Pelvic Physical Therapy

Urinary Incontinence

Both men and women suffer from urinary incontinence.  There are a variety of reasons that it may start to occur.  It can be  due to having/delivering children, surgeries, aging muscles and tissues, back injuries, prostatitis, or functional limitations.  It is a very common issue that affects people across their lifespan.  It is very important that someone has a full physical therapy examination to determine what objective issues are leading to their incontinence.  At Method Physical Therapy, we make it our mission to get to root of the issue and get our patient’s back to their previous quality of life.  Whether that is jumping on a trampoline again, decreasing the need for urinary incontinence pads, or not needing to look for the bathroom at every new place you go; we are here to help.  

Fecal Incontinence

This is the inability for someone to hold stool.  This can be on a range of leaking a bit of stool while passing gas, to complete loss of one’s bowels.  This can be an embarrassing issue that people do not feel comfortable talking about with their family or medical providers.  However, there are many different options available to help improve this condition.  There are different reasons that this fecal incontinence can start - ranging from diet to cancer treatments/radiation, to muscular weakness.  Pelvic floor physical therapy helps address these issues to improve their patients quality of life.

Pelvic Organ Prolapse

This happens predominately to women, and will be seen in about 30% of women.  Pelvic organ prolapse is when the ligaments and tissue that support our pelvic organs lengthen, and the organ starts to push down onto the pelvic floor, creating a pressure sensation or a physical bulge through the vaginal opening.  This most commonly happens to the bladder, uterus, or rectum.  There are some things that may increase the chances of this occurring:  long stages of pushing during childbirth, history of constipation, age and hormonal changes, conditions that cause ligamentous laxity, and genetic components.  Most women are very alarmed when they first start to notice the symptoms of POP, and rush into their doctors office to be dismissed or told that they need surgery.  However, they should first try physical therapy to address their symptoms.  The research has found that Pelvic Floor Physical Therapy is very successful in improving symptoms and quality of life, and can help avoid surgery.  The surgical options available usually have a 5-10 year life span; and do not guarantee improvements.  Therefore, we always encourage patients to research to try the more conservative treatment options prior to trying surgery.  

Pelvic Pain

Pelvic pain affects men and women, alike.  It often is described as a “headache in the pelvis”.  It can present as a dull ache, shooting nerve pain, inability to sit, wear tight clothing, have sexual intercourse, or painful urination or bowel movements.  There is often a physical explanation for why someone may be experiencing these symptoms.  However, this patient population is often told that it is in their head; and can take a long time before they find a medical provider that truly believes them.  Method Physical Therapy loves working with this patient population, and getting down to the root physical issues that are causing these symptoms.  

Painful Intercourse

The medical term for this is:  Dyspareunia.  Women who suffer from painful interourse are often told that this is in their head; however, there is usually a physical reason the great majority of the time.  Sometimes the pelvic floor muscles are stuck in hypertonic state, meaning that they do not know how to lengthen appropriately during intercourse.  Or there can be scar tissue after having a baby or pelvic surgery, and the muscles can no longer stretch.  Sometimes there can be too many nerve endings at the entrance of the vagina, that cause extreme pain with pressure.  Or sometimes it is due to hormonal imbalances that cause the muscles to atrophy.  Whatever the reason, never let someone tell you that it is in your head.  See a pelvic physical therapist who can do a full physical exam and help you address your issues and help return you to full sexual health.

Vulvodynia

Chronic pain around the entrance of the vagina.  This can present with a burning sensation with or without physical pressure.  Often times, women with severe vulvodynia cannot wear any compressive clothing, have trouble sitting, and have pain with intercourse.  Some advise for this patient population is: wear loose clothing, always wear 100% cotton underwear, only use unscented and “clean” products while bathing, and use special pelvic floor cushions while sitting (link in our resource page).  Again, pelvic floor physical therapy is always suggested for this population, to help assess why this is happening and improve function and pain. 

Endometriosis

This is a condition where the endometrium grows outside of the uterus, and it is most commonly found on the ovaries, fallopian tubes, and lining of the pelvis.  The endometrial tissue thickens, breaks down, and bleeds each menstrual cycle.  This tissue then gets trapped in the pelvic cavity, which creates inflammation, and leads to growth of adhesions and scar tissues.  This can lead to the pelvic organs adhering together, and infiltration into the muscles and nerves - leading to dysfunction and pain.  On average, it takes women 8 years to be diagnosed with, and is a leading cause of infertility.  Pelvic Floor PT’s have a long history of working with these women, and love advocating for them in the medical community.  We will always believe your symptoms and do everything in our power to get you the medical care you deserve.  We assist with symptom management, and pre or post surgical rehab, should it be needed.  (See blog post)

Polycystic Ovary Syndrome

PCOS is a condition in which the ovaries over produce the male sex hormone: androgen.  The ovaries may develop an abundance of fluid filled sacs, and may not consistently be able to release eggs.  Symptoms can include: long heavy periods, or infrequent periods, severe acne, excess facial/body hair, and pelvic floor dysfunction.  While PCOS cannot be cured, pelvic floor physical therapy has been found to significantly decrease the symptoms of dysfunction that oftentimes accompany this disease.  As well, improving physical health has been shown to improve menstrual irregularities and the ovaries ability to ovulate. 

Lichen Sclerosus

LS is an auto immune disease that presents itself with painful white,  patchy skin around the opening of the vagina and anus.  It appears as very thin/fragile skin that is prone to tearing and scarring.  This should never be left untreated, because it can lead to serious sexual and urinary dysfunction.  Physical therapists work with one’s medical provider to treat this disease; in that it usually requires different steroid prescriptions to help manage the inflammation; while PT will provide services to help break up scar tissue and re-educate movement to this tissue. 

Post Menopausal Atrophic Vaginitis

As women age and go through menapause, they lose estrogen.  Estrogen is the hormone that keeps our pelvic tissue plump and hydrated.  For 40% of women, as they lose estrogen, their pelvic floor muscles get thinner and lose the ability to stretch.  This can make intercourse very painful, and/or lead to a burning sensation at the entrance of the vagina.  Treatment options generally can include hormone therapies, in conjunction with physical therapy.  PFPT will help re-educate the muscles how to stretch and lengthen again; so that these women can return back to their previous quality of life. 

Contact us to schedule an evaluation.