FORT HOOD, TX  –   Carl R. Darnall Army Medical Center is piloting a first-of-its-kind virtual pelvic floor physical therapy program aimed at improving access to care for active-duty servicewomen while strengthening overall force readiness.

Pelvic floor disorders, including chronic pelvic pain, affect nearly one in three women nationwide, according to the Journal of the American Medical Association. These conditions are often tied to ongoing pain, depression, and long-term disability.

For active-duty servicewomen, the impact can be even greater. Pelvic floor conditions can impact deployability, physical performance, and quality of life. Even when pelvic floor rehabilitation is the recommended first-line treatment, many women in uniform face barriers to care within the Military Health System, including long wait times or the need to seek treatment off the installation.

To help close that gap, CRDAMC is piloting a virtual pelvic floor physical therapy program that combines personalized care from women’s health physical therapists with real-time biofeedback technology. The pilot, supported by the Defense Health Agency Innovation Fellowship Program, will engage up to 150 active-duty servicemembers and is currently enrolling participants.

“This program removes barriers that have kept our Soldiers from getting timely care,” said Lt. Col. Merry J. Fontenot, department chief of OB/GYN. “By offering discreet, virtual pelvic floor therapy, we’re giving them an option that fits into the reality of military life while directly supporting readiness and overall well-being.”

The program allows patients to complete short, guided therapy sessions at home using their smartphone. Sessions typically last five to ten minutes and are overseen remotely by a Doctor of Physical Therapy specializing in women’s health.
 
“This program provides Soldiers with an effective and private alternative to traditional treatment as in-person pelvic floor physical therapy is not offered at CRDAMC,” Fontenot said. “It empowers them with the flexibility to access this specialized care without the burdens of long commutes, scheduling conflicts, or privacy concerns.”

For Soldiers enrolled in the pilot, the difference is already noticeable.

“I’ve dealt with pelvic health issues for a long time,” one Soldier said. “This is the first time I’ve received care without the runaround or long wait times. I’ve already completed a practice session, set my reminders, and I’m excited to get started.”

Another participant praised the program’s feedback. "I honestly really like this program. I get real time feedback and get to see my progress each session. I get to see how my body functions with each exercise."

Timing is also a key benefit for some. “I was facing a three-month wait for care off post, so I’m very grateful to be part of the pilot. I’m excited to start this weekend.”

Dr. Mathew Frazier, chief of the CRDAMC Clinical Investigation Program and a physical therapist, said the pilot addresses system-wide challenges.

“Women’s health physical therapy has been difficult to access across the Fort Hood area due to a limited number of board-certified specialists,” Dr. Frazier said. “This partnership allows us to pair Soldiers with women’s health physical therapists in days instead of months, improving compliance, outcomes, and continuity of care.”

Conditions addressed through the program include urinary leakage, pelvic pain, pelvic organ prolapse, postpartum recovery, menopause-related pelvic issues, bowel dysfunction, painful periods, and scarring from childbirth-related injuries. Patients can continue therapy during temporary duty, permanent change of station moves, or deployments, reducing interruptions in care.

Maj. Timiyin E-Nunu, MD, CRDAMC Chief of Urology, said the program expands access without replacing traditional care.

“This is about increasing options,” E-Nunu said. “Patients are currently waiting three to six months to see a pelvic floor physical therapist. The program gives them a way to begin treatment sooner, on their schedule, without leaving work or delaying care due to operational demands.”

Leaders emphasize that improving pelvic health directly supports the warfighter.

“Pelvic floor conditions can interfere with physical activity, training, and everyday tasks,” Fontenot said. “This program improves access to pelvic floor physical therapy, helping Soldiers restore function and minimize time away from mission-critical tasks, which supports readiness.”

CRDAMC is the first and only Defense Health Agency facility piloting the program. This project supports Lines of Effort 2 and 3 in the Defense Health Agency’s Mission-Focused Directive by both keeping care in our system and integrating human and technological operations. 

Dr. Pauline Swiger, director of DHA’s Innovation Fellowship Program, noted that this is an ideal innovation project, “Dr. Frazier and the CRDAMC team identified a need and presented an innovative solution that could be rapidly implemented and assessed for impact.”

“This is about meeting Soldiers where they are,” Dr. Frazier said. “They’ve put the mission first for years. This pilot gives them a way to prioritize their health without sacrificing readiness.”

Active-duty servicewomen experiencing pelvic health concerns who receive care at CRDAMC should speak with their provider to determine if virtual physical therapy is appropriate for them.