Pelvic Health

Our Pelvic Health Program offers assistance to men and women within a caring and private setting. Jane K. O’Brien, MSPT will create a treatment program tailored specifically for the individual needs of the client.

List of Services:

Pelvic Floor Dysfunction (PFD)

PFD includes a myriad of diagnoses which affect both men and women. Symptoms may limit a person’s ability to perform daily activities, cause one to change exercise habits and create embarrassment.

Underactive Pelvic Floor Muscles

• Incontinence, Male and Female
• Pelvic Organ Prolapse
• Weakness

Overactive Pelvic Floor Muscles

Pelvic Pain/Spasm

• Levator Ani Syndrome
• Penetration Pain
• Painful intercourse
• Dysmenorrhea (painful periods)
• Vulvodynia
• Hip, Abdomen, Low Back, Buttocks Pain

Other Issues

• Pre and Postpartum Musculoskeletal Pain
• Abdominal Rehab (post surgical/diastasis)
• Fibromyalgia
• Osteoporosis
• Post Breast Surgery Scarring and Pain
• Sacroiliac ( SIJ) Pain
• Prenatal Fitness
• Post Prostatectomy Weakness
• Endometriosis
• Abdominal Adhesions

Both men and women can benefit from our services for PFD. We have answers and solutions. PFD is common but not normal. You can take control of your symptoms and often relieve them completely.

Post Partum Pelvic Floor dysfunctions

Location: Purely Pilates Longley Blvd

Jane O’Brien, PT, MSPT

Have you experienced leakage, painful intercourse, pelvic pain, organ Prolapse or tearing after childbirth? Have you tried Kegels and Advil to no avail? Do you wonder what Kegels are? This talk will review common pelvic floor dysfunctions after childbirth and give information on how to correct them through self help and Physical therapy, review the how, what, and quantity of Kegels and clear up misconceptions often taught by well meaning health care professionals.

Incontinence Helpful Hints

1. Allow no more than 2-4 hours between voiding.
2. Avoid bladder irritant of tea, fruit juices, acids
3. Consume adequate water and fiber
4. Squeeze before you sneeze
5. Avoid liquids 2-3 hours before bedtime
6. Avoid tendency to go “Just In Case” ( JIC pees)
7. Do your Kegels 10 seconds each 30-80 times per day.

Links and Information

• Pelvic floor exercise program
• Bladder diary and log and instructions

FAQ’s

1 ) What is our success rate on stress incontinence ?

Very high. This is generally a PFM strength issue. We work on having patient engage PFMs during times of increased IAP, (intraabdominal pressure) ie sneeze, cough, lifting.

2 ) Why are patients who are doing Kegels not having success on their own?

Often , the client is not contracting the proper muscles so they are not getting any benefit at the pelvic floor. They think they are doing kegels, but they may be squeezing other muscles, not those of the pelvic floor. During treatment, we teach them to contract the proper muscles. We also tea h them the proper number of reps and time to hold the contractions.

3 ) How can PT help with bladder control?

The PT will review the patients bladder diary to determine if the patient has been taking in foods or drinks that adversely affect the bladder. They will also determine how often the client urinates. She will educated the patient on changes to correct these factors and may put the client on a voiding schedule. The strength of the PFMs will be assessed and a strengthening program will be developed to correct weaknesses.

4 ) What can a PT do to help with pelvic pain?

Many times, pelvic pain comes from tight pelvic floor muscles. Treatment would include releases of the tight muscles of the pelvic floor and any associated muscles tightness in the abdomen, hips, legs, and back. Biofeedback may be used to help with relaxing the pelvic floor. Stretches and postural reeducation are also important for this diagnosis.

5 ) What causes UI?

Under active pelvic floor muscles, overactive muscles, surgeries ( such as a prostatectomy), eating and drinking bladder irritants, pain, and bad habits such as going to the bathroom when it is not necessary, but “just in case.”

6 ) Why can’t I stop the stream despite doing kegels at home?

The pelvic floor muscles are weakened and need to be strengthened.

7 ) Without treatment, will my Pelvic floor issues continue to get worse?

Most likely, yes!

8 ) Do medications work for UI?

Yes, but who wants to take medicine for the rest of their life? Pelvic floor PT can permanently correct these issues. Of course, the client needs to maintain their exercise program once they are discharged.

9 ) How can PT help after breast surgery?

PT can help to stretch the tightened tissues that form from surgery. The breasts will sit more evenly, the rippling between breasts can be lessened, the hardened areas around the nipple and breast can be softened and the overall comfort level can be greatly improved. In addition, any limitation in range of motion can be improved.

Journal articles

• Case Study: Physical Therapy Management of a Patient with Dyspareunia and Scoliosis
• ACPWH Guidance on the Safe Use of Transcutaneous Electrical Nerve Stimulation (TENS) for Musculosketal Pain during Pregnancy
• Rett MT, et al. Management of Stress Urinary Incontinence with Surface Electromyography-Assisted Biofeedback in Women of Reproductive Age. Phys Ther. 2007;87(2):136-142.
• Weiss JM, et al. Pelvic floor myofascial trigger points: manual therapy for interstitial cystitis and urgency-frequency syndrome. J or Urol. 2001;166:2226-2231.
• Veeming A, et al. European guidelines for the diagnosis and treatment of pelvic girdle pain. Eur Spine J. 2007.
• FitzGerald MF, Kotarinos R. Rehabilitation of the short pelvic floor 1: Background and patient education. Int Urogynecol J. 2003;14:261-268.
• Underactive Pelvic Floor Muscle – leakage, prolapse.  Jarvis SK, et al. Peri-operative physiotherapy outcomes for women undergoing incontinence and or prolapse surgery: results of a randomized controlled trail. Aust N Z J Obstet Gynecol. 2005;45(4):300-303.
• Borello-France DF, et al. Continence and quality-of-life outcomes 6 months following an intensive pelvic-floor muscle exercise program for female stress urinary incontinence: a randomized trial comparing low- and high-frequency maintenance exercise. Phys Ther. 2008;88(12):1545-1553.
• Messelink B, et al. Standardization of Terminology of Pelvic Floor Muscle Function and Dysfunction: report from the pelvic floor clinical assessment group of the International continence society. Neurourol and Urodynam. 1005;24:374-380.
• Shamiliyan TA, et al. Systematic Review: Randomized, Controlled Trials of Nonsurgical Treatments for Urinary Incontinence in Women. Ann Internal Med. 2008;148(6).