Women’s Pelvic Floor Therapy

Sound Familiar?

Sally, in her mid-thirties loves crossfit which she has been passionate about since before the birth of her baby girl. She enjoys the workouts and meeting up with friends, but she does not like the urine leakage that occurs every time she squats and drops for a burpee. She is considering stopping her workout program due to amount of leakage.

Sally has Stress Urinary Incontinence which is the most common form of incontinence affecting 25% of women over the age of 18. Childbirth and trauma are the most common causes of stress incontinence and research shows that women will wait up to 6 years before seeking help. BODYCENTRAL Physical Therapy has the largest Women’s Health Practice in Tucson and our Doctors of Physical Therapy have taken specialized post-doctorate coursework incorporating surface electromyography, internal examination, and manual interventions to optimize pelvic floor functioning and regulate bladder control. Not only are our therapists effective with pelvic floor rehabilitation, but many are athletes participating in crossfit, high intensity interval training, and running just to name a few. Our team is passionate about your return to sport, social activity and jumping on the trampoline with your children in the back yard!

Michelle, a 65 year old, voids every 1-2 hours during the day. She knows where every bathroom is along the interstate and throughout the city. She gets the urge to urinate and often does not make it to the bathroom in time. She wears a large maxi-pad around her home and will often use a Depends if she goes out in public. Michelle wakes 2-3 times per night to go to the bathroom. She has looked forward to her retirement, but has postponed traveling and even socializing with friends due to her bladder controlling her life.

Michelle has an overactive bladder syndrome most commonly known as Urge Urinary Incontinence. About 17% of women in our nation have urge incontinence mostly affecting women 50 years of age or older. Less than half of these women will ever seek medical advice which is unfortunate because 60% of these women will experience depression. At BODYCENTRAL we have seen clinically that most women with Urge Incontinence have started with Stress Incontinence and it has progressed. We have thoroughly reviewed the research and along with extensive clinical experience, can implement a treatment program that can minimize and even eliminate the symptoms.

Jean, a 45 year old runner is experiencing low back and buttock pain which worsens when she sits for prolonged periods. She is unable to stand for long periods of time although initially standing gives her some relief. Her pain radiates down her right leg but stops at her knee. She cannot lie on her back at all and rolls side to side all night to sleep. She is looking forward to seeing her primary care physician next week.

Jean has a Sacroiliac Joint Dysfunction which is common in the female athlete and occurrence is certain after a pregnancy with a vaginal delivery. Due to the presence of leg pain this problem is most often mis-diagnosed and patients can go 10-20 years without proper treatment. Sacroiliac dysfunction most often presents with a pelvic floor dysfunction that is also not addressed with a general physical therapist. Seeing a Women’s Health Specialist is imperative to get a full orthopedic and pelvic health examination to gather all the information needed for a proper diagnosis.

Mary, a 39 year old mother of 3 and has had groin and buttock pain for 10 years since the birth of her first child. She has difficulty sitting and has sharp pain moving from sit to stand. Mary has struggled with constipation for many years and can even have an occasional sharp pain during a bowel movement. She has started having pain with intercourse and has experienced some depression due to lifestyle changes.

Mary has a very common pelvic pain syndrome which is aggravated by pelvic floor muscle spasms and tension. It is disturbing to know that 1 in 7 women between the ages of 18 and 50 suffer from chronic pelvic pain. The lifetime incidence of chronic pelvic pain is as high as 33%. The majority of patients are seen by gynecologists and family practitioners, and less than 1% utilize the resources of pain management or physical therapy. As many as 75% of women with chronic pelvic pain have not seen a healthcare provider for 3 months despite pain that affects their daily activities.

Some women will agree to a laparoscopy and even if pathology is found, it may not be the cause of the pain. With patients undergoing laparoscopy for chronic pelvic pain, only 1/3 have resolution of the pain with surgical treatment. Chronic pelvic pain accounts for 10-12% of all hysterectomies and unfortunately 22% of patients still have pain after their surgery.

