A "One-Stop Shop": Integrating Orthopedic and Pelvic Physical Therapy

Author: Dr. Robin Ellis PT, DPT, OCS

One of the things I’ve become increasingly passionate about over the past few years is bridging the gap between orthopedic and pelvic floor physical therapy. Too often, patients get funneled into one type of care or the other, but in reality, our bodies don’t work in isolated systems. As a specialist in orthopedic and pelvic floor dysfunction, I’ve come to realize how powerful it can be to approach the whole person, not just the part they were referred for. The more I practice, the more I see that some of the most stubborn, confusing, or chronic cases often sit at the intersection of these two specialties.

A few years ago, I treated a woman who had been struggling with chronic hip pain for nearly a decade. She’d seen multiple providers, done every type of orthopedic PT imaginable, and while she had moments of improvement, the pain always came back. When she came to me, she assumed we’d do more of the same—strengthening, stretching, maybe dry needling. But after listening to her story and doing a thorough assessment, it became clear that her pelvic floor was playing a big role in her symptoms. Once we began addressing internal tension patterns and coordination issues in her pelvic floor—along with the hip and core—the pain that had lingered for years began to melt away in just a few sessions. It was a game-changer, both for her and for me.

That experience confirmed something I had been suspecting for a long time: treating the pelvis in isolation just doesn’t cut it, and the same goes for treating orthopedic issues without considering the pelvic floor. When someone comes in for pelvic floor dysfunction, I always make sure to zoom out and look at how their whole body is functioning. Sometimes a stiff mid-back, a weak hip, or even foot mechanics are contributing to pelvic pain or bladder symptoms. And the reverse is true too—someone with low back or hip pain may have underlying pelvic floor dysfunction that’s holding them back from getting better.

What sets our clinic apart is that we’re able to offer this integrated care all in one place. Most physical therapists are trained in either orthopedics or pelvic health, but rarely both. While I’m proud of the extra training I’ve pursued, I also believe this shouldn’t be so rare. It just makes sense to treat the whole person. My dream is that this kind of approach becomes more mainstream in our field, because patients deserve providers who can see the bigger picture.

At the end of the day, I love what I do because I get to help people feel seen, heard, and understood—not just as a set of symptoms, but as a whole human being. Whether someone is coming in for pelvic floor dysfunction or persistent back pain, I’m always thinking about how all the systems of the body are working together (or not) and what clues might have been missed in the past. It’s not just about where it hurts—it’s about why it hurts, and how we can work together to get to the root of it.