The best pelvic floor physical therapy care for all persons.

 

What is Pelvic Floor Dysfunction?

 

Pelvic floor dysfunction (PFD) refers to conditions which involve the pelvic floor muscles (muscles which surround the vagina and rectum) when they do not function “normally”.

This may be seen as laxity and low tone in the muscles and surrounding tissues or spasming and increased tone in the muscles. Symptoms may include pelvic pain, urinary and/or bowel dysfunction (incontinence, urgency, frequency, nocturia) and sexual dysfunction (painful intercourse, painful ejaculation, etc).

Pelvic Pain
Persistence of unexplained pain in the lower abdominal and pelvic region without evidence of active disease.
Vestibulodynia/Vulvodynia/Vulvar Vestibulitis
Chronic vulvar discomfort or pain, characterized by burning, stinging, irritation or rawness of the female genitalia in cases in which there is no infection or skin disease of the vulva or vagina causing these symptoms. Burning sensations are the most common, but the type and severity of symptoms are highly individualized. Pain may be constant or intermittent, localized or diffuse.
Interstitial Cystitis
Chronic inflammatory condition of the bladder. Symptoms may include urinary frequency, urgency and pain.
Vaginismus
Involuntary tightness of the vagina during attempted intercourse, which may be caused by involuntary contractions of the pelvic floor. Maybe associated with impossible penetration, burning/stinging with tightness during sex, difficulty inserting tampons or undergoing pelvic examination.
Dyspareunia
Painful sexual intercourse
Pudendal Neuralgia
Painful neuropathic condition that is caused by inflammation of the pudendal nerve.
Incontinence
Involuntary loss of urine or feces that is sufficient to be a problem.
– Stress Urinary Incontinence
– Urge Incontinence
– Mixed Incontinence
– Fecal Incontinence
Obstetrical Dysfunction/Pre-Natal Care
Women are prone to pain or ache in the back, shoulder, rib cage, wrists, and ankles. Changes may occur in their posture and balance. Post-partum women need strengthening and endurance programs.
Postpartum Care

Postpartum pain and symptoms are rarely discussed, but do need to be addressed. Such symptoms as Diastasis Rectus Abdominis, Urinary Incontinence, Sacro-Iliac Joint pain, Lumbar (low) back or Thoracic (mid back) pain, abdominal pain or weakness, post C-section, posture, etc.

Prolapse
A condition where an organ such as the uterus, bladder or rectum, falls out. Common complaints are feeling of pressure or heaviness, low back pain, sensation of something coming out of the vagina.
Pre and Post Pelvic/Abdominal Surgery

Hysterectomy, laparoscopy, C-section, TVT, Prolapse repair, Sling procedure, Prostatectomy, Endometriosis Excision surgery, Colon surgeries, etc.

Coccydynia
Coccyx or tailbone pain.
Constipation
Infrequent or hard to pass bowel movements.
Post Prostatectomy
 

Men often deal with urinary symptoms such as incontinence and erectile dysfunction after their surgery.

 

Pediatric
 

Children may be dealing with Enuresis (bedwetting), constipation and pelvic pain.

Treatment 

 

  • Manual Therapy: Soft tissue mobilization, Myofascial Release, Trigger Point release, Visceral Mobilization, Joint Mobilization
  • Neuromuscular re-education: coordination, awareness, proprioception, graded exposure, polyvagal exercises
  • Therapeutic exercise: strengthening, stretching, movement, return to sport/activity, lifting
  • Patient education and coaching
  • Posture, lifting techniques and biomechanics
  • Biofeedback/SEMG, Rectal Balloon