Pelvic Floor Health

At Touch of Life Physical Therapy we recognize that at some point in a woman’s life she will have special health needs. As many as 10 million American women will develop incontinence¹ and 50% of women will develop organ prolapse². We want women in our community to know they are not alone. Research has shown that pelvic floor therapy can reduce incontinence symptoms by as much as 98%³, and reduce pelvic pain dramatically⁴, ⁵.

Physical therapy and exercise can also help reduce the pains associated with pregnancy⁶. Our women’s health program addresses many of the health concerns that face women: incontinence, pelvic/vaginal pain, prenatal and postpartum pain, osteoporosis, fibromyalgia, wellness and exercise training. Our therapists use every facet of their physical therapy training to evaluate and treat our female patients promoting and enhancing health throughout the lifespan. We offer individualized attention. Each treatment is designed specifically for you after thorough evaluation, and you will be treated by your physical therapist from beginning to end of treatment.

We understand that pelvic dysfunction is a sensitive issue, but it is important to remember that most pelvic disorders can be treated conservatively. Our goal is to give you the most effective combination of treatments to address your specific needs while ensuring your comfort.

Our program offers multiple strategies to help you heal from a variety of conditions including:

Fibromyalgia
Fibromyalgia is a syndrome described by patients as widespread aching, burning, stabbing or throbbing in the muscles throughout the body. Patients who suffer with fibromyalgia tend to experience headaches, irritable bowel syndrome, intense pelvic pain, temporomandibular joint disorder (TMJD), sleep disturbance and chronic fatigue. It often hurts to be touched. In addition to typical manual therapy techniques, we use a treatment technique called Reflex Relaxation Technique. It is a gently treatment used to help quiet the pain and relax the body through light touch in specific patterns. Many of our patients have found relief with this technique in conjunction with other manual therapy treatment.

Incontinence
Incontinence is the inability to stop the flow of urine. Many women refer to it as “leaking.” Incontinence affects up to 10 million women in the US and not only the elderly. It is a common, TREATABLE, condition. IT IS NOT A NORMAL PART OF AGING! Incontinence varies in its severity and causes. Typically, weakened pelvic floor muscles are involved. Surgery, pregnancy and childbirth, infection, chronic constipation, repeated high impact activities, obesity and menopause can weaken these muscles. Pelvic Floor Muscle strengthening and re-education has been shown to reduce or eliminate these symptoms in 98% of people suffering with incontinence.

Interstitial Cystitis (IC) and Over Active Bladder (OAB)
Over Active Bladder and Interstitial Cystitis can be caused by an irritated bladder. “Over active” pelvic floor muscles, neurogenic dysfunction, and dietary irritants can result in urge symptoms and an over active pelvic floor. This dysfunction can result in urge incontinence or chronic pain. Often IC and OAB can be effectively treated with bladder retraining and diet modification.

Osteoporosis
Osteoporosis is the loss of bone density and strength. Approximately 30% of menopausal women have been diagnosed with osteoporosis¹ and 54% have been diagnosed with osteopeneia¹. Osteopenia is the precursor to Osteoporosis. It simply means you have begun to lose bone density. Exercise has been shown to improve bone strength. At Touch of Life Physical Therapy we will work with you to help develop a safe exercise program that will help you regain your strength and help prevent injury.

Pelvic Pain
Women experience pelvic pain in a variety of ways. Some women experience painful menstruation (dysmenorrhea), vaginal spasms (vaginismus), painful sex (dyspareunia), irritable bowel syndrome, chronic diffuse pelvic or vaginal pain (vulvodynia), or tailbone pain (coccygodynia). Often the pain is a result of muscular spasm related to childbirth or other trauma/injury. Menopause can also cause a thinning of the lining of the vagina which can lead to pain and discomfort. Physical therapy treatments including myofascial release techniques, trigger point release, biofeedback and relaxation techniques can be used to effectively treat these conditions. We want you to know there is no need to endure a chronic pain condition which decreases the quality of your life.

Pudendal Nerve Entrapment/Pudendal Neuralgia
Pudendal Neuralgia is a painful condition typically causing burning and itching. It is a compression injury (entrapment) of the pudendal nerve. Our therapists can help alleviate this pain by performing manual therapy techniques on the pelvic ligaments and muscles that compress this nerve. Home exercises are then given, to maintain the space around created around the nerve.

Pregnancy Related Pain
During pregnancy women can experience postural, hormonal, and physical changes that can lead to new pains or worsen existing conditions. Common areas of pain include the upper and lower back, buttocks, tailbone, and groin. Symptoms often radiate down one or both legs, a condition called sciatica. Through individual evaluation and treatment our physical therapists can effectively provide manual techniques to decrease pain and create safe strength and conditioning programs. Your therapist can work with you to supply the correct support belts as needed. Our goal is to help you gain strength and stability to prepare you to hold, carry and play with your child.

