Pelvic Health & Orthopedic Physical Therapy
Addressing your questions about pelvic, women's, and musculoskeletal health. Health is a journey. Movement is healing!
Mother's Day marked the beginning of Women's Health week. What are some things you can be doing to ensure you are up to par with your health as a woman?
Chronic pain can be life altering. It is complex in nature with multiple variables and subtleties that contribute to it. Pain can be difficult to treat and manage. Women's health related pain conditions may require a myriad of Physical Therapy, medication, counseling, changes to diet, and other treatments.
There are a number of conditions that can cause pelvic pain. Here is a list of just a few examples:
A women's health PT can help you to manage pain related to many of these conditions. They can help to address the restrictions to the structures of the anatomy, educate you on self stretching, oscillatory exercises, massage, and techniques to properly engage your pelvic floor (just to name a few things). A women's health PT will help guide you through how to properly modulate your pain and give you techniques so that YOU are in control of your body. Sometimes the most frustrating part is finding the right practitioner to diagnose your pain or refer you to women's health PT if your state requires a referral to visit a PT. It can at times be an isolating experience for a patient if they feel their experience of pain is not being taken serious or properly addressed. Please rest assured that you are not alone. Many individuals experience pelvic pain, however, that does not normalize the pain. Pelvic pain is not a normal experience with urination, bowel movements, intercourse, sitting, exercise, using feminine hygiene products, or wearing pants. You should seek treatment. Just because you are a woman does not mean you have to grin and bear pelvic pain. I encourage you to utilize the Section on Women's Health PT Locator to find a PT near you if you are experiencing pelvic pain symptoms. They can help get you connected with the appropriate resources or schedule you for an evaluation.
http://www.womenshealthapta.org/pt-locator/
I've been reflecting a lot on transitions lately. With graduation quickly approaching (it's only TWENTY days away) there are a lot of exciting opportunities on the horizon. It also has me thinking on other transitions in life for people. One really big transition for the human body is giving birth, preparing to give birth, and then recovering from the birth process.
Your body goes through a lot of changes in order to prepare for birth. It produces a variety of hormones one of which is relaxin, a hormone that increases the laxity in your ligaments throughout your body. By increasing the laxity of your ligaments, your body makes it easier for the baby to pass through the pelvis, it can also alter the alignment of your sacroiliac joint. As the baby grows it changes your center of gravity. Essentially you are now carrying this growing basketball in the front of your abdomen as your baby grows it changes the way that forces are transmitted through your spine because it changes your posture in sitting, standing, and walking. This change in position and force in the spine can lead to back pain. As the baby grows it also changes the pressure on your abdominal and pelvic floor musculature as well as your bladder, it is constantly stretching these structures in order to make room. This can contribute to urinary frequency and urgency. Overall, your body is preparing to make space for your baby. A Women's Health Physical Therapist can help you to manage different musculoskeletal pain that arises during pregnancy as well as helping you to prepare for the birth of your child. Following childbirth those muscles and structures that were changed during pregnancy and the birthing process require time for rehabilitation. A Women's Health Physical Therapist can help to facilitate this process and return you to your baseline. Childbirth is a leading cause in developing urinary incontinence issues down the road so properly rehabilitating your pelvic floor as well as your back, hips, and abdomen following birth can be important in preventing symptoms of urinary frequency, urgency, and leakage. Yesterday I attended a course on physical therapy intervention with individuals who have survived urogenital and breast cancers. I continue to be amazed at the under utilization of pelvic rehabilitation by our medical system. A large portion of our population is aging. Age contributes to the risk of developing many types of cancer. As the baby boomer generation continues to age the number of individuals will continue to grow. Fortunately advances in medicine are improving the effectiveness of cancer treatments and increasing survivorship. The question for many physical therapists, especially women's health physical therapists, is when in this process of survivorship is it best to educate individuals on the availability of services?
