–Do you leak urine with laughing, coughing, sneezing, or exercise?

Do you have moments where you really need to use the restroom, but are unable to get there in time?

Do you have low back pain?

Do you have pelvic pain?

Do you have pain with intercourse?

Do you have tailbone pain or difficulty with sitting?

Have you been given a diagnosis of Osteoporosis by your primary care provider?

Do you experience pain or discomfort associated with pregnancy or delivery?

Have you been given a diagnosis of Fibromyalgia by your primary care provider?

If you can answer yes to any of the above questions, a Physical Therapist trained in women's health may be able to help!
 

Stress Incontinence is the leakage of urine due to weakness in the pelvic floor musculature. It occurs in times of “stress,” such as running, laughing, coughing, sneezing, jumping, or other activities that increase intra-abdominal pressure. Treatment includes exercise prescription for strengthening and function, structural assessment and correction for proper pelvic alignment. It may also include a review of possible dietary contributors and/or use of electrical stimulation or bio-feedback. Most patients will experience significant improvement in six to eight visits.

Urge Incontinence is the sudden and often frequent need to urinate due to involuntary bladder spasms or contractions, regardless of the amount of urine that is in the bladder. Women may feel a strong urge to use the bathroom, but have difficulty getting there in time. They may also notice that once in the bathroom not much urine is voided. Treatment for this is a combination of patient education regarding the causes, bladder behavior retraining to interrupt the pattern of urgency and frequency, a review of dietary habits that may be contributing, and strengthening or relaxation of the pelvic floor muscles. As mal-alignment of the bones in the area may contribute to erroneous nervous system input to the bladder, alignment of the lumbar spine and pelvis may also be addressed as well.

Low Back Pain may have a component of pelvic floor muscle dysfunction, as these muscles form a “sling” or “hammock” across the bottom of the pelvis and support the bladder, vagina, and rectum. Tightness or imbalance in these muscles can contribute to low back pain. Physical therapy is most effective in treating this by combining manual therapy, exercise, and modalities. Manual therapy is done to correct the position of the pelvis and loosen the pelvic floor muscles; exercises are aimed at stabilizing the pelvis via abdominal and pelvic floor strengthening; modalities such as electrical stimulation, biofeedback, and ultrasound may be used as an adjunct to the other treatment techniques. Your therapist will decide which combination of treatments is appropriate based on your symptoms, which may include some of the other diagnoses listed in this brochure.

Pelvic Pain can be secondary to conditions such as pelvic floor muscle imbalance, endometriosis, post-surgical abdominal adhesions, interstitial cystitis, and post-partum adhesions or scarring. This is treated most effectively with manual therapy targeting both soft-tissue and sacroiliac alignment. Additional treatment may include exercises to relax the pelvic floor musculature, intra-vaginal bio-feedback, and/or electrical stimulation. Treatment duration for this diagnosis varies due to the myriad of causes.

Tailbone (Coccyx) Pain may result from injury after a recent or past fall and/or tightness of the pelvic floor musculature, as the coccyx is the attachment site for these muscles. Treatment includes manual therapy to loosen the pelvic floor muscles, gentle mobilization of the coccyx to correct its position, specific exercises, and patient education.

Pregnancy and Post-partum Care addresses the many changes the body undergoes during and after pregnancy. Some of these changes include weakness in the pelvic floor and abdominal muscles, pelvic mal-alignment, neurological involvement, postural problems, and unhealthy movement patterns developed both during pregnancy and during care of the newborn. Less common but also possible, are diastasis recti, which is a separation of the abdominals
caused by stretching of the rectus abdominis, and stress incontinence as mentioned previously. Treatment addresses the symptoms reported during the initial evaluation with a combination of manual therapy, education, movement modification, and exercise to correct muscular or biomechanical dysfunction.

Osteoporosis is the thinning of bone tissue and loss of density over time, and affects 1 in 5 women over the age of 50. A diagnosis of osteoporosis is determined after your medical provider obtains a DXA to measure your bone mineral density. Diet, exercise, and improving certain
lifestyle habits can slow the progression of the disease. Physical therapy treatment is aimed towards minimizing fall risk to prevent fracture, patient education and exercise to slow bone loss, decreasing pain associated with posturing due to the disease process, and home exercises to improve balance, strength, and flexibility. We may also encourage you to include a nutritionist in your care team to assist with maximizing absorption of calcium in your diet.

Fibromyalgia is a syndrome that primarily affects 20-50 year-old women. Symptoms are variable and can include chronic body-wide pain, muscular tender points, joint pain, fatigue, sleep difficulties, and headaches. Physical therapy treatment focuses on manual therapies to promote muscular relaxation, soft-tissue flexibility, improved circulation, and improved lymphatic drainage. In addition, education regarding sleep positions, activity pacing, self-pain management, and the introduction of exercise is included, as tolerated by the patient.