You Are Not Alone
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Pelvic pain and incontinence are rarely discussed but very common issues. Chronic pelvic pain has a prevalence similar to asthma or chronic low back pain.* 1 in 5 women will suffer from pelvic pain at some point in their lives.* 26% of women between the ages of 18-59 experience involuntary urinary leakage.* For postpartum women, pain with intercourse is very common and almost 1 in 4 women will still have pain with intercourse 18 months after delivery.* Although these problems occur frequently,
they are not normal. Pelvic Floor Physical Therapy can help! |
*Zondervan, K.T., et al. (1999). Prevalence and incidence of chronic pelvic pain in primary care: evidence from a national general practice database. Br J Obstet Gynaecol, 106(11), 1149-55.
*Apte, G., et al. (2012). Chronic Female Pelvic Pain: Part 1: Clinical Pathoanatomy and Examination of the Pelvic Region. Pain Practice, 12(2), 88-110.
*National Association for Continence: https://www.nafc.org/womens-conditions/
*McDonald, E.A., et al. (2015). Dyspareunia and Childbirth: A Prospective Cohort Study. British Journal of Obstetrics and Gynecology, 122(5), 672-679.
*Apte, G., et al. (2012). Chronic Female Pelvic Pain: Part 1: Clinical Pathoanatomy and Examination of the Pelvic Region. Pain Practice, 12(2), 88-110.
*National Association for Continence: https://www.nafc.org/womens-conditions/
*McDonald, E.A., et al. (2015). Dyspareunia and Childbirth: A Prospective Cohort Study. British Journal of Obstetrics and Gynecology, 122(5), 672-679.
About Therapy Roo
Therapy Roo Physical Therapy was created to help women. For so many women, it is difficult to access pelvic floor physical therapy services. Many doctors are unaware of pelvic floor PT or don't understand its role in treating incontinence, pain, and postpartum weakness. Many women are unable to access PT clinics due to scheduling conflicts, inability to bring their children with them, lack of insurance coverage, or distance from services. Therapy Roo seeks to help solve these problems and get women the care they need. All women deserve to feel comfortable and confident in their bodies and seek treatment and education to improve pain, incontinence, and strength.
Jessica Abele received her Doctorate of Physical Therapy from Boston University in 2010. She started her career with a focus on neurological hospital based practice and was awarded her Neurological Clinical Specialty in Physical Therapy in 2014. She has worked in many of the major hospital systems in the bay area, including California Pacific Medical Center, UCSF, Kaiser South San Francisco/San Bruno, and Alta Bates.
Jessica began her education in pelvic floor physical therapy in January 2016 and has received her training through Herman & Wallace. She was immediately drawn to the needs of this patient population and the miraculous nature of recovery that these patients can experience with proper, supportive care. Jessica started Therapy Roo Physical Therapy in order to improve access to pelvic floor therapy, with direct access treatment, more flexible scheduling, longer appointments, and by providing care in patients' homes.
When not saving the world one vagina at a time, Jessica enjoys raising her daughter, reading, knitting, cooking, hiking with her family, and spending time with her silly cats, Boo & Peter.
Jessica Abele received her Doctorate of Physical Therapy from Boston University in 2010. She started her career with a focus on neurological hospital based practice and was awarded her Neurological Clinical Specialty in Physical Therapy in 2014. She has worked in many of the major hospital systems in the bay area, including California Pacific Medical Center, UCSF, Kaiser South San Francisco/San Bruno, and Alta Bates.
Jessica began her education in pelvic floor physical therapy in January 2016 and has received her training through Herman & Wallace. She was immediately drawn to the needs of this patient population and the miraculous nature of recovery that these patients can experience with proper, supportive care. Jessica started Therapy Roo Physical Therapy in order to improve access to pelvic floor therapy, with direct access treatment, more flexible scheduling, longer appointments, and by providing care in patients' homes.
When not saving the world one vagina at a time, Jessica enjoys raising her daughter, reading, knitting, cooking, hiking with her family, and spending time with her silly cats, Boo & Peter.
What should I expect from my first appointment?
- First appointments are a little longer, as we'll be doing more assessment. Expect the first appointment to last approx 75-90 minutes.
- Please wear comfortable, movement clothes so that I can easily see your alignment.
- Please have ready: 2 large pillows, 1 large towel, and a chair for me.
- We will first talk about your goals and symptoms. Then I'll assess your posture, gait, hip, and back alignment. I will then ask you to privately undress from the waist down and I will complete the internal vaginal pelvic floor muscle assessment if you are agreeable to it. This is typically done on your bed, with me sitting in a chair beside you. I use the pillows or towel rolls that you provide to assist in your comfort with positioning of your legs and hips. No stirrups needed!!
