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Pelvic

Are you suffering from occasional or chronic pelvic pain, especially pelvic pain with intercourse? If so, pelvic floor physical therapy can help. 

If you’re dealing with this condition, know that you are not alone. Many women are in your shoes, and oftentimes don’t come forward due to embarrassment. At Ability Physiotherapy, we believe that this topic should not be one that women should be embarrassed about.

Pelvic pain can occur for a vast number of reasons, and a certain pelvic therapy known as “pelvic floor rehabilitation” can help reduce or eliminate the pain and symptoms you are experiencing.

 Our Calgary, AB physical therapists are here to start the conversation of how to relieve your pelvic pain so that it doesn’t control your life! 

Pelvic pain from dyspareunia

Pain with intercourse is commonly referred to as “dyspareunia.” According to Healthline, dyspareunia can be defined as:

“Dyspareunia is the term for recurring pain in the genital area or within the pelvis during sexual intercourse. The pain can be sharp or intense. It can occur before, during, or after sexual intercourse.”

A common treatment for pelvic pain is known as pelvic floor rehabilitation. 

Pelvic floor rehabilitation works on strengthening the muscles, tendons, and ligaments of the pelvic floor. When muscles in the pelvic area become tight or weak, your daily life can be greatly affected, as this region helps in supporting the core of your body and is an integral part of everyday movement. Therefore, tight or weak pelvic floor muscles could lead to pain with intercourse.

How can therapy help?

Pelvic rehabilitation can provide relief from dyspareunia pain. One of our dedicated pelvic physical therapists will perform a thorough examination to determine what specific type of therapy treatment you’ll need. 

Some common techniques used during pelvic floor rehabilitation include:

  • Postural exercises
  • Myofascial exercises
  • Deep breathing exercises 
  • Relaxation techniques
  • Ultrasound therapy

At Ability Physiotherapy, your physical therapist will conduct a thorough examination, find the source of your pain, and create a customized treatment plan to help reduce the severity of your symptoms. 

We want to make sure you feel seen and heard, and leave our office knowing you’re in good hands. 

Pelvic pain after childbirth

Ability Physiotherapy also offers postnatal rehab to help patients as they recover postpartum. Muscles and connective tissues can stretch and become damaged or scarred during childbirth, so pelvic floor rehabilitation may be necessary.

Postnatal rehab focuses on many of the same treatment techniques that prenatal rehab does; however, with postnatal rehab your physical therapist will focus more on quickening your recovery process rather than preparing your body for its physical journey.

With postnatal rehab, your physical therapist will provide you with the proper resources needed for pain and muscle management, strength training, body mechanics, and flexibility/stretching. This will help your body ease pain and speed up its recovery process, in addition to gaining back any strength or flexibility that was lost during pregnancy as a result of scarring.  and making you more comfortable overall.  

Are you ready to ditch the pain?

It is important to note that there are also a wide variety of conditions that could lead to pain with intercourse, and our Calgary, AB physical therapists can help diagnose the root of the problem before providing treatment. 

While dyspareunia may be the condition you suspect you’re dealing with, the only way to be sure is to visit a licensed therapist for examination. Contact our clinic today for more information, and to schedule a visit with one of our therapists.

What is vaginismus?

Vaginismus is a spasm or contraction of the muscles around the vagina. This can happen during sexual intercourse. It can also happen when you try to insert a tampon into the vagina, or during a Pap test.

What are the causes of vaginismus?

  • Psychological conditions such as; Fear of ses, Anxiety, Past sexual abuse or trauma, Negative emotions towards sex
  • Physical conditions involving:
    • Scar tissue 
    • Tight pelvic floor muscles 
    • Tight connective tissue
    • Chronic constipation 
    • Digestive dysfunction 

What are the symptoms of vaginismus?

The main symptom of vaginismus is painful, and sometimes impossible, vaginal penetration. 

Reference

What is Vulvodynia?

Pain that affects the external female genital area, called the vulva. Vulvodynia is pain that lasts for 3 months or longer and is not caused by an infection, skin disorder, or other medical condition. Patients tend to have a hard time with intercourse, personal hygiene, tight clothes, sitting and bowel movement due to pain. 

What are some of the possible causes of vulvodynia?

