Pelvic Health Rehabilitation at Brighton Outpatient

Urinary Incontinence

Urinary incontinence is the involuntary leakage of urine.  Urinary incontinence affects 25% to 30% of women ages 18-40 and increases up to 50% of women over age 65. Urinary leakage can be caused by pelvic floor weakness and or tightness as well as decreased coordination of the pelvic floor with associated pelvic girdle supportive muscles.  Pregnancy, childbirth, menopause, hysterectomy, pelvic and abdominal surgery, and obesity are risk factors. A pelvic health physical therapist will assist you in regaining control over your bladder through evaluating, strengthening, mobilizing, and retraining the pelvic floor muscles.

Fecal Incontinence

Fecal incontinence is unexpected leakage of stool from the rectum and loss of bowel control. Urgency and incontinence can be due to pelvic floor weakness from tissue or muscle damage during childbirth or be correlated with other bowel dysfunctions. A pelvic health physical therapist will assist you in regaining control over your bowel control with skilled manual therapy, behavioral education, and pelvic floor strengthening and mobilization.

Pregnancy Pain Management and Exercise Prescription

During pregnancy, women often experience low back pain, pelvic girdle and sacral pain, urinary leakage, tingling in the arms and swelling of the extremities. These symptoms may cause uncertainty regarding the safe amount and types of exercise advise-able at this time. A women’s health physical therapist will provide skilled therapeutic massage, manual therapy, postural re-training, education on bracing, and instruction on safe effective exercises. 

Postpartum Care

In the postpartum period after delivery, a women’s body undergoes a challenging stage of recovery amid many new physical demands and lack of sleep. Complication can arise. Common conditions include diastasis recti abdominis, painful c-section and episiotomy scars, bladder dysfunction, urinary incontinence, pelvic organ prolapse, painful intercourse, sacroiliac joint pain, back pain, and wrist pain. Although these conditions are common they are not normal. Early intervention with a women's health physical therapist is beneficial to address these immediate concerns to decrease risk of future complications.

Diastasis Recti Abdominis is the separation of the abdominal muscles at the left and right side of the abdominis muscle. Diastasis Rectus Abdominis most commonly occurs with the sudden growth of the abdominal wall but also occurs in women who have never been pregnant. Typically, the separation will resolve on its own by 6 weeks postpartum.  However, if the diastasis does not resolve it can contribute to issues such as back pain, sciatica, sacroiliac joint dysfunction, pelvic pain, and urinary leakage. A women’s health physical therapist will evaluate and prescribe specific safe exercises for diastasis recti abdominis to reduce separation, increase tone the abdominal region, and restore stability and postural control.

The term ‘Pelvic Pain’ encompasses pain in the pelvic girdle, sacral region, low back, buttocks, vulva, as well as the internal and external genitalia.  Pelvic pain commonly presents with pelvic floor muscle dysfunction inclusive of pelvic floor tightness, overactive trigger points, spasms and associated poor coordination of the pelvic floor & surrounding pelvic girdle muscles. A skilled pelvic floor specialist will address these issues through biofeedback, relaxation training, soft tissue and trigger point release.

Pelvic pain diagnoses that often present with pelvic floor dysfunction and that will benefit from physical therapy:

• Vulvodynia/Vestibulodynia
• Dyspareunia/Vaginismus
• Pelvic Girdle Pain
• Interstitial Cystitis
• Constipation
• Coccydynia
• Endometriosis
• Sacroiliac Joint Dysfunction
• Chronic Hip Pain
• Post-Operative Pelvic Pain:
  • Pelvic and abdominal surgeries such as s hysterectomy, cesarean section, and other uro-gynecological surgeries can result in scar tissue formation, and reduced function of the pelvic floor muscle and surrounding muscles.  This loss of muscle support can cause pelvic pain as well as bladder or bowel dysfunction. Early intervention post operatively from a skilled pelvic floor specialist will optimize the post-surgical outcome resulting in restored mobility and strength.

Pelvic organ prolapse is the descent of the bladder, rectum or uterus into the vaginal canal that can occur from injuries sustained by childbirth, repetitive heavy lifting, poor bowel habits, previous hysterectomy, and age-related weakness. Symptoms may include vaginal heaviness/ bulging, feelings of pressure or “falling out”, lower back and pelvic pain