Physical Therapy Can Treat Pelvic Pain, Incontinence
WHEELING — Wheeling Hospital is providing physical therapy to help patients who have pelvic floor dysfunction, an often-overlooked health matter.
Board-certified physical therapist Dina Cooney, who provides the treatment, said, “The problems that are treated in pelvic floor PT are usually not discussed because people are often embarrassed by their condition. Many do not even know that the issues they are experiencing are merely symptoms of pelvic floor dysfunction that can be treated with physical therapy.”
The pelvic floor is the muscular layer that spans the base of the bony pelvis. This layer supports organs including the bowel and bladder in males and females. The pelvic floor muscles assist in urinary and fecal continence, aid in sexual performance, and stabilize connecting joints such as the spine and hips.
Common conditions that are experienced with pelvic floor dysfunction include:
— Leaking urine or stool with any daily activities, including exercising, or at rest.
— Urinary or fecal urge or frequency (urinating more than every two to five hours).
— Abdominal separation after delivery (Diastasis Recti).
— C-section scars or pain after delivery.
— Vaginal, vulvar or episiotomy pain after delivery.
— Pelvic organ prolapse, or feeling a bulge or pressure in the vagina.
— Painful sex or penetration (difficulty wearing a tampon).
— Bladder pain.
_ Pain with sitting: tailbone, pudendal neuralgia.
— Genital pain.
— Any type of pain or function change after surgeries in the abdomen or pelvis.
“Living with these conditions is not necessary,” said Cooney, who has a doctorate in physical therapy. “Even if the symptoms are mild, they can be treated.”
She said a common misconception is that these symptoms are normal with aging or after having a baby. But while there is a higher prevalence with aging, none of the symptoms is a normal part of aging.
“Sure incontinence, prolapse, etc., are commonly seen post-partum, but don’t ‘give it time’,” she said. “If you rehab with a trained professional, these signs and symptoms can go away for good.”
Currently Cooney treats women in the adult population. She also treats girls and boys.
“Children do not have to suffer or be embarrassed by daytime ‘accidents’ or bedwetting,” she said. “Often times their social life and confidence are damaged because they are bullied for wetting their pants or soiling themselves at school. These kids do not want to go to sleepovers or be on a travel sports team staying at hotels with teammates because they still need a pull-up at night. But they do not have to suffer from the discomfort of chronic constipation and repeated trips to GI doctors, and trying countless medications. Pelvic floor physical therapy can help them, too. “
Conditions commonly treated in the pediatric population are enuresis (daytime wetting), encopresis (fecal incontinence), bedwetting, constipation or pelvic pain.
On the initial therapy day, a detailed history is taken, and the patient/family is educated on the anatomy and function of the pelvic floor. For women, an internal exam is performed to assess muscle strength, endurance and look for muscle spasms that may be causing pain. Cooney also assesses core strength, breathing patterns and posture.
For children there is never internal assessment or treatment. Cooney assesses children by observing muscle contractions.
Treatment may include but is not limited to:
— Therapeutic exercises for the pelvic floor and surrounding muscles (hips, core, etc.).
— Manual therapy such as soft tissue mobilization, scar massage, joint mobilizations, visceral massage.
— Neuromuscular re-education with biofeedback EMG.
— Toilet training, using bowel and bladder diaries, timed toileting, toilet posture.
— Relaxation techniques.
— Education on how diet and lifestyle may affect the bowel and bladder, or pelvic pain.
Those interested in receiving treatment for pelvic floor dysfunction should contact their doctors. Most insurance plans will cover this treatment.