re not normal,” she says. “Any issue related to bowel or bladder dysfunction or pain, please talk to your provider. Because there’s usually a lot more help out there than people realize.”

That conversation is easier at Riverside, where referrals and records live in one place—MyRiverside MyChart—and communication is streamlined. Pelvic health patients can be referred by OB/GYNs, urologists, primary care providers, gastroenterologists. “Really any provider that you’re seeing,” Fillmore mentions. Illinois is also a direct access state, meaning you can schedule an evaluation with a physical therapist without a physician’s order; a provider’s order is required to continue treatment beyond that evaluation. In practice, starting with your clinician makes the process smooth from the start.

Care That Changes Quality of Life

Fillmore measures success in very human terms: confidence to leave the house without scouting every restroom; intimacy without fear; a return to running, lifting, or simply laughing without leakage. “These are major quality of life issues for a lot of people. With almost every patient walking through my door, we’ve either dramatically improved or been able to resolve a lot of those issues,” she assures.

Her closing advice is simple, and emphatic: “If you’re having any concerns, please, please, please talk to somebody and then seek out that referral.” You don’t have to live with it, and you’re not alone.

Learn more about Riverside Rehabilitation and Therapy at myrhc.net/rehabilitation or call the Pelvic Floor Clinic at (815) 614-5476.