Mary did not realize that during her second vaginal delivery she had a coccyx fracture which caused it to bend inward and put pressure along her rectal wall. The coccyx in a flexed position caused a shortening and tension of her pelvic floor. Due to the lack of mobility in her coccyx and sacrum, Mary was unable to tolerate sitting or transitional movements, and her bowel movements were limited due to distensibility restrictions of the coccyx. Mary underwent 3 laparoscopic surgeries and had a hysterectomy before coming to BODYCENTRAL. Mary’s pain and sitting intolerances were improved in 6 visits and Mary was discharged from physical therapy.

Susan, a 52 year old has noticed a sensation of sitting on a ball and pressure in her perineum when she is on her feet for 30 minutes or more. She has stopped wearing underwear and has stopped exercising as her doctor told her that the condition would only worsen. She is not a candidate for surgery at this time and she wonders if she is going to have to live with this for the rest of her life.

Susan has a pelvic organ prolapse which is common with vaginal deliveries that required extensive pushing during labor. A woman can also develop a prolapse from extensive jumping, running and bearing down to empty one’s bowel or bladder. Seeing a Women’s Health specialist, Susan could get her pelvic floor strength and endurance evaluated by surface electromyography (EMG) and be given a progressive strengthening program to affect the length tension relationship of the musculo-tendonous areas and improve support within her pelvis. Along with rehabilitating the pelvic floor, our Doctors of Physical Therapy are experts at core stabilization, reestablishing synergy between the pelvic floor and the 42 muscles that attach to the pelvis.

BODYCENTRAL Physical Therapy is passionate about Women’s Health Physical Therapy as one of its founders was the first Physical Therapist to practice as a Women’s Health specialist in the Tucson community. Saying that you treat Women’s Health is more than just treating a woman during or after a pregnancy for low back pain. Women’s Health is a comprehensive term that implies not only the orthopedic management of back pain but integrating pelvic floor evaluation and treatment. Women’s Health Physical Therapy is all inclusive approach to the body, using our expertise in biomechanics and knowing how dysfunction in one joint can affect several other surrounding areas. It is about finding the cause of the problem and not just treating the symptoms. Our team will treat your pain but discharge does not happen once the pain is resolved. Unfortunately with most physical therapy, there is concern about keeping the insurances happy instead of what is best for the patient. If the problem and return to function is not addressed, the pain will return. Specific, customized exercise programs are created for each and every patient to address their needs and diagnosis. Through regular testing, EMG and functional, a patient’s muscle balancing and endurance can be improved and patients can achieve a full resolution of pain.

Please give us the chance to resolve the following Medical Diagnoses:

Musculoskeletal:

Diastasis Recti

Coccyx Pain

Sacroiliac Pain

Migraine Headaches

Neck pain

Rib/Thoracic pain

Groin pain

Hip pain

Genitourinary:

Cystocele

Rectocele

Uterine Prolapse

Stress Incontinence

Urge Incontinence

Mixed Incontinence

Urinary Frequency

Urgency

Urinary Retention (Strain to empty bladder)

Bladder Suspension

Bladder Sling Placement

Pelvic Floor Reconstruction

Bladder Reconstruction

Interstitial Cystitis

Pregnancy:

Low back pain

Carpal tunnel

Foot Pain

Knee Pain

Hip Pain

Headaches

Neck Pain

Diastasis Recti

Groin pain

Coccyx pain

Incontinence

Constipation

Pain with Intercourse

Blocked Duct in the Breast

Colorectal:

Constipation

Fecal Incontinence

Irritable Bowel Syndrome

Colostomy

Hemorrhoidectomy

Bowel Reconstruction

Gynecological:

Ceasarian

Vaginal Delivery Tearing

Episiotomies

Endometriosis

Hysterectomy

Painful Intercourse

Inability to have an Orgasm

Painful periods

Menopause

Osteopenia

Osteoporosis

Oncology: Post-surgical Management

Breast Cancer

Uterine Cancer

Ovarian Cancer

Rectal Cancer

Bladder Cancer

Cancers in Abdominal Cavity

Mastectomy

Lymphedema

Breast Reconstruction