Excel PT: Pelvic Floor

THE NEWSLETTER ABOUT YOUR HEALTH AND CARING FOR YOUR BODY Health Tips Newsletter

LEARN ABOUT THE BENEFITS OF PELVIC FLOOR PHYSICAL THERAPY

What is the pelvic floor? The pelvic floor is a group of muscles located at the bottom of your pelvis, which surround your genitalia. These muscles work to support your abdominal contents (specifically the rectum, bladder and uterus), allow for urination and defecation, prevent leakage of urine or stool when not desired, and help sexual processes including pleasure responses and reproductive functioning. (continued inside)

By Samantha Fazio, PT, DPT

INSIDE : • Learn About The Benefits of Pelvic Floor PT • How Can A Pelvic Floor Physical Therapist Help?

• Exercise Of The Month • Featured PT

www.excelphysicaltherapy.com

THE NEWSLETTER ABOUT YOUR HEALTH AND CARING FOR YOUR BODY Health Tips Newsletter

LEARN ABOUT THE BENEFITS OF PELVIC FLOOR PHYSICAL THERAPY

floor, which could lead to tension, weakness, and motor control impairments. If you are currently pregnant, that is often the best time to see a pelvic floor physical therapist. You then have the opportunity to not only learn how to use your pelvic floor as your body changes and grows, but also how to effectively use your pelvic floor during labor and delivery. This can help reduce the risk of tearing and post-partum related issues like incontinence and pain. Having a baby is beautiful and joyous, but physically demanding! A pelvic floor physical therapist can help you prepare for the changes and rehabilitate your body so you can be at your best for your baby!

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These muscles also help to stabilize the pelvis, working with your abdominal muscles, back muscles, and diaphragm to make up your core. For proper functioning of the pelvic floor, it is important to have:

By Samantha Fazio, PT, DPT

Strength: •To stabilize the pelvis and prevent hip, low back and pelvic pain •To prevent leakage of urine or stool with increases in abdominal pressure, such as with sneezing, coughing, squatting, or jumping Endurance: •To maintain proper spine posture and stabilize the pelvis over longer periods of time and with longer physical activity Flexibility: •To relax and stretch for bearing down when trying to urinate, defecate, or during childbirth •To promote pelvic mobility for dynamic activities, such as walking, running or stair climbing Motor control: •To allow you full control of when you urinate, defecate or flatulate •To prevent painful conditions of the hip, low back and pelvis Does everyone have a pelvic floor? Yes! All people, regardless of gender, have pelvises and therefore have pelvic floor muscles. Should pregnant or postpartum women have pelvic floor physical therapy? Absolutely! Whether you’ve delivered vaginally or through a Cesarean section, being pregnant for 40 weeks puts a lot of pressure on the pelvic

Common Misconceptions: “I do kegels so I don’t need pelvic floor physical therapy!”

•Kegel is the term for pelvic floor contractions, named after the person who studied the effects of strengthening the pelvic floor. While kegels can be a very helpful tool in pelvic floor rehab, strengthening is not always the answer for incontinence. Sometimes incontinence can be caused by muscles that are too tight or too contracted. If the muscles are always contracted or “on” then contracting them further will just lead to more tightness, more fatigue, and more leakage. Plus, studies have shown that most people do kegels incorrectly! A pelvic floor physical therapist will help you determine if kegels are right for you! “I don’t plan on having a baby and I’ve never had a baby so I don’t need pelvic floor physical therapy!” •Women are not the only people that have pelvic floors. Still, pelvic floor dysfunction can arise in women even if they have not had children. There are common diagnoses which can be treated with pelvic floor physical therapy.

“Men don’t have pelvic floor problems!”

•There is a very high prevalence of prostate problems in older men. Because of this, men are particularly susceptible to pelvic floor issues such as incontinence or difficulty voiding. There are some common diagnoses which can be treated by a pelvic floor physical therapist.

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PENNSYLVANIA ALLOWS DIRECT ACCESS TO PHYSICAL THERAPY WITHOUT A PHYSICIAN REFERRAL CONTACT US TODAY TO LEARN IF YOUR INSURANCE CARRIER COVERS THIS SERVICE

Alexis Dispenziere, PT, DPT Alexis is a therapist at our Society Hill clinic location. Read her full profile here: FEATURED PT

How Can A Pelvic Floor Physical Therapist Help? At your initial evaluation, a pelvic floor physical therapist will first discuss your concern and answer any questions in order to try to find out your goals for physical therapy treatment. Patients often have a lot of questions about their bladder, bowel and sexual health. Following the initial discussion, we will perform a physical evaluation, which includes watching you walk, squat, bend over, and breathe – all to observe for any muscle imbalances, mobility deficits, or postural dysfunction. In addition, we may also assess your hip and core strength. Then, we will evaluate the strength, endurance, flexibility, and motor control of the pelvic floor muscles. This will typically involve internal palpation of these muscles via the vaginal or rectal canals. We will then develop a treatment program together to help you achieve your goals. The Pelvic Floor Physical Therapists at Excel Physical Therapy pride ourselves on being open minded, conscientious and calm. We understand the sensitive nature of the pelvic region and will never do anything which makes a patient feel uncomfortable. Pelvic Floor Physical Therapy is performed in a private area to be respectful and sensitive to a patient’s needs. We do our best to educate you on what is happening, what we’ll be doing, and what to expect in your plan of care. Our mission is to to help you achieve your recovery goals! Common Diagnoses: *Not a complete list of ALL diagnoses seen by a pelvic floor PT! • Pelvic Pain

