What’s a pelvic floor occupational therapist vs physical therapist?
Oooh I have been asked this question more times than I can count! Furthermore, I have also been called a physical therapist maybe an actual billion times?
I’ve heard many opinions and perspectives on the difference between a pelvic floor occupational therapist (OT) and a pelvic floor physical therapist (PT).
Firstly: what’s an OT? Well, I have my masters’ degree in occupational therapy. In school, we worked alongside students in the physical therapy department for our anatomy class one summer, but that was the only overlap. I also have worked in hospitals and clinics alongside physical therapists and have been lucky enough to collaborate with them. Even better, I’m close friends with a few pelvic floor physical therapists.
Ok back to “definitions”: An OT tends to work with patients with the focus on understanding who they are and now what habits/roles/routines are impacted by the current “disability” or ailment. In pelvic floor therapy, the impacting situations tend to be incontinence/leakage, pain, pregnancy, constipation or postpartum “getting back into your body.” As an OT, my job is to learn what life looked like prior, and what’s different now. What is/was important to you? How can we get you back doing those things?
Also, a very fun side of OT is the figuring-it-out -ness. For example, I had a patient who was really struggling with nausea and “morning sickness.” She would be working at her computer from home and then have to rush to the toilet to throw up. Horrible! She was having pain with the urgency of moving quickly from her desk to the bathroom, and then the bending over was becoming problematic for her back. Also, no one really loves having to throw up in a toilet! So we problem-solved together and figured out that, unfortunately we couldn’t do much to change her nausea in and of itself, but we could make the act of vomiting less insane. So we got “emesis bags,” aka hospital bags meant for throwing up. Then, when the need to throw up occurred, she could contain it in that bag, without having to lean so far forward, and then she could dispose of the bag how she wanted. This took a lot of the physical pressure off her back and let her have less anxiety about the entire situation.
To me, the problem solving is the highlight of the OT lens comapred to the PT lens.
Ok, so then how is pelvic floor physical therapist different? Well, ideally, whether you have a pelvic floor physical therapist or a pelvic floor occupational therapist, your pelvic floor therapist will be able to address your concerns as they impact your life. The difference that I am aware of between myself and a physical therapist is the background training and the general lens of practice. Typically (and this definitely varies from therapist to therapist), a physical therapist focuses on the body mechanics, movement patterns, muscle systems and measurable changes in range of motion and strength. Generally, they may be less honed in on behaviors such as frequency of urination, food influence on bowel and bladder, the nervous system involvement. OR they may simply have less training in those areas.
As an OT, we have training in body mechanics, movement patterns, muscle systems, range of motions and strength. It just is in the context of the person as a whole and then the pieces individually.
I will say, though - any pelvic floor therapist who is worth your time and money is constantly learning to fill in any gaps they are missing, and also able to acknowledge when they don’t know something. The reality is - women’s health is an incredibly broad topic. Furthermore, physical therapy and occupational therapy are incredibly large disciplines. Even narrowed down to pelvic floor/pelvic health, we still have to decide where to point our focus. Pediatrics? Pregnancy? Postpartum? Leakage? Hormones? The mind/body connection? Diet/nutrition? Surgical interventions? Pessaries? Myofascial connections?
Many of us know quite a lot and also acknowledge that there’s ALWAYS more to learn. I’m grateful to know many pelvic floor therapists, OTs and PTs alike. I am constantly learning and constantly collaborating - with the explicit hope and goal to serve my patients the best I can.