Tag Archives: women’s health

4 Common Pelvic Issues Seen by Physical Therapists

July 3, 2019 Teresa Stockton - Blog, Women's Health

Women’s bodies and their wellness are unique. Many factors cause problems specific to women’s bodies. Physical therapists specializing in women’s health can help female patients eliminate or manage pelvic pain or problems while restoring their quality of life. Using a comprehensive approach to evaluation and treatment, women’s health physical therapy programs can provide relief for these 4 common pelvic issues:

Pelvic floor pain or dysfunction
Pelvic organ prolapse (POP)
Postpartum recovery and or pain
Urinary incontinence

1. Pelvic Floor Pain or Dysfunction

Pelvic pain can occur for many reasons. One typical cause is what is called a hypertonus dysfunction or an unusual tightening of the pelvic floor muscles. This is common after a long delivery and scar tissue formation from a healing episiotomy. It can also occur from sexual abuse or when the muscles tighten to prevent the “falling out” sensation that occurs with the prolapse of the internal organs. The primary symptom is pain, but it can occur in the back, perivaginal area, lower abdomen, or thighs.

How physical therapy can help pelvic pain patients:

Physical therapy can help to eliminate or manage pelvic pain while restoring the quality of life. This is possible through a comprehensive approach to the evaluation and treatment of the pelvic floor.

2. Pelvic Organ Prolapse

According to the International Urogynecology Association (IUGA) and the International Continence Society (ICS), pelvic organ prolapse is defined as the descent of one or more of the anterior vaginal wall, the posterior vaginal wall, the uterus (cervix) or the apex of the vagina (vaginal vault or cuff after hysterectomy). POP can be caused by a variety of circumstances including vaginal childbirth, increased age and/or BMI, increased abdominal pressure, and connective tissue disorder. The symptoms of pelvic organ prolapse (POP) include:

Many women are asymptomatic
The sensation of pressure or heaviness in the vagina
Feeling of bulging or something coming out of the vagina
Urinary symptoms: incontinence, position change or manual reduction of prolapse needed to initiate or complete voiding, weak or prolonged stream, incomplete emptying, obstructed voiding symptoms
Bowel symptoms: incontinence, feeling of incomplete emptying, straining, digital evacuation, splinting of vagina or perineum to aid emptying
Sexual symptoms: decreased lubrication, sensation, arousal, or dyspareunia

How physical therapy can help pelvic organ prolapse patients:

Pelvic floor muscle training (recommended as the first line of treatment in stage 1-2 of pelvic organ prolapse)
Strength and endurance training of underactive pelvic floor
Stretching and relaxation of an overactive pelvic floor
Lifestyle modification to reduce the effect of increased abdominal pressure on the pelvic organ support system

In addition to physical therapy, other treatments for POP may include pharmacological treatment, the use of mechanical devices, and surgical intervention.

3. Post Partum Recovery and/or Pain

Birthing a baby is a joyful and yet very traumatic experience. Regardless of the method of delivery, whether VBAC or Cesarean Section, each birth comes with its own potential postpartum problems. From urinary incontinence to pelvic pain, there are just some things after childbirth that are not glamorous and can be embarrassing
to discuss.

While some issues will resolve over time, there may be treatments that can help. Pelvic health physical therapy can address diastasis recti (a tear in the
abdominal wall), urinary incontinence, low back/ pelvic girdle/hip pain, pain with intercourse, or scar pain to name a few postpartum unpleasantries that may benefit from physical therapy.

Potential postpartum problems that can be helped with physical therapy:

Urinary incontinence
Pain with intercourse
Pelvic floor pain
Scar pain
Diastasis recti
Pelvic organ prolapse
Difficulty returning to exercise

If you find yourself 6 weeks postpartum and still suffering, please discuss with your OB-GYN and decide if a referral to physical therapy may help.

