When Is Therapy Needed?
A woman undergoes and endures several wonderful and challenging physiological changes throughout her journey of life. Pelvic Floor Muscle Dysfunction can occur when pelvic joints including the pubic symphysis, sacroiliac joints, and hip joints are not working in harmony. This often results in restricted soft tissues and weak muscles as well as damaged nerves. Impairments of the sacroiliac joint, low back, coccyx and/or hip joint can contribute to pain and loss of function. The result is often a short term or chronic pain state leading to physical therapy.
Continence and pelvic floor physical therapy pertains to disorders and dysfunctions of the bladder, bowel, and the pelvic floor muscle as well as the accessory muscles above, below, and around the pelvic floor muscle. Common conditions evaluated and treated by a Continence and Pelvic Floor Specialist Physical Therapist are as follows: urinary incontinence, urinary urgency, urinary frequency, incomplete emptying of the bladder, nocturia, and bed wetting. Bowel diagnoses include: fecal incontinence, constipation, dyssynergic defecation, incomplete evacuation, abdominal pain and cramping, and irritable bowel syndrome. Urogenital prolapse such as cystocele, rectocele, and enterocele are also treated. Pelvic pain diagnoses include: endometriosis, vulvodynia, vestibulitis, vaginismus, dyspareunia, coccyx pain. Scar tissue management for pre and post urogynecological surgery, s/p c-section, s/p vaginal delivery laceration and tears, abdominal surgery, laparoscopic surgery, vestibulectomy, anal sphincter repair, s/p hip labrum tear surgery, hemorrhoidectomy, transgender reassignment surgery, vaginoplasty are also included in the treatment program.
Your First Appointment
Be prepared to complete a questionnaire detailing the history of your pain, when the discomfort began, the cause, treatment history, and current medications. Past medical history and past surgical history will be part of the questionnaire. Amanda will also record your PCP and Specialist MD contact information, in case there are any urgent questions or problems that need to be addressed and discussed. After a complete patient history has been completed, she will perform a musculoskeletal and spine physical therapy evaluation and/or an internal examination.
Internal Examination
With your verbal and written consent, Amanda will perform an internal pelvic floor muscle examination vaginally and or rectally. She will palpate the skin, muscles, and fascial tissues, very gently. You can stop the examination at any point. Amanda will continue evaluating the tone of the muscles and their strength, speed, and endurance as well as the quality of your pelvic floor muscle contractions vs relaxations (Kegels and Pelvic Drops) as well as your pelvic bracing, the Knack.
THERE IS NO INTERNAL PELVIC FLOOR MUSCLE EXAMINATION FOR CHILDREN.
PARENTS/GUARDIANS MUST BE PHYSICALLY PRESENT DURING the PHYSICAL THERAPY SESSION. No cellphones. If a parent/guardian accepts a phone call or leaves the treatment room for whatever reason during the PT session, the evaluation/treatment will immediately stop until the parent/guardian returns to full presence in the treatment room. There is no make-up time in that scenario either.
Pelvic Floor Physical Therapy
After the first appointment, Amanda will prescribe additional visits as needed to treat the dysfunction of the pelvic floor muscles using a range of techniques and modalities including: soft tissue mobilization, myofascial release, visceral mobilization, and may include therapeutic exercise, electromyographic (EMG) biofeedback, electrical stimulation, vaginal dilators, and kinesiotaping.
Physical Therapy Aftercare
After therapy, you might leave with some exercises to do at home, or some tips on lifestyle changes that will help you recover. Amanda will also have an idea of what your recovery path will look like. If you start with exercises, you may feel mild soreness for 12-24 hours and you should use ice and heat accordingly. Check with your MD, PCP, or NP regarding appropriate anti-inflammatories and or pain relief medication.
Schedule An Appointment
For Appointments At Integrated Gastroenterology Consultants, North Chelmsford, MA:
Please call Larkin Ward, Physical Therapy Coordinator at 978-459-6737, x 109
Medicare and Private Health Insurance accepted.
For Appointments At Orthopaedics Plus Physical Therapy, Bedford, MA:
Please call 781-229-8011
Private Pay accepted.
All Women’s Health and Men's Health Patients MUST BE followed by a PCP and SPECIALIST MD such as Obstetric Gynecologist, Urogynecologist, Gastroenterologist, Physiatrist, Urologist. Accepting patients from orthopedic and neuro surgeons as well.
All Pediatric (under the age of 18) bowel, bladder, pelvic pain, abdominal pain patients must be followed by a pediatrician and or pediatric specialist MD.