Women's pelvic health · Baltimore and Central Maryland

Pelvic floor physical therapy for women in Baltimore and Central Maryland, by video.

Pregnancy and postpartum recovery, bladder and bowel symptoms, prolapse, and pelvic pain. One-on-one with a Doctor of Physical Therapy who specializes in pelvic health, from home anywhere in Baltimore and Central Maryland.

  • CareFirst BlueCross BlueShield, Aetna and Medicare in-network; private pay for other plans
  • No referral needed (unrestricted direct access)
  • Usually seen within a week
A pregnant woman walking along a tree-lined path

Women's pelvic health

What this is, and who it is for.

About one in four women in the United States lives with at least one pelvic floor disorder, and most never see a specialist. The pelvic floor is a group of muscles at the base of the pelvis that supports the bladder, uterus, and bowel and works with the diaphragm and deep abdominal muscles every time a person breathes, lifts, coughs, or runs. Pregnancy, childbirth, surgery, menopause, and years of habit change how those muscles coordinate, and that shows up as leaking, heaviness, pain, or urgency.

Pelvic floor physical therapy treats those muscles the way orthopedic physical therapy treats a shoulder: assess how they are working, retrain coordination, strength, and relaxation, and build a short daily program the patient can keep up. Clinical guidelines recommend pelvic floor muscle training as first-line care for urinary incontinence and for pelvic organ prolapse, before medication or surgery.

Baltimore and the Washington suburbs have pelvic health specialists, and most have waitlists, high cash prices, and a Beltway commute attached. A video visit gives you the same one-on-one care from home, in-network with CareFirst, Aetna and Medicare, usually within a week.

What we treat

Conditions we see in Baltimore and Central Maryland

Each condition has its own page with what it is, what the evaluation looks at, and how the program is built.

Pregnancy and after birth

Postpartum recovery
In France and much of Europe, pelvic floor rehab after birth is routine. In the United States, most women get a six-week check and...
Pregnancy pelvic and back pain
About half of pregnant women have pelvic girdle or low back pain, and most are told it is normal. It is common, but it is treatable, and...
Diastasis recti
Diastasis recti is a widening of the gap between the two halves of the rectus abdominis. It happens in most pregnancies, and physical...
C-section recovery
A cesarean is major abdominal surgery, and most women are sent home with no rehab plan at all. Scar care, core retraining, and pelvic...

Bladder and bowel

Urinary incontinence
Leaking with a cough, a sneeze, a jump, or on the way to the bathroom affects about one in three women at some point. It is common, it...
Overactive bladder, urgency and frequency
Running to the bathroom ten times a day, waking twice a night, and the sudden urge that comes out of nowhere are the signs of an...
Pelvic organ prolapse
Prolapse is when the bladder, uterus, or rectum drops lower in the pelvis. About half of women who have given birth have some degree of...
Constipation and bowel dysfunction
Chronic constipation and straining are often a muscle coordination problem, not a fiber problem. When the pelvic floor tightens instead...

Pain and recovery

Painful intercourse
Pain with intimacy is one of the most common and least discussed pelvic floor problems. It is usually driven by muscles that have...
Chronic pelvic pain
Pelvic pain that has lasted more than six months almost always involves the pelvic floor muscles, whatever started it. Treating those...
Menopause pelvic health
Falling estrogen changes the pelvic floor, the bladder, and the vaginal tissue. The leaking, urgency, dryness, and heaviness that follow...
Recovery after pelvic surgery
Hysterectomy, prolapse repair, bladder sling, and endometriosis surgery all change how the pelvic floor and core work. A structured...

Coverage in Maryland

Insurance and pricing

Bring your plan name to the discovery call and we confirm your physical therapy benefit before the first visit.

CareFirst BlueCross BlueShield

In-network with CareFirst, Maryland's Blue Cross Blue Shield plan. We confirm your physical therapy benefit before the first visit.

Aetna

In-network with Aetna in Maryland. Most Aetna plans cover physical therapy with a copay or coinsurance; we confirm yours before the first visit.