Vulvodynic is likely caused by many factors working together. Some of these factors include:

  • Damage or irritation of the nerves of the vulva or surrounding regions 
  • Inflammation of the vulva
  • Long-term reactions to certain infections (yeast or UTI)
  • Certain genetic disorders 
  • Sensitivity to certain foods
  • Dysfunction of the muscles of the pelvic floor 
  • Conditions that affect nearby muscles or bones
  • Chronic constipation 
  • IBS 

What is Coccygodynia? 

Coccyx pain or tailbone pain (coccydynia) makes it painful to sit down. There are effective treatments available, and the great majority of sufferers can be cured. You’re not alone, and you’re not going mad!

Coccyx pain can follow after falls, childbirth, repetitive strain or surgery. In some cases the cause is unknown.

Reference 

What is Interstitial Cystitis? 

Interstitial cystitis (IC)/bladder pain syndrome (BPS)/ Hypersensitive bladder syndrome (HBS)/Painful bladder syndrome (PBS) is a chronic bladder health issue. It is a feeling of pain, soreness and pressure in the bladder area. Along with this pain are lower urinary tract symptoms which have lasted for more than 6 weeks, without having an infection or other clear causes.

Currently there are two recognized subtypes of IC: non-ulcerative and ulcerative.

  • Non-ulcerative: 90% of IC patients have the non-ulcerative form of IC. Non-ulcerative IC presents with pinpoint hemorrhages, also known as glomerulations, in the bladder wall. However, these are not specific for IC and any inflammation of the bladder can give that appearance.

These patients have true pelvic floor dysfunction (Kenneth Peters, MD)

  • Ulcerative: 5 to 10% of IC patients have the ulcerative form of IC. These patients usually have Hunner’s ulcers or patches, which are red, bleeding areas on the bladder wall. Diagnosed via Cystoscopy by a Urologist. 

Signs and Symptoms: 

  • Bladder pain with urination 
  • Frequency and Urgency 
  • Suprapubic pain 
  • Lower abdominal pain 
  • Painful intercourse 
  • Nocturia with sleep disturbance 
  • Hesitancy and decrease urine flow 
  • Incomplete bladder voiding 
  • Recurrent UTI

    Special Techniques along with traditional pelvic floor therapy

  • Arvigo technique
  • Visceral mobilization 
  • Cold laser
  • Real time ultrasound (to view bladder function)

Reference: Urology Health, IC Help 

15 Million adults in the U.S. suffer from some form of Incontinence. This frustrating and embarrassing condition can easily be addressed by strengthening the pelvic floor and improving function of the pelvis.

There are multiple kinds of incontinence:

  • Frequency
  • Urgency
  • Mixed
  • Stress
  • Post Prostatectomy
  • Overactive Bladder
  • Fecal

Causes of Incontinence

  • Most causes of Incontinence are caused due to:
  • Pregnancy
  • Childbirth
  • Menopause
  • Surgery
  • Chronic Constipation

How can a Physical Therapist help?

Based on the evaluation results, your Pelvic Floor Physical Therapist will individualize treatment to strengthen your Pelvic Floor muscles and to improve their function. You will also gain control over your symptoms and reduce your dysfunctions. Your physical therapist will discuss diet and nutrition, change in behavior, postural training, and develop a plan to return you to your previous level of function.

Dr. Scott Kelly in Clinics in Colon and Rectal Surgery, Sept, 2014 published an article Pelvic Floor Rehab in the treatment of incontinence stated that Pelvic Floor Physical Therapy is an important first-line treatment for patients with incontinence.

During Your First Evaluation:

Your physical therapist will complete a thorough review of your medical history, and perform a physical examination to identify the causes of your pelvic pain and any joint issues, muscle tightness or weakness, or nerve involvement.

The exam may include:

Pelvic girdle screening, Soft tissue assessment, Visual inspection of the tissues, Reflex testing, Sensation testing, Internal assessment of pelvic floor muscles.

Your physical therapist also will determine whether you should be referred to a physician to assist in your interdisciplinary plan of care.

Pelvic pain is pain felt in the lower abdomen, pelvis, sacrum, hips or perineum. It has many possible causes and affects up to 20% of the population in the United States, including women and men. Pelvic Floor Physical therapists help people experiencing pelvic pain restore strength and flexibility to the muscles and joints in the pelvic region, and reduce their pain through internal pelvic floor intervention.