4. Urinary Incontinence

Urinary incontinence can be embarrassing but it doesn’t have to be part of your life. Do you have to change pads every couple of hours? Do you worry
about going out because you need to know where the closest bathroom is? Do you always carry a change of clothes with you? Do you not travel or exercise because of fear of leakage? Don’t live in fear of urinary leakage.

Symptoms of Urinary Incontinence Include:

Involuntary loss of urine
Increased daytime/ nighttime frequency
Urgency
Post voiding retention
Straining to avoid dribble
Leakage with efforts like coughing or other activities.

How physical therapy can help urinary incontinence patients:

Behavioral interventions (urge suppression techniques, dietary modifications, appropriate fluid intake, weight loss, habit training)
Pelvic muscle re-training (for overactive) as well as underactive pelvic floor
Bladder training (bladder diary or scheduled voiding)
Neuromuscular re-education (NMES) and biofeedback devices

What to expect during a women’s health physical therapy session:

Each person will be individually evaluated and treated in a quiet, private, safe space. The initial evaluation may include an internal exam if the patient is comfortable in order to properly assess the patient’s musculature and symptoms.

Musculoskeletal assessment: An evaluation to identify causes of poor postural alignment, strength, flexibility and movement patterns which cause orthopedic pain Soft Tissue Mobilization – to release adhesional restrictions.
Observation and palpation of the pelvic floor to the patient’s comfort level
Stretching and strengthening techniques
Relaxation techniques
Soft tissue and joint mobilization
Modalities: Interferential electrical stimulation, ultrasound, heat or cold therapy.
Biofeedback: Provides measurable assessment of the pelvic floor muscles ability to contract and relax in function.
Behavior modification
Educational instruction: Home exercise programs and information concerning diet, sleep, work and rest positions and self-management of symptoms.

If you find yourself in need of women’s health physical therapy, talk to your doctor or physical therapist and see if physical therapy would be a good fit for your symptoms. To find a physical therapist near you visit our Find A PT page.

Contributions to this blog post were provided by Spring-Klein Physical Therapy (Spring, TX), Therapy Partners of North Texas (North Richland Hills), and STAR Physical Therapy (65 locations throughout TN)

What You Can Do About Diastis Recti (Abdominal Separation)

April 10, 2019 Teresa Stockton - Blog, Women's Health

There’s a lot to absorb when you become pregnant. You have a whole new person growing inside of you, and with that the excitement of what they’ll look like — and what kind of mother you’ll be — to this brand new human. And of course, there are a lot of physical changes that women undergo. From morning sickness to foods that seem unpalatable (or highly desirable), our bodies seem to have a mind of their own when pregnant. Along with gaining a healthy amount of weight and planning on what birth will look like for you, there’s also residual effects. One of them that can come with motherhood but can also affect other people is called diastasis recti (abdominal separation).

This condition occurs with the dramatic change in belly structure that happens when women become pregnant. The abdominal walls separate, leading the belly to stick out more. Who else does this affect and how can you deal with it? This graphic explains it.

“What is Diastasis? And What You Can Do About it” on Health Perch

Ask for Help.

If you are unsure of whether or not you have diastasis recti talk to your OB-GYN or physical therapist and ask them to evaluate your core. If you do have abdominal separation, a physical therapy program can give you all of the tools you need to bring the muscles back together.

Physical therapy programs for diastasis recti patients may include:

Core stabilization and postural strengthening
An abdominal brace to provide support and reduce pain
An exercise program designed to stretch overly tightened muscles
Education and training on how to lift and carry your baby as your abdomen recovers

Women’s Health: The Sacroilial (SI) Joint and How It Affects You

September 19, 2017 Teresa Stockton - Back, Blog, Women's Health

It has been estimated that about 95% of the population will experience low back pain at some point during a lifetime. Low back pain may be due to many different causes and anatomical structures, one such structure is the SI joint. Here is some pertinent information about the SI joint and how it may affect your general health.

8 FUN FACTS:

What is the SI joint?
It is a joint connecting the sacrum and the ilium, 2 bones included in the pelvis. The pelvis connects the upper body to the lower body, more specifically the spine to the hips.