Post-Partum Care
After delivery, many women find their bodies in a weakened state from episiotomy and tearing, c-sections, or as a result of a difficult pregnancy. About 30% of women will have developed a condition during pregnancy called rectus diastasis, a separation of the abdominal muscles. This happens when the abdominal muscles have reached their maximum capacity to stretch. Research has shown that women who receive physical therapy for this condition ultimately have a better resolution of the diastasis than women who do not receive therapy.⁷ After delivery some women will develop scar tissue as a result of a c-section or episiotomy.⁸ As with any scar tissue, our manual therapy program can normalize soft tissue. Our post-partum care program also includes safely beginning or restoring your exercise routine.

1. APTA
2. Hagen S, et al. Conservative management of pelvic organ prolapse in women. Cochrane Database Sys Rev. 2005;4CD003882.
3. Miller JM, Ashton-Miller JA, Delancey JO. A pelvic muscle pre-contraction can reduce cough-related urine loss in selected women with mild SUI. J Am Geriatr Soc. 1998;46:870-874.
4. Anderson, R. Wise, D. A Headache in the Pelvis. National Center for Pelvic Pain Research Publishing, 2011
5. Bo K. Adherence to pelvic floor muscle exercise and long-term effect on stress urinary incontinence; a five year follow up. Scan J Sci Sports. 1995;5:36-39.
6. Journal of Women’s Health Physical Therapy Volume 36, No. 2, May/August 20
7. Journal of Women’s Health Physical Therapy Volume 29, No. 1, Spring, 2005
8. National Perinatal Center for Information: Quality Analytic Services V09.3 Special Analysis: Incidence of Episiotomy

At Touch of Life Physical Therapy we understand that pelvic health is a complex and sensitive issue. It affects both genders, and all ethnicities. Research has shown that 50% of men will develop chronic pelvic pain syndrome/prostatitis at some point in their lifetime.¹ Physical therapy for pelvic pain has been shown to dramatically reduce pelvic pain for good, and improve sexual dysfunction by almost 90%.¹,² Our therapists will use every facet of their training.

Our program offers multiple strategies to help you heal from a variety of conditions including:

Benign Prostatic Hypertrophy
BPH is a non-cancerous enlargement of the prostate. When the prostate becomes enlarged it can cause a plethora of problems including compression of the urethra and can slow or stop the passage of urine. ¹,³ Our goal is to create space around the prostate using manual therapy techniques to allow for the passage of urine and decrease pain.

Erectile and Ejaculatory Dysfunction
Erectile and Ejaculatory Dysfunction can arise when the prostate becomes enlarged and impedes the flow of blood to the penis, or irritates surrounding nerve tissue. Problems can also arise after surgery when inflammation impedes nerve conduction. Our goal is to determine the primary cause of dysfunction after a thorough evaluation. Rather by increasing space around the prostate, decreasing inflammation or increasing pelvic mobility our goal is to eliminate pain and decrease dysfunction.

Incontinence
Incontinence is the inability to stop the flow of urine. Although less common in men than women, it is a very real problem Typically it occurs after an injury or surgical insult. Our therapists will perform an evaluation to determine how to direct treatment. Treatment may include manual therapy techniques to the pelvis, spine or bladder. They may also include a pelvic floor strengthening or stretching program.

Pelvic Pain and Prostatitis
Prostatitis has two forms: Acute and Chronic.

Acute pain is treated by your physician and should never receive manual therapy.¹,³ Its symptom include genital pain and burning, fatigue, and a fever of typically 102°-104°.¹,³ Chronic Prostatitis is an ideal candidate for manual therapy. Symptoms are similar to acute prostatitis but present with no fever, and slowly build over a period of time.

Chronic Prostatitis symptoms also include pain with urination, penile, ejaculatory and anal pain. Our goal is to use manual therapy techniques to alleviate pain and increase mobility of the pelvis and prostate. Trigger point release and myofascial release of the pelvic floor are often helpful modalities.

“You can think of muscle-based pelvic pain as a chronic spasm or Charlie horse in the pelvic floor fed by tension, pain, anxiety and protective guarding.”¹ Pelvic pain can be caused by a direct trauma to the pelvis or it can have an insidious onset and develop over time. Our therapists will take a thorough history and perform an evaluation to help determine contributing factors to your pain. Modalities such as manual therapy, biofeedback and ultrasound can help to alleviate chronic and acute pelvic pain.

Rectal Pain
Rectal pain can be caused by an insult to the rectum, surgery, infections of the pelvis or prostatitis. Our program goal is to help you identify factors contributing the pain, and eliminate sources of dysfunction.

1. Anderson, Rodney. Wise, David. A Headache in the Pelvis. National Center for Pelvic Pain Research Publishing, 2011
2. Bo 1995
3. Barral, Jean-Pierre. Manual Therapy for the Prostate. North Atlantic Books, 2010