While cancer treatment can be tailored to a specific region, the treatment can still have acute and chronic systemic effects. Chemotherapy can lead to pain, fatigue, as well as changes in bowel, bladder, and sexual function. Radiation can cause an individual to experience bladder changes, difficulties with the bowels, fibrosis of tissue, lymphedema, joint pain, fatigue, and difficulties with sexual function. (These are not exhaustive lists of the side effects of these types of treatments, just a few relevant to pelvic health.) There is evidence that physical therapy prior to treatment for cancer can play a beneficial role in post-treatment outcomes. Individuals that start improving physical shape before treatment often heal better. However, many insurance providers do not currently support "prehab". So the other options, target the individuals during or after treatment? There just doesn't seem to be a good time to address everything a survivor of cancer may face following treatment. Many individuals report feeling overwhelmed throughout the duration of treatment, which is understandable. Of course feeling constant diarrhea or bladder leakage or even changes in sexual function wouldn't necessarily be in the forefront of an individual's mind during treatment. These people are fighting to survive, which takes precedence. But then once they are discharged from cancer treatment, their needs beyond surviving cancer may fall between the cracks.They may even feel like they are the only one experiencing these symptoms or that there are no treatment options to help gain control of bowel, bladder, and sexual function. It is important to advocate and educate on pelvic health offerings along with other physical therapy services to help improve the quality of life. Regardless if you treat pelvic floor specifically, you will most likely have a cancer survivor as a patient and it is crucial to ask pertinent questions related to bladder, bowel, and sexual function in order to connect patients with appropriate resources. So my next clinical experience is in outpatient orthopedics and pelvic floor therapy (sometimes referred to as "Women's Health"). I don't think many people realize that there are Physical Therapists who are qualified to treat pelvic disorders. I'll save the reasons for my interest in learning more about this field of therapy for a different blog post. Instead let me tell you more about my past weekend. Last weekend I attended the SOWH's Pelvic Floor Physical Therapy Level I class in St. Louis. I did not know what to fully expect and while I was excited for the course, I was extremely apprehensive for the lab portions. What I did not expect was for my fears to be assuaged so quickly and to feel so empowered from the action-packed three day course. We really hit the ground running. Physical therapy is a broad field. One component of the body people are often uncomfortable confronting is the pelvis. In our culture it seems taboo to bring up disorders related to the pelvic region, but let me let you in on a little secret....everybody has a pelvis. That pelvic region is made up of many bones, nerves, arteries, veins, lymphatics, organs, ligaments, and muscles that serve very important roles. The pelvis region helps to transmit forces for the legs to spine or vice versa, the pelvic musculature/bones/ligaments offer a bowl like support to all organs, the musculature of the pelvic floor can alter your ability to appropriately excrete waste. The bony pelvis and the musculature that makes up this pelvic floor is a keystone to our anatomy, serving many important purposes, yet we oftentimes ignore the treatment of this area because we don't fully understand it or it is uncomfortable to treat. Let's embrace this crucial part of our anatomy. Personally, I think that people are oftentimes apprehensive about seeking treatment for pelvic issues. Pelvic Floor or Women's Health Physical Therapists are specially trained to deal with incontinence, organ prolapse, pelvic pain, and constipation, just to name a few of the common diagnoses. And while it may be a bit misleading Women's Health Physical Therapists oftentimes also take male patients and children with pelvic floor issues. Women's Health therapists may actually treat a lot of different types of patients and diagnosis (not just related to the pelvis) including patients with breast cancer, patients before or after having a child, patients with fibromyalgia, patients requiring lymphedema management...the list really does go on and on. You might be thinking, I already know how to do Kegel (pronounced like kay-gal) exercises, I don't need to see anyone about that. Kegel exercises are important to the integrity and control of the pelvic floor musculature. If you are having pelvic floor related issues, it would be of benefit to have a PT ensure you are doing your Kegel exercises correctly (that you have the right form, you have enough power with the contraction, can properly perform this exercise as an endurance exercise). Beyond that there is so much more to rehabbing these individuals than just prescribing Kegel exercises. It really is just the tip of the proverbial iceberg. Issues in your pelvic floor musculature could be a result of postural abnormalities or muscular imbalances in other areas of the body that are manifesting as pelvic symptoms because they altered the integrity of the pelvic floor. Depending on the symptoms/ diagnosis there are hormonal and behavioral interventions that must be addressed in order to properly rehabilitate the pelvic floor musculature. There are many considerations for appropriate treatment. Bottom line, as a student in Physical Therapy school I really appreciated the continuing education course. I thought it was a great way to learn more about a subject we learn very little about in school. It was a fantastic way to prepare for my upcoming clinical and gain new clinical skills. It also allowed me to network with other PT students and many practicing PTs. This class made me excited to attend more courses, especially those pertaining to Women's Health. |
AuthorHello! I am Caitlyn, Doctor of Physical Therapy and Board Certified Women's Health Physical Therapist working in St Louis, Missouri. Faculty in developing residency program. Endowarrior Categories
All
Archives
July 2021
|