What does the SI joint do?
It helps to stabilize your core during functional and work activities and helps with shock absorption during weight-bearing activities including walking. Stability is also assisted by the ligaments, fascia, and muscles that attach to the joint. This includes back, gluteal, hip, and pelvic floor musculature.

Who feels SI pain?
People with leg length discrepancies, asymmetrical lower extremity weakness, scoliosis, pregnant women due to increased ligamentous laxity, women > men due to pelvic anatomy, and those who have experienced a traumatic event such as a fall or a motor vehicle accident or that perform repetitive activities with poor body mechanics including lifting and bending.

Where would you feel SI pain?
Directly over the SI joint, in the buttock, lateral or posterior thigh, or sometimes in the groin.

When may you feel SI pain?
Rolling in bed, rotating your trunk, walking, stair ascent or descent, standing from a sitting position, single leg activities

What positions/activities should be adopted?
Sleep with a pillow between your lower extremities, perform slow, controlled movements, maintain equal weight-bearing through lower extremities with transitional movements and standing, log roll during bed mobility to keep lower extremities symmetrical, swing lower extremities out of the car before standing up to prevent trunk rotation.

How can PT help?
Physical therapy has been found to help patients with SI pain get pain relief, reduce inflammation and muscle spasms, improve healing, muscle extensibility, joint mobility and range of motion, strength, muscle control, and gait mechanics.

What does PT treatment for SI pain involve?
Stretching, mobilization techniques, education on proper body mechanics with functional activities, massage, myofascial release, modalities including electrical stimulation for pain modulation and ultrasound to assist with healing and inflammation, muscle energy techniques, and a core stabilization and strengthening exercise program, tailored to the individual patient. If a leg length discrepancy is found, a heel lift may be helpful to restore abnormal forces being placed through the SI joint with weight-bearing activities. An initiation of a home exercise program is also an integral part of physical therapy treatment.

The Benefits of Physical Therapy for Women’s Health

April 18, 2017 Teresa Stockton - Blog, Women's Health

Women’s health can cover a multitude of subjects, from pregnancy to aging – the female body undergoes many changes. Physical therapists’ most common women’s health clients come in experiencing incontinence, osteoporosis, and pregnancy-related back pain.

URINARY INCONTINENCE
Urinary incontinence is a loss of bladder control that results in leakage when the muscles of the pelvic floor are weak or overactive. Causes include childbirth, hormonal changes, surgical trauma, pelvic fractures, chronic cough, obesity, muscle weakness, or even repetitive lifting. Physical therapy can help decrease or resolve urinary leakage, identify bladder irritants and strengthen pelvic floor muscles through an individualized exercise program.

OSTEOPOROSIS
Keeping the bones strong as you age, especially after menopause, is a challenge many women face. An excessive decline in bone mass is called osteoporosis, and it is a leading healthcare concern for women. A physical therapy program can help improve your posture and strength, prevent falls, and decrease your risk for fractures.

A physical therapist that specializes in women’s health and treating pelvic floor dysfunction can help as well.

PELVIC FLOOR DYSFUNCTION
Exhibits Several Symptoms:

Urinary Incontinence
Fecal Incontinence
Constipation
Diarrhea
Pelvic Floor Pain

PREGNANCY-RELATED BACK PAIN
Many women experience low back pain during pregnancy. This is due to several factors such as:

Hormonal Changes – this causes increased looseness of the pelvic ligaments to prepare your body for birthing your baby.
Increased Weight Gain – This places increased stress on all the joints of the body. Increased breast weight can overload
the neck and upper back.
Postural Changes – Body weight shifts forward as the baby grows and this increases the arch in the lower back. Stomach
muscles and the lower pelvic muscles become weaker which decreases support for the lower back.
Altered Movement Patterns – Due to your changing body, women often begin to move in different patterns that can increase stress to the low back or pelvic joints.

