Women's pelvic health · Maui, Molokai and Lanai
Physical therapy for pregnancy pelvic and back pain in Maui, Molokai and Lanai
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 prenatal pelvic floor work also prepares the body for birth and recovery.
- TRICARE, HMSA, and HMSA QUEST in-network
- No state referral requirement; some plans need one
- Video visits anywhere in Maui, Molokai and Lanai
About the condition
Pregnancy pelvic and back pain: what is going on.
As the belly grows and ligaments soften, the sacroiliac joints, the pubic symphysis, and the low back carry load differently. Many women feel a sharp pain at the front of the pelvis when turning in bed or climbing stairs, a deep ache on one side of the back of the pelvis, or low back pain by the end of the day. Round ligament pain, sciatica-like leg symptoms, and rib pain are common too.
Prenatal pelvic floor physical therapy does two things: it treats the pain now, with positioning, support, and specific exercise, and it prepares the pelvic floor for birth by teaching how to relax and lengthen it, how to push effectively, and how to protect the perineum.
Common experiences
What people with pregnancy pelvic and back pain often describe
These are the patterns Dr. Shalem hears most often. Any of them is a reason to book a discovery call.
Pain at the front of the pelvis with stairs, turning over, or standing on one leg
Deep ache at one or both sacroiliac joints
Low back pain that builds through the day
Sciatica-like pain into the buttock or leg
Leaking urine during pregnancy
Uncertainty about safe exercise and about pushing during labor
Treatment
How physical therapy addresses it.
Treatment combines movement modifications for the daily tasks that hurt, exercises for the hip and core muscles that stabilize the pelvis, support options such as a pelvic belt, and pelvic floor relaxation and pushing practice in the third trimester. Perineal massage instruction is included for women who want it.
What a video visit looks like
Prenatal visits are done from the living room with pillows and a chair. Dr. Shalem watches how the patient moves, adjusts positions on camera, and teaches the birth-preparation work in the final weeks.
Coverage in Hawaii
Insurance and pricing
Bring your plan name to the discovery call and we confirm your physical therapy benefit before the first visit.
TRICARE
In-network (TRICARE West). TRICARE Select members can book directly with no referral. TRICARE Prime members need a referral from their primary care manager, and we tell you exactly what to ask for.
HMSA
In-network with HMSA PPO and HMO plans. Some HMSA plans require a referral from your primary care provider; we check yours before the first visit.
HMSA QUEST
In-network with HMSA QUEST (Hawaii Medicaid). We confirm coverage before your first visit.
Private pay
Available for any other plan. HSA and FSA cards accepted.
Referrals
Hawaii allows you to start physical therapy without a physician referral. Your insurance plan may still ask for one (TRICARE Prime and some HMSA plans do), and we check that for you before the first visit.
All of Maui, Molokai, and Lanai are seen by video.
Questions
Questions people ask about pregnancy pelvic and back pain
How it works
How a virtual visit works
Prenatal visits are done from the living room with pillows and a chair. Dr. Shalem watches how the patient moves, adjusts positions on camera, and teaches the birth-preparation work in the final weeks.
Discovery call
15 minutes, free, by phoneA short call to hear what is going on, explain how visits work, and check insurance or pricing. No pressure to book.
Evaluation
60 minutes, by videoDr. Shalem takes a full history, watches how you move and breathe, and guides the self-assessments she needs to build a plan.
Your plan
Same visitYou leave the evaluation with a plain-language explanation and a short home program, usually a few minutes a day.
Follow-ups
45 minutes, every 1 to 2 weeksProgress 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
Pregnancy pelvic and back pain questions in Maui, Molokai and Lanai
Is physical therapy safe during pregnancy?
Yes, with a provider who treats pregnant patients. Exercise and positioning are adapted to each trimester, and anything that needs the obstetric provider's input is coordinated with them.
When should prenatal pelvic floor therapy start?
Any time. For pain, as soon as it appears. For birth preparation, the third trimester is the most useful window.
Will the pain go away after delivery?
Pelvic girdle pain often improves after birth, but for some women it persists, and treating it during pregnancy makes the postpartum period easier.
Do I need a referral for physical therapy in Hawaii?
Hawaii allows you to start physical therapy without a physician referral. Your insurance plan may still ask for one (TRICARE Prime and some HMSA plans do), and we check that for you before the first visit.
What insurance do you take in Hawaii?
TRICARE: In-network (TRICARE West). TRICARE Select members can book directly with no referral. TRICARE Prime members need a referral from their primary care manager, and we tell you exactly what to ask for. HMSA: In-network with HMSA PPO and HMO plans. Some HMSA plans require a referral from your primary care provider; we check yours before the first visit. HMSA QUEST: In-network with HMSA QUEST (Hawaii Medicaid). We confirm coverage before your first visit. Private pay: Available for any other plan. HSA and FSA cards accepted.
Your physical therapist
Dr. Elana Shalem, DPT
Doctor of Physical Therapy, University of St. Augustine for Health Sciences, Miami. Licensed in Hawaii.
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. ShalemPrefer to write? Send a message.
Questions about insurance, pricing, or whether physical therapy is the right next step? We reply within one business day.
Start with a free 15-minute call.
Tell us what is going on, hear how Dr. Shalem would approach it, and decide from there.