- Please do not worry about cleaning your home for my visit. Please also do not worry about shaving/showering first or if you are menstruating. I treat and accept all women as they are.
What if I can't tolerate an internal evaluation? I cannot stand gynecological exams!
- Pelvic floor physical therapy internal exams are muscle assessments. So, no speculum is involved and no use of stirrups. Only one gloved, lubricated finger is used for internal examination. Pillows and/or towel rolls are used to position your legs for maximum comfort.
- There are other forms of external examination techniques and treatments we can try if you cannot tolerate an internal evaluation on any day.
- It is always ok for you to decide you don't want to do internal work at any point before or during our time together, and I will always appreciate and respect your communication about your comfort level.
Do I need to cancel my appointment if I'm menstruating?
- No. If I didn't see my patients while they were menstruating, I wouldn't see 25% of my patients at any given time!
- However, as you are likely aware, women's bodies are often more sensitive around the time of menstruation. So, we may need to be more careful and perform treatment more gently during a session if you are menstruating. Please always communicate with me about how you are feeling.
I am the only one home with my baby during the day. Do I need to get childcare in order to have an appointment with you?
- No! One of the advantages of my business model is convenience for you. I come to you and can work around nap times or breastfeeding schedules.
- We can try to schedule sessions when your baby is taking a nap, so that you can be relaxed and focused on treatment, but still available in your home in case your baby needs attention.
- If you have pain with positioning during breastfeeding, carrying your baby, bath time, etc, having your baby present during our session is a great opportunity for us to problem solve the most pain-free positioning solutions for you to complete these tasks!
- If you prefer to get childcare during appointments, that's fine too!
Isn't an internal vaginal assessment painful for everybody?
- No, it shouldn't be painful. If it hurts, that is a definite sign of dysfunction in the pelvic floor muscles. In a study of 108 women with chronic pelvic pain and 48 healthy female volunteers, 58% of the women with chronic pelvic pain had tenderness with pelvic floor muscle evaluation compared to just 4% of the controls.* If it hurts, we have work to do to relax and rehabilitate those painful muscles.
Is this treatment just Kegels? I have tried Kegels before and felt no benefit.
- No! This is not just Kegels. In most cases of pelvic pain, doing Kegels may actually exacerbate symptoms. We need to complete a comprehensive evaluation of your movement patterns, alignment, and muscle condition to determine the best treatment plan for you.
- Also, though Kegels and pelvic floor muscle strengthening exercises are beneficial for weakness, about 30-40% of women perform Kegels incorrectly when only receiving verbal instruction.* It's so important that when we do Kegels, we do them correctly to avoid increasing bearing down pressure and risk for prolapse. This is another important reason to seek out pelvic floor physical therapy to ensure you are doing exercises correctly.
Do you only treat women who are within the first year postpartum?
- I treat many kinds of pelvic floor dysfunction. You can see me during pregnancy or 6 weeks postpartum to 30+ years postpartum.
- You also do not need to be postpartum to work with me. I have experience treating stress, urge, and mixed urinary incontinence, pelvic pain, endometriosis related pelvic pain, dyspareunia (painful intercourse), vaginal prolapse, diastasis recti, coccydynia (tailbone pain), pelvic girdle and back pain during pregnancy and postpartum periods, and post-surgical conditions.
- Currently, the only populations I don't have experience with are cis men and the transgender community. Care for clients who are transgender is an area of interest for me and I completed a continuing education course with this focus in April 2019!
How do I know if you're covered by my insurance? How do I seek reimbursement?
- Contact your insurance provider and ask for their coverage of "Out of Network Physical Therapy"
- If you are looking to submit for reimbursement to your insurance company or HSA, you may need a "Superbill" from me. This is an itemized receipt of services. Please request this when I see you and I will be happy to provide you with an itemized bill.
What is Direct Access Physical Therapy?
- California is a direct access state for Physical Therapy. This means that physical therapists can treat patients privately without an MD referral within certain constraints.
- Direct access laws in California allow PTs to see non-medicare patients for a plan of care of 12 visits or 45 days, whichever comes first. Patients must then visit their doctor and have the doctor sign off on the Physical Therapist's plan of care to continue receiving PT.
- Medicare patients cannot be seen with direct access.
- Please see the APTA Website for more information about direct access laws.
What forms of payment do you accept?
- I accept cash, check, and credit card payments and HSA cards through Square.
- Payment is expected at the time services are provided.
Can I use my HSA (Health Savings Account) for your services?
- Yes, you should be able to!
- In January 2019, I started using Square to accept credit cards and HSA cards. We should be able to use your HSA card directly, or you can pay first and we will give you an itemized receipt that you can submit to your HSA for reimbursement.
