Could Physical Therapy Be Even Better Than Surgery or Medicine?

One of the most fulfilling aspects of my job as a pelvic floor physical therapist is helping patients realize that treating pelvic floor conditions doesn’t have to mean having surgery or taking medicine. Yes, surgery and medicine can be vital tools when the body is misbehaving, and you should always consult with your doctor when deciding on a treatment, but surgery and medicine are not without their drawbacks. Surgery is risky. Medicine can have side effects. Pelvic floor physical therapy is a less frightening option, and helps with a wide range of pelvic floor conditions.

In fact, according to UC San Diego Health, the majority of pelvic health conditions do not require surgery and can be resolved by more conservative methods, including the pelvic floor physical therapy I regularly administer in my practice as a pelvic floor physical therapist in New York City. Of course this isn’t just limited to the pelvic floor. Patients with other conditions can benefit from physical therapy as well. Harvard has noted how it can be “as good as surgery and less risky” for lumbar spinal stenosis, a form of low back pain.

The New York Times recently published an article entitled “When to Try Physical Therapy Before Surgery.” The article looks at Dr. Lindsey Plass, a physical therapist who was diagnosed with the hip issue femoroacetabular impingement syndrome (F.A.I.). A surgeon told her that she had to have hip arthroscopy if she wanted to have any chance to run in marathons ever again. Despite the recommendation, Plass was unsure it would help. But taking a chance on physical therapy paid off. She was able to get back into marathons and never had to go under the knife thanks to physical therapy.

One drawback to physical therapy? It can require more patience, as it is a process that can take months and sometimes years, but for so many, it is the better option. Still doubt the power of pelvic floor physical therapy? Many of my patients have seen life-changing improvements from the pelvic floor physical therapy they’ve received from Revitalize Physical Therapy. On my Google reviews page, for instance, Anya mentions how we cured (yes, cured!) her prolapsed bladder after childbirth in only a few weeks, while Elka raves about how I helped her diastasis recti, a postpartum abdominal muscle separation.

Do you have a pelvic floor condition that’s getting in the way of you being the best and happiest version of yourself? Or do you just feel weird “down there” and you’re not really sure what’s going on? Have you heard about pelvic floor physical therapy, and are you perhaps curious how or if it might be able to help? It costs nothing to find out if pelvic floor physical therapy can
change your life, and you have everything to gain! Click the button on the upper right corner of this page to schedule a free phone consultation with me to discuss the difference pelvic floor physical therapy can make in your life.


The Inside Story is Out!

(The following piece was contributed by journalist Nati Burnside who attended the book launch of The Inside Story.)

Originally from Bergenfield, Dr. Riva Preil lives and works in Manhattan where she has multiple locations for her pelvic floor therapy private practice, Revitalize Physical Therapy. If you don’t know much about pelvic floor therapy, you’re not the only one. In fact, Preil herself didn’t know much about it until her last year of physical therapy graduate school.

She was inspired to learn about the topic after a friend of hers had a traumatic injury while giving birth. Until that point, Preil had basically been told that the pelvic floor was a specialty that required additional coursework. Her friend’s injury sparked her to find out more about the field and change her career path.

Pelvic floor dysfunction is any circumstance in which the muscles at the bottom of a person’s core are either too tight or too loose. Those conditions can lead to bowel, bladder, or sexual issues.

“I think that, growing up as an orthodox Jew, I knew that there were certain topics that we just don’t talk about for tznius reasons,” Preil said at her book launch. “I completely understand and respect that and I think there’s tremendous value to that.”

However, Preil has discovered over the years that this isn’t really a Jewish issue. She’s found that one of the reasons that her specialty is so hard to come by is because these issues are taboo for almost everyone. Those who do tell someone, usually tell their doctors. Unfortunately, not all doctors can diagnose these issues correctly because they wouldn’t be found on any of the usual scans and pelvic floor therapy isn’t exactly the most widely known specialty.

The main goal of The Inside Story seems to be awareness. Preil wants people to be able to recognize pelvic floor issues so that they know when they need to ask for help. Recent studies have found that one third of women will suffer from a pelvic floor disorder at some point. Yet Preil estimates that for every person who walks through her office doors, there will be ten more who don’t.

Preil is looking to de-stigmatize an issue she feels is too common to be kept in the shadows. “I just felt such a strong calling and need to share this information with people so they can get help in a dignified and timely manner,” Preil said to applause from the crowd of 75+ that gathered on a recent Saturday night to hear her speak at Mount Sinai Jewish Center (MSJC) in Washington Heights.

The event featured Preil being interviewed by MSJC’s own Rebbetzin and Yoetzet Halacha Racheli Taubes, followed by questions from the crowd. The forum featured an open atmosphere for discussion and even included a substantial attendance by men (about 1/3 of the crowd).

While men are less likely to need pelvic floor therapy, Preil encourages them to read her book in order to gain a better understanding of the topic both for themselves and in order to support their partners. The days of referring to the specialty as “women’s health” are gone and men might even need a pelvic floor therapist’s help one day.

The book is specifically targeted to Jewish women and Preil made sure that sensitive topics were dealt with in appropriate ways. There are many pictures in the book of stretches and exercises for people to do in order to combat different issues that they might have or to prevent issues from arising in the first place. Preil used herself as the model and made sure the pictures were as tznius as possible for the comfort of her readership.

Preil believes that The Inside Story should be part of the “kallah canon” for all women heading down the aisle. In fact, she’s offering a copy to any kallah teacher who wants one in order to raise awareness about the issues contained in her book.

“Riva Preil opens a conversation, friendly and empathetic, instructive and informative, in which she highlights the tools of her craft which can give women confidence  and comfort in many parshiyot of life,” said Rabbi Yaakov Neuberger, rabbi of Congregation Beth Abraham in Bergenfield and a Rosh Yeshiva at Yeshiva University, and Rebbetzin Peshi Neuberger, formerly a kallah teacher for 25 years and current teacher at Manhattan High School for Girls, in a statement endorsing The Inside Story. “Her engaging balance of modesty and clarity will make this volume invaluable for kallah teachers who wish to replace fear and insecurity with joyful anticipation, as they prepare young brides for robust and fulfilling marriages.”

Following the stereotypical lifecycle of the orthodox Jewish woman, the book moves along the timeline of a woman’s life. The first chapter (Pelvic Floor 101) focuses on the basic concepts of pelvic floor therapy as Preil realizes that many people reading the book are not aware of the subject matter, but also aren’t professional medical personnel.

From there, she discusses the life of a recently married woman and potential issues that can arise with beginning physical intimacy. Next up are postpartum complications, one of the most likely culprits for needing to see a pelvic floor therapist. As Preil points out, some countries automatically refer women to a pelvic floor therapist after giving birth. She recommends that every woman make at least one appointment to assess their status after having a baby.

Speaking of babies, the next chapter discusses pediatric issues such as toilet training from a pelvic floor perspective to allow parents to understand the issues better from that standpoint. The book then closes with a section about the possible pelvic floor changes and concerns that may arise for women during menopause and later in life.

All in all, The Inside Story is a concise and informative guide to a subject on which the majority of people could benefit from increased knowledge. Preil makes the material accessible to the masses and allows the reader to feel comfortable as the author discusses topics that many would shy away from discussing in public.

The book is available on Amazon and the Yeshiva University Seforim Sale. Feel free to contact the author at