This information was written by Advance Rehabilitation Physical Therapy, an outpatient physical therapy group with 24 locations in Georgia and Florida. Advance Rehabilitation is a physical therapy practice that focuses on providing the highest quality rehabilitation services. We specialize in physical therapy, sports medicine, industrial rehabilitation and athletic training. Our staff includes highly-trained professionals that serve as a bridge between injury and recovery to help patients get back to pre-injury status as quickly as possible. For more information click here.

Exercise Associated with Healthy Baby Weight

August 4, 2015 contentadmin - Blog

ThinkstockPhotos-494389715

Prenatal care can increase health benefits for both mother and baby as well as reduce the risk of certain complications. It not only includes seeking medical care but also adopting certain lifestyle habits. Good nutrition and regular physical activity have both been linked to a number of benefits including a healthy birth-weight for babies.

Researchers from Canada wanted to estimate the influence of structured prenatal exercise on birth weight. A secondary assessment was done on the rate of cesarean since one reason for cesarean is a larger than normal fetus. The study, published in The Cochrane Database of Systematic Reviews, found that that structured prenatal exercise reduces the risk of having a large newborn without increasing the risk of low birth weight babies. Exercise was also associated with a lower risk of cesarean section.

About the Study
The meta-analysis included 28 randomized trials evaluating exercise interventions in 5,322 pregnancies for which birth size information was available. Participants were assigned to a standard prenatal care group or a standard prenatal care group plus supervised prenatal exercise group of at least 1 exercise session every 2 weeks throughout the study duration.

Participants who were in the prenatal exercise group were:

31% less likely to have a large newborn (birth weight of 8.8 pounds)
20% less likely to need cesarean section
no more likely to have a low birth weight baby than those without exercise program

The mothers that participated in the regular exercise program also gained less weight than those in the group that did not receive the exercise intervention.

Information provided by the EBSCO Health Library

Low Back Pain in Pregnancy?

March 3, 2015 contentadmin - Blog, Women's Health

Pregnancy and new motherhood should be times of joy and promise – not pain. Fortunately, times have changed, you don’t have to live with pain or other problems related to pregnancy or delivery. That’s because physical therapy has changed too. It is no longer solely for joint problems; it’s also a safe, proven and widely prescribed treatment for pregnant women and new mothers.

Physical Therapy can help you manage your low back pain in pregnancy safely!
Many women experience low back pain during pregnancy. This is due to several factors such as:

Hormonal Changes – this causes increased looseness of the pelvic ligaments to prepare your body for birthing your baby.
Increased Weight Gain – This places increased stress on all the joints of the body. Increased breast weight can overload the neck and upper back.
Postural Changes – Body weight shifts forward as the baby grows and this increases the arch in the lower back. Stomach muscles and the lower pelvic muscles become weaker which decreases support for the lower back.
Altered Movement Patterns – Due to your changing body, women often begin to move in different patterns that can increase stress to the low back or pelvic joints.

A physical therapy evaluation will include an assessment of:

Pelvic/Sacro-iliac joints
Abdominal Musculature
Spinal Alignment
Strength/Flexibility
Posture
Body Mechanics

Treatment objectives are to:

Reduce Pain
Promote improved posture
Education re: safe movement patterns
Teach proper exercises for strengthening and flexibility and guidance toward cardiovascular fitness

The physical therapist may also plan a specialized exercise program for a pregnant or postpartum patient.
The goals and benefits of exercise for pregnant women include:

Promotes good posture
Increases or maintains aerobic fitness
Improves muscle tone
Improves sleep
Prevents low back pain
Reduces the risk of gestational diabetes
Improved physiological and psychological health
Prepares mom for labor and delivery

The goals of an exercise program for new moms (postpartum patients) are.

Faster recovery from labor and delivery
Increased endurance for taking care of self and baby

If you are experiencing low back pain in pregnancy please check out our Find A PT Page to find a women’s health specialist in your area.