1. How did you decide to become a physical therapist and what motivates you to work with patients? In the outpatient clinic setting, I love teaching someone ways to find autonomy over their body and creating customized exercises to improve their motor patterns. I supplement my pelvic floor focus with restoring postural stability and coordination.These techniques cross over with non-pelvic rehab patients, helping prevent injury and improve movement efficiency. The joy my patients express when they come in/leave feeling better is priceless. We also have fun dancing and laughing in the clinic’s back corner. 2. In your words, what makes Excel PhysicalTherapy different from other physical therapy clinics? Excel allows each therapist to treat from their own perspective, supporting new ideas and collaboration.The emphasis on educational growth to benefit the patient is not seen in many PT firms. It is one of the few companies that truly pushes best practices. 3. What was your most memorable patient experience? Prior to accepting pelvic rehab patients, I was treating someone for low back pain. I incorporated breathing techniques and coordination training with pelvic floor recruitment. After two weeks of treatment, this patient expressed that her incontinence had improved after struggling with symptoms for over 5 years! This experience felt like a sign that it was the right move to pursue my therapeutic interest in the pelvis. 4. If you could be any animal, what would it be and why? I would be an owl. They are unassuming but see everything. Flying is a definite perk. 5. If you could describe yourself in one word what would it be and why? My patients have dubbed me the “enthusiastic torturer.” I stand by that. I will present exercises that are complex and seemingly impossible, yet my patients will successfully perform the task as I smile and root them on from the floor right next to them (most of the time squeezing my own butt and abs for moral support). 6. What do you like to do in your off time, outside the clinic? I will be found at the yoga studio or the latest brewery in the city on any given weekend. Vacations usually consist of hiking/camping or exploring another city’s culture. I will always accept suggestions for hiking trails or restaurants (local too!)

• Vulvodynia, Vestibulodynia • Vaginismus, Dyspareunia • Pelvic Organ Prolapse

• Pudendal Neuralgia • Overactive Bladder • Urinary Frequency • Nocturia (urine frequency at night) • Urine or Fecal Incontinence • Interstitial Cystitis • Constipation • Incomplete Evacuation

• Irritable Bowel Syndrome (including Crohn’s, ulcerative colitis) • Post-Surgical (abdominal surgeries, prostatectomy, hysterectomy, gender affirmation surgery) If you are experiencing any of the above mentioned conditions, or if you have additional questions, please feel free to contact us and we will connect you with a pelvic floor physical therapist in your area who can provide further assistance! Sources: HerschornS.FemalePelvicFloorAnatomy:ThePelvicFloor,SupportingStructures,andPelvicOrgans.RevUrol.2004;6(5): S2-S10. HungHC,etal.Analternative intervention forurinary incontinence:Retratiningdiaphragmatic,deepabdominalandpelvicfloor muscle coordinated function.ManTher.2010;15:273-279. PhilipPA.PelvicPainandDysfunction:aDifferentialDiagnosisManual. Stuttgart:Thieme;2016. Podschun,L.etal.DifferentialDiagnosisofDeepGlutealPain inaFemaleRunnerwithPelvic Involvement: IntJ SportsPhysTher.ACaseReport.2013;8(4):462-471. PratherH,etal.MusculoskeletalEtiologiesofPelvicPain.Obst&GynecolClinicsof NorthAmer.2014;41(3):433-442. PratherH,etal.RecognizingandTreatingPelvicPainandPelvicFloorDysfunction.PhysMedRehabil ClinNAm.2007;18:477-496.Tu,FF.etal.Physicaltherapyevaluationofpatientswithchronicpelvicpain:acontrolledstudy.GenGynecol. 2008;198:272.e1–272.e7 Vandyken,C.etal.ThePuzzleofPelvicPain:ARehabilitationFrameworkforBalancingTissueDysfunctionand CentralSensitizationII:AReviewofTreatmentConsiderations.ClinicalCommentary–APTASectiononWomen’sHealth.2012;36(1):44-54.

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Patient Success Spotlight

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Expectant mom Gabi V. was suffering from hip pain, which prevented her from caring for her infant in the way she always dreamed. She came to Excel Physical Therapy - King of Prussia with the goal of healing her prolonged pain. Read her success story here:

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“I’m not going to lie, when I first came to Excel PT my first time I was several months pregnant, I had very low expectations. I thought my pain was going to be ever-lasting and that I would never get any relief. Everyday tasks were a struggle and I felt such “mom guilt” for not being able to tend to my toddler the way I wanted. But I am so pleased and thrilled with the care I received at Excel PT. I felt like I finally had an advocate in my corner who wanted to see me get better and heal. Jessica Hoerr, PT, DPT, ATC has been nothing but a phenomenal Physical Therapist. She not only significantly reduced both the intensity and frequency of my pain, but she also gave me the skills to be successful at home! I feel like a brand new person and could not be happier with the results. Miss Briley was born January 24th at 3:00am. She was 7 lbs and 4 oz, 21 inches long. I could not have made it through pregnancy without you and I am forever grateful for helping to heal my hip pain! You are amazing!!” - Gabi V. Don’t delay we can help you! Contact us: Downtown Philadelphia & South Jersey, Northeast Philadelphia and Lower Bucks County, Montgomery County, The Main Line, Delaware County, Chester County, Allentown, Lancaster: www.excelphysicaltherapy.com/contact-us Lie on your back with your arms across your chest. Bend your knees up so that your feet are flat. Rotate your hips by slightly lifting your lower back off the surface. Rotate your hips by gently pushing your lower back downward. Repeat 10 times. Pelvic Tilts EXERCISE OF THE MONTH

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COMPLIMENTARY PAIN ASSESSMENT

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Your complimentary pain assessment may be conducted via telephone

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