We recently welcomed Dr. Riva Preil from Revitalize Physical Therapy to our Empowering Intimacy partner group. She offers a myriad of information and knowledge regarding women’s pelvic health & issues that arise throughout a woman’s lifespan. Her book, The Inside Story, gives an expansive and insightful base for vagina-owners to better understand their bodies and need for pelvic floor health.
The Inside Story Dr. Riva Preil
While the pelvic floor is expansive and linked to many common body issues, some of the things that Dr. Preil and her practice for female and male focus on are:
- Under and Over-Active pelvic floor
- Bladder dysfunction
- Bowel dysfunction
- Manual Therapies
- Neuromuscular Re-education
- Therapeutic exercise
- Body awareness
I interviewed Dr. Preil to learn more about her practice, the importance of pelvic floor health, & how women can ensure they are maintaining their own personal pelvic floor strength and health.
Find more about Dr. Preil in the Partner & Resources section and with the links below.
Interview with Dr. Riva Preil
Q: “How did you know you wanted to make a career in women’s pelvic floor health and therapy?”
Dr. Preil: “Throughout graduate school, I barely knew anything about pelvic health! Unfortunately, one of my close friends sustained a traumatic injury during the birth of her first child, and she benefited significantly from pelvic floor physical therapy. She encouraged me to consider the field, and she introduced me to her physical therapist, Dr. Marilyn Friedman, who kindly took time out of her busy schedule to meet with me and share knowledge about pelvic floor physical therapy with me. She also encouraged me to take Herman and Wallace (aka Pelvic Rehab Institute) continuing education courses to get a better sense of whether or not this field was a good fit. Well, as divine providence would have it, they were teaching the pelvic floor 101 class several weeks later…at Hunter College, where I was a graduate student! The director of my program told me I could take the course for free, which I gladly did, and I was blown away by what I learned. I distinctly remember calling my mother later that day and telling her that I had found my calling. I can honestly say that that was a life highlight, and I am so grateful that God inspired my path and directed me towards this extremely meaningful and fulfilling profession.”
Q: “Please tell us about your practice, Revitalize Physical Therapy.”
Dr. Preil: “My practice, aka my baby, is called Revitalize Physical Therapy (Riva…Revitalize…see what I did there? 😊) and we have three locations, Upper West Side, Washington Heights, and Midtown East. I treat women with various pelvic floor disorders, including, dyspareunia, interstitial cystitis, vulvodynia, pudendal neuralgia, constipation, incontinence, prenatal and postpartum conditions, pelvic organ prolapse, and chronic pelvic pain. I also treat pediatric bladder and bowel dysfunction as well as male pelvic floor dysfunction. My current staff includes a per diem male pelvic floor therapist named Jonathan Noury and a per diem female pelvic floor therapist named Miriam Max. We will be celebrating Revitalize PT’s eight-year anniversary this coming December, God willing.”
Q: “How did writing a book about this topic come about?”
Dr. Preil: “I feel blessed and privileged to have access to VERY IMPORTANT information that every woman deserves to know. Every day, I have the opportunity to share this information with my patients, on a micro level, and I realized that that wasn’t enough. I am sitting on a pot of gold, and it is my obligation to share the wealth about pelvic health with as many people as possible, on a macro level. To quote Uncle Ben from Spiderman, “With great power comes great responsibility!” Therein lies the inspiration behind my decision to write my book.” 😊
Q: “It’s often said and repeated that women’s pelvic floor issues are underdiagnosed and misdiagnosed (as are men’s issues). Would you agree or disagree with this?”
Dr. Preil: “Sadly, that is ABSOLUTELY true. Unfortunately, many people with pelvic floor dysfunction have had trouble getting the correct diagnosis, because unfortunately, an overactive pelvic floor will not be detected by the typical tests that a doctor might order. This can be very invalidating: you are suffering, but the doctor can’t find anything that is wrong! Is the problem all in your head? This is where pelvic floor physical therapists enter the picture. Pelvic floor physical therapists are musculoskeletal experts, who can manually detect and diagnose the problems that can’t be picked up by an x-ray, MRI, colonoscopy, or cystoscopy. When I encounter a client who has been suffering from muscle tightness for a long time without a diagnosis, I like to make the following distinction: No, the problem is not in your head, and I am just as frustrated as you are that you have felt invalidated throughout this process. But, what is in your head (i.e., the stress you feel because of your undiagnosed problem) can, and does, affect muscle tightness. So, I try as hard as I can to encourage the client to move beyond those feelings of invalidation and recognize that he or she has more control over their symptoms than they may realize. Especially if he or she is the type of person who internalizes stress and inadvertently stores it in the pelvic floor—in that case, we will definitely include relaxation training and self-help techniques in the treatment program.”
