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Pelvic Health Physical Therapy versus Occupational Therapy: so what's the difference?!

  • Writer: Carly Gossard
    Carly Gossard
  • 4 days ago
  • 4 min read

When it comes to pelvic health, the first professionals that often come to mind are physical therapists—but did you know occupational therapists can also specialize in pelvic health? While the two roles may seem similar, especially when focused on the same part of the body, they bring distinct approaches and strengths to patient care.


In this blog, we’ll break down the differences between pelvic health physical therapists (PTs) and occupational therapists (OTs), and how both can play vital roles in helping individuals reclaim comfort, function, and quality of life.


What Is Pelvic Health?

Pelvic health involves the muscles, ligaments, nerves, and connective tissue of the pelvic region, which supports bladder, bowel, and sexual function. Dysfunction in this area can lead to pain, incontinence, prolapse, constipation, and other concerns. Specialized therapy can be a game-changer for people of all genders across the lifespan.


Pelvic Health Physical Therapists (PTs)

Training & Scope:

Pelvic health PTs are trained in evaluating and treating the neuromusculoskeletal system, focusing on restoring movement, strength, and function. They undergo additional pelvic health training after their general physical therapy education (DPT), including internal pelvic floor muscle examinations and hands-on techniques for the pelvic floor.

What They Do:

  • Assess and treat pelvic floor muscle dysfunction (weakness, tightness, coordination)

  • Address orthopedic issues that affect the pelvis (e.g., hip or back pain)

  • Rehabilitate post-surgical patients (e.g., hysterectomy, prostatectomy)

  • Guide patients through movement re-education, body mechanics, and postural corrections

  • Use manual therapy, biofeedback, neuromuscular re-education, and therapeutic exercise

Goal:

To restore optimal musculoskeletal function and reduce pain or limitations in movement and daily activities related to the pelvic floor.



Pelvic Health Occupational Therapists (OTs)

Training & Scope:

Pelvic health OTs also receive education in anatomy, neurology, and function, but their core philosophy is rooted in helping people perform meaningful activities of daily life (or “ADLs”). They may pursue advanced training in pelvic health post-licensure. Most pelvic health specialists receive the same training through the Herman and Wallace Pelvic Rehabilitation Institute. 

What They Do:

  • Address pelvic floor dysfunction with a focus on its impact on daily routines (e.g., toileting, intimacy, caregiving, sleep)

  • Emphasize behavioral strategies, sensory integration, and environmental modifications

  • Work on pain management, especially in the context of chronic conditions

  • Provide education on lifestyle factors, stress management, and energy conservation

  • Often integrate mental health strategies like mindfulness and cognitive reframing

  • Provide home exercise programming including therapeutic exercise, strength training and stretches

Goal:

To support function, independence, and well-being by addressing how pelvic health conditions interfere with the client’s ability to engage in daily life.


Where They Overlap

Both PTs and OTs:

  • Can be trained in internal pelvic floor muscle examinations and treatment

  • Help manage pelvic pain, incontinence, and prolapse with manual techniques and exercise/mobility programming

  • Offer patient education and empowerment

  • Collaborate with other providers (OB/GYNs, urologists, pain specialists, mental health professionals)



So, Which One Should You See?

The great news is: you don’t necessarily have to choose! There are so many routes to healing that both a trained PT or OT pelvic health specialist should help you get the results you are looking for.

For example:

  • A PT may help restore pelvic floor muscle strength and coordination,

  • While an OT helps integrate those changes into daily life with toileting routines or intimacy.


Keep in mind, you’ll find that even two physical therapists don’t treat the same - we all come with our different skill sets and additional training that all work to help our patients! If you’re experiencing pelvic health challenges, seeking out a provider who specializes in this area—regardless of PT or OT—is a smart step. Ask about their training, approach, and how they personalize care.


The Bottom Line

Pelvic floor rehabilitation is under the scope of practice for BOTH physical and occupational therapists. They each bring unique, valuable perspectives to your care. Physical therapists often zoom in on movement, strength, and musculoskeletal function, while occupational therapists focus on how pelvic issues affect your ability to live life fully and independently. There is more than one route for the same healing journey!


Interested in learning more about how pelvic health therapy can help you?

Reach out to a specialist in your area—or feel free to contact us with your questions. Your comfort and function matter, and you deserve care that meets you where you are. You can also find pelvic health specialists (both PT and OT) at www.pelvicrehab.com



 

References:

  • American Occupational Therapy Association (AOTA). (2020). Occupational therapy’s role in pelvic health. Retrieved from https://www.aota.org/practice/manage/therapy-pelvic-health

  • American Physical Therapy Association (APTA). (2023). Pelvic health physical therapy. Retrieved from https://www.choosept.com/health-issues/pelvic-health

  • Dumoulin, C., Cacciari, L. P., & Hay‐Smith, E. J. C. (2018). Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women. Cochrane Database of Systematic Reviews, (10). https://doi.org/10.1002/14651858.CD005654.pub4

  • Fitz, F., & Overstreet, C. (2020). The role of occupational therapy in pelvic health: A scoping review. Occupational Therapy in Health Care, 34(1), 1–17. https://doi.org/10.1080/07380577.2019.1704780

  • Herman & Wallace Pelvic Rehabilitation Institute. (n.d.). Pelvic floor rehabilitation education for PTs and OTs. Retrieved from https://hermanwallace.com

  • Laycock, J., & Haslam, J. (2008). Therapeutic management of incontinence and pelvic pain: Pelvic organ disorders. Springer.

  • Roush, S. E., & Sonstroem, R. J. (1999). Development of the Physical Therapy Outpatient Satisfaction Survey (PTOPS). Physical Therapy, 79(2), 159–170. https://doi.org/10.1093/ptj/79.2.159

  • World Health Organization. (2001). International classification of functioning, disability and health (ICF). Geneva: World Health Organization.

  • Wynd, C. A., & Zychowicz, M. E. (2019). Pelvic floor health: The emerging role of the advanced practice nurse. Urologic Nursing, 39(1), 11–17. https://doi.org/10.7257/1053-816X.2019.39.1.11


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