Signs and Symptoms:

  • Inability to sit for normal periods of time.
  • Reduced ability to move your hips or low back.
  • Difficulty walking, sleeping, or performing daily activities.
  • Pain, pressure or numbness in the pelvic region with exercise or recreational activities.
  • Pain during sexual activity.
  • Urinary frequency, urgency, or incontinence, or pain during urination.
  • Constipation or straining with bowel movements, or pain during bowel movements.
  • Difficulty using tampons

How can a Physical Therapist help?

Based on the evaluation results, your Pelvic Floor Physical Therapist will individualize treatment to strengthen your Pelvic Floor muscles and to improve their function. You will also gain control over your symptoms and reduce your dysfunctions. Your physical therapist will discuss diet and nutrition, change in behavior, postural training, and develop a plan to return you to your previous level of function.

Dr. Scott Kelly in Clinics in Colon and Rectal Surgery, Sept, 2014 published an article Pelvic Floor Rehab in the treatment of incontinence stated that Pelvic Floor Physical Therapy is an important first-line treatment for patients with incontinence.

What to Expect During Your First Evaluation:

Your physical therapist will complete a thorough review of your medical history, and perform a physical examination to identify the causes of your pelvic pain and any joint issues, muscle tightness or weakness, or nerve involvement.

The exam may include:

Pelvic girdle screening, Soft tissue assessment, Visual inspection of the tissues, Reflex testing, Sensation testing, Internal assessment of pelvic floor muscles.

Your physical therapist also will determine whether you should be referred to a physician to assist in your interdisciplinary plan of care.

What is Diastasis Rectus Abdominis?

DRA is a common condition that affects many women during the childbearing years. As a fetus grows within the uterus, the uterus expands, which places stress across the structures surrounding it, specifically the muscles. The primary abdominal muscle on the front side of the body is called the rectus abdominis. This muscle is divided into a left and right half by a thick band of connective tissue called the linea alba. You may hear people talk about “6-pack abs”; this is referring to the rectus abdominis. As the uterus expands, stretching across the rectus abdominis potentially could occur. In some cases, the weakening and stretching of the linea alba connective tissue creates a separation between the right and left sides of the muscle, or diastasis.

DRA may affect women during and after pregnancy. Typically, DRA develops in the second or third trimester. It is during this time that the fetus is growing most rapidly, and can result in the greatest increase in distance between the 2 sides of the muscle.

There are several factors that may make a woman more susceptible to developing DRA. These include age, being pregnant with multiple children (multiparity), and having many pregnancies. The abdominal muscles have many important functions within the body, including postural support, movement, breathing, and protection of the internal organs. Therefore, if their structure is affected by DRA, a woman may have difficulty controlling her posture, which may put her at an increased risk for injury. Additionally, for a woman juggling the many stresses of having a new baby, the discomfort, weakness, and changes to postural control that may result from DRA can negatively affect her quality of life.

During your DRA evaluation we will be educating you on postural training, myofascial release, spinal mobilization, stretching and bracing to reverse your DRA symptoms. 

At ProTouch Physical Therapy we developed a 7 step protocol that has been 98% successful with addressing all of the dysfunctions of DRA. 

Reference

Did You Undergo an Episiotomy During Childbirth? Find Relief With Us

Did you recently deliver a baby? If so, you may have experienced an episiotomy. An episiotomy is a surgical cut between the vagina and the anus designed to provide more room for the baby to exit the birth canal. In many cases where an episiotomy is not performed, the area tears naturally as the infant is born. This can increase healing time and cause pain and discomfort for many mothers.

Episiotomies used to be a fairly routine part of giving birth, but the procedure is no longer performed except in special circumstances. For instance, if your baby’s heart rate slows significantly during birth, your obstetrician may elect to perform one for the purpose of hastening the birth. Episiotomies are also recommended for a condition known as shoulder dystocia, which occurs when the baby’s shoulder gets stuck in the birth canal. No matter what the reason for having an episiotomy, physical therapy can help you quickly return to a healthy and active lifestyle.

Healing After an Episiotomy

The average healing time for this procedure is between seven and ten days. Your health care professional will check the area for infection, and you might be prescribed oral antibiotics or a topical cream to help guard against infection. Whether you’ve had an episiotomy or vaginal tearing has occurred naturally during birth, there is always a significant risk of scar tissue developing in the area, and this can develop into issues such as pain during sexual intercourse and incontinence. Fortunately, physical therapy is an effective treatment for perineal tearing.