Medicare

Enrolled with traditional Medicare (Part B). Medicare Advantage plans vary and are checked before the first visit.

Private pay

Available for any other plan. We provide a superbill you can submit for out-of-network reimbursement. HSA and FSA cards accepted.

Referrals

Maryland allows you to see a physical therapist for evaluation and treatment without a physician referral, with no visit limit. Some insurance plans still ask for one, and we check that for you.

Baltimore City and County, Anne Arundel, Howard, Harford, Montgomery, and Prince George's counties are seen by video.

How it works

How a virtual visit works

Most of pelvic floor physical therapy is education, breathing and pressure management, movement retraining, and a home program. All of it works on camera. During the evaluation, Dr. Shalem guides a self-assessment so she can see how the pelvic floor is coordinating with breath and movement. An internal examination is not possible by video; if a hands-on assessment would change the plan, she says so and helps the patient find local care.

A woman at her kitchen table on a video visit with her physical therapist
  1. Discovery call

    15 minutes, free, by phone

    A short call to hear what is going on, explain how visits work, and check insurance or pricing. No pressure to book.

  2. Evaluation

    60 minutes, by video

    Dr. Shalem takes a full history, watches how you move and breathe, and guides the self-assessments she needs to build a plan.

  3. Your plan

    Same visit

    You leave the evaluation with a plain-language explanation and a short home program, usually a few minutes a day.

  4. Follow-ups

    45 minutes, every 1 to 2 weeks

    Progress checks, program updates, and techniques you can do yourself, for as long as they are useful.

For a video visit you will need

  • A phone, tablet, or laptop with a camera
  • A private room
  • A mat or towel
  • About an hour

Questions

Women's pelvic health questions in Baltimore and Central Maryland

Does pelvic floor physical therapy work over video?

Much of it is education, breathing and pressure management, movement retraining, and a home program, and all of that works on camera. During the evaluation Dr. Shalem guides a self-assessment so she can see how the pelvic floor is coordinating. An internal examination is not possible by video. If a hands-on assessment would change the plan, she will say so and help you find local care.

How many visits does pelvic floor physical therapy usually take?

Most plans run six to twelve visits over two to three months, with a short home program between visits. The evaluation sets the plan, and it is adjusted as things change.

Is it only for women who have had children?

No. Pelvic floor symptoms affect women who have never been pregnant, athletes, women in perimenopause and after menopause, and women recovering from pelvic or abdominal surgery.

What happens at the first visit?

A 60-minute video evaluation: a full history, a look at posture, breathing, and movement, and a guided self-assessment of the pelvic floor. You leave with a plain-language explanation and a first home program.

Do I need a referral for physical therapy in Maryland?

Maryland allows you to see a physical therapist for evaluation and treatment without a physician referral, with no visit limit. Some insurance plans still ask for one, and we check that for you.

What insurance do you take in Maryland?

CareFirst BlueCross BlueShield: In-network with CareFirst, Maryland's Blue Cross Blue Shield plan. We confirm your physical therapy benefit before the first visit. Aetna: In-network with Aetna in Maryland. Most Aetna plans cover physical therapy with a copay or coinsurance; we confirm yours before the first visit. Medicare: Enrolled with traditional Medicare (Part B). Medicare Advantage plans vary and are checked before the first visit. Private pay: Available for any other plan. We provide a superbill you can submit for out-of-network reimbursement. HSA and FSA cards accepted.

Dr. Elana Shalem, DPT

Your physical therapist

Dr. Elana Shalem, DPT

Doctor of Physical Therapy, University of St. Augustine for Health Sciences, Miami. Licensed in Maryland.

Dr. Shalem treats pelvic health for women and men, from pregnancy and postpartum recovery to bladder, bowel, and pelvic pain conditions and recovery after prostate or pelvic surgery, and general orthopedic conditions of the back, neck, hips, knees, shoulders, and feet. Visits are one-on-one and unhurried, and she explains what she is seeing in plain language.

More about Dr. Shalem

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