Q: “. What is the best advice you would give a woman who is struggling with issues related to the pelvic floor? What actions should she take first? And so on?”
Dr. Preil: “The message I want to convey to women struggling with pelvic floor dysfunction is: THIS IS NOT YOUR FAULT. Many women that I see feel broken, isolated, and alone. They feel like their bodies are failing them, and they feel shame, embarrassment, and sadness about not being able to participate in activities that they want and feel they should be able to perform. Women who are in too much pain to have sex with their partner often express that they feel like they are failing and disappointing their partner. Pelvic floor dysfunction is not your fault, and fortunately, you now know that hope exists. There are people who can help you fix the problem. Furthermore, YOU ARE NOT ALONE. In fact, one in three women will experience pelvic pain at some point in her life! For understandable reasons, many women with pelvic floor dysfunction are private about their symptoms, and most don’t sit around the table at dinner parties discussing these highly sensitive topics. However, just because people aren’t sharing doesn’t mean that it isn’t happening. I can guarantee that you probably have friends who have experienced pelvic floor dysfunction and who have benefitted from pelvic floor physical therapy. Many women that I work with find it helpful to know that they are in good company and that others are in the same boat as them. Hopefully, through spreading the word through platforms such as this, women will benefit from pelvic floor physical therapy and suffer no further.”
Q: “What are some of the best resources available to people (other than your fabulous book!) who may not be able to afford healthcare services, but are still looking for direction and guidance?”
Dr. Preil: “Several excellent resources that exist for individuals who experience pelvic pain:
1. National Vulvodynia Association (NVA): nva.org
2. International Society for the Study of Women’s Sexual Health (ISSWSH, pronounced “ish-wish”): isswsh.org
3. International Pelvic Pain Society (IPPS): pelvicpain.org
4. The Centers for Vulvovaginal Disorders: vulvodynia.com When Sex Hurts and Sexual Pain Disorders: Evaluation and Management, by Dr. Andrew T. Goldstein, MD FACOG IF
5. Tight Lipped (support network for women experiencing chronic pelvic pain): https://tightlipped.org/our-zine
Finding a pelvic floor physical therapist near me: If you live within the United States, you can search the American Physical Therapy Association for a trained pelvic floor physical therapist as follows:
1. Visit Apta.org
2. Click on “menu” and then in the blue column on the right, click “I want to… Find a PT”
3. Enter all relevant information pertaining to you, and then under “Find By Specialist,” select ““Women’s Health” from the scroll down list.”
Q: “What are some of the first signs or symptoms a woman might notice that could tell her she may be facing some pelvic floor issues?”
Dr. Preil: “Several tell-tale signs that one may be experiencing pelvic floor dysfunction are as follows: urinary frequency, urinary urgency, urinary incontinence, constipation, straining while urinating or defecating, pelvic pain, pain during intercourse (dyspareunia), or even pain with trying to insert a tampon or during gynecological speculum examination (for individuals who are not sexually active). In addition, pelvic floor dysfunction often masquerades as frequent or recurring UTIs. Many patients report when they first come to see me that they experienced UTI like symptoms (ex. frequent urination) and that when they saw their doctor or went to urgent care, they were prescribed meds that didn;t work…because antibiotics won’t help address muscle tightness/overactivity! If you experience “frequent UTIs” and have been prescribed antibiotics, please request that your doctor perform a urine culture to determine whether or not you truly have a UTI. If the results are negative, you may actually have a pelvic floor muscle issue, not an infection, and physical therapy can help.
9. Please include any other information, facts, info tips, or your knowledge to add in to the article!
Please be your own biggest advocate! You know your body better than any doctor ever will. If you suspect something that you may have pelvic floor dysfunction or can relate all too well to any of the issues I mentioned, please schedule a consultation with a pelvic floor specialist.”
We are grateful to have partners like Dr. Riva Preil who take the time to answer questions about pelvic floor health to help the population better understand the importance. Our team and readers appreciate you!
Resources Used:
Dr. Riva Preil Revitalize Physical Therapy