Tip of the Month

How can pelvic health physical therapy help you?

Physical therapy is a very effective and conservative approach to treating pain and the musculoskeletal dysfunction of the pelvic floor region that can occur in both men and women.

These conditions may include:

  • Back and pelvic pain related to pregnancy
  • Post-partum pain
  • Prolapse
  • Urinary incontinence
  • Bowel incontinence
  • Pelvic floor pain
  • Pain with sexual intercourse

You will be evaluated by a pelvic health physical therapist who is trained in meeting the unique needs of men and women across a lifespan and is specialized in pelvic floor rehabilitation.

You will leave the evaluation with a much better understanding of your current condition and symptoms, along with a detailed plan of care and home exercise program. Treatment will be specific to your symptoms and can include a variety of treatment options.

Urinary Incontinence

Woman holding baby

Do you find yourself "just in case" peeing or having to run back to the bathroom a few minutes after voiding? You are not alone. Urinary Incontinence affects 25 million adults in the United States. 26% of women between the ages of 18-59 years old have involuntary leakage. 20% of women over 40 years old have an overactive bladder. Between 5-21% of men, ranging from 19-65 years of age, experience urinary incontinence. There are many types of urinary incontinence, the most common being stress incontinence, urge incontinence and mixed incontinence.

Urge  Incontinence: the complaint of involuntary urine loss accompanied by or immediately preceded by urgency (a strong desire to void)

Stress Incontinence: the involuntary loss of urine with physical exertion such as with coughing, sneezing, jumping or laughing

Mixed Incontinence: a combination of stress and urge incontinence

These conditions can be treated by behavioral changes, a bladder retraining program, pelvic floor strengthening, pelvic floor relaxation, postural re-education, functional training, biofeedback and/or manual techniques.

Pelvic Floor Pain

1 in 7 American women ages 18-50 experience pelvic pain with 61% having no diagnosis. Chronic pelvic pain can affect between 2-16% of men. Conditions that can cause pelvic floor pain include, but are not limited to, post-partum pelvic syndrome, irritable bowel syndrome, depression, constipation, pelvic inflammatory disease, sexual or physical trauma, and endometriosis. Common complaints include pelvic pain, difficulty voiding and defecating, pain with intercourse, limited sitting and the inability to wear tight clothing or jeans.

Types of pelvic pain include:

  • Chronic Pelvic Pain: a non-menstrual pain of 6 or more months that is severe enough to cause functional disability or to require medical or surgical treatment
  • Dyspareunia: a pain in the absence of organic disease localized to the vagina or lower pelvis during intercourse
  • Vaginismus: the inability to penetrate the vagina due to over-activity of superficial or deep muscles
  • Vulvodynia: a condition with chronic vulvar discomfort or pain characterized by burning, stinging, irritation or rawness of the female genitilia/vulva
  • Prostatitis: a condition in men which can cause urinary and bowel symptoms, painful sexual intercourse, groin pain, low back pain, and/or penile pain.

Treatment for these symptoms and conditions include therapeutic exercise, relaxation training, manual therapy, patient education, psychological and social support, modalities, biofeedback and/or dilators.

Pregnancy induced pain

Woman on physio ball

50-70% of women experience some form of back, pelvic or hip pain during their pregnancy. This is due to an increase in hormones increasing joint laxity, a change of the body's center of gravity, an increase in body weight and altered posture. Common symptoms include, but are not limited to, low back pain, buttock pain, pelvic pressure and pain and radicular symptoms. Treatment for these symptoms may include manual therapy, therapeutic exercise, relaxation training, patient education, postural training and neuromuscular re-education.

These are only a few conditions that a pelvic health physical therapist can treat. If you have symptoms outside of these you can always speak with your physician or contact  our office to discuss if you would benefit from physical therapy.

What to expect at your first visit

At your first visit, our pelvic health physical therapist, Rachael Amos, DPT, who is trained in pelvic floor dysfunction will do a comprehensive evaluation. This may include questions about past medical history, the medical history of your current condition and questions about your eating, drinking and voiding habits. Rachael will examine your posture and hip/abdominal muscles to determine any tightness or weakness that could be  contributing to your condition. The muscles of your pelvic floor will be evaluated to determine any weakness, hyperactivity, hypertonicity or incoordination. This may include an external and internal examination of the  pelvic floor muscles. It is recommended that you wear comfortable/athletic attire.

Rachael looks forward to working with you to resolve or improve your symptoms to achieve a better quality of life. If you  would like to know more information about Pelvic Health physical therapy or if you have any further questions please contact Rachael at ramos@beantownphyio.com or contact our Brookline office at 617-232-7246 to schedule an evaluation.

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