Clinical Practice Guidelines and Position Statements

Published January 1, 2026

What You Need to Know

Leading pelvic health organizations have established clinical practice guidelines (CPGs) recommending pelvic health physical therapy as essential for treating urinary and pelvic pain conditions. The APTA Academy of Pelvic Health Physical Therapy has and will continue to contribute to this growing body of evidence.  

• Clinical practice guideline standards: The Institute of Medicine (IOM) set standards in 2011 for trustworthy CPGs, emphasizing evidence-based recommendations to optimize patient care.    

• The role of APTA’s Academy of Pelvic Health Physical Therapy: The Academy has published 4 CPGs and is developing 5 more, with future plans targeting exercise in pregnancy, oncology-related dysfunction, and updates to existing guidelines.

The Institute of Medicine (IOM) published standards for developing trustworthy clinical practice guidelines in 2011, highlighting the need for statements that include recommendations informed by systematic review of evidence of particular condition and aimed at optimizing patient care. (Institute of Medicine et al., 2011). Leading national and international associations in the field of pelvic health disorders including the International continence society (ICS), the American Urology Association (AUA), The European Urology Association (EUA), the American College of Obstetricians and Gynecologists (ACOG), and the Royal College of Obstetricians and Gynecologists (RCOG) Canadian have established clinical practice guidelines that consistently recommended pelvic physical therapy as first or second line treatment for urinary and pelvic pain diagnoses.( ICS Standards, 2024; Breyer et al., 2024; Cameron et al., 2024; Fall et al., 2010; RCOG, 2012; Chronic Pelvic Pain: ACOG Practice Bulletin, 2020). In pursuit of developing quality clinical practice guidelines (CPG) specific to pelvic physical therapy assessment and intervention in line with the IOM’s standards, The Academy of Pelvic Health Physical Therapy formed its CPG Steering Committee in 2015.  

Under the direction of the CPG steering committee, four clinical practice guidelines have been published, with five currently in development. Existing CPGs developed within the Academy of Pelvic Health cover the following conditions: pelvic girdle pain in the antepartum population, (Clinton et al., 2017). pelvic girdle pain in the postpartum population, (Simonds et al., 2022) physical therapy management of functional constipation in adults, (LaCross et al., 2022), and rehabilitation interventions for urge urinary incontinence, urgency, or frequency among adult women. (McAuley et al., 2023). Current guidelines in development and supported with grant funding from the APTA focus on pelvic pain, assessment and treatment of perinatal diastasis rectus abdominis, pelvic health rehabilitation for patients with prostate cancer, and revisions (updated literature review) of two existing CPGs on pelvic girdle pain in the antepartum population (Clinton et al.,2017) and rehabilitation interventions for urge urinary incontinence, urgency, or frequency among adult women.( McAuley et al., 2023). The CPG Steering Committee has identified areas for future guideline development of exercise in pregnancy, management of oncology related pelvic floor dysfunction, and revisions of the functional constipation (LaCross et al., 2022) and pelvic girdle pain in the postpartum population (Simonds et al., 2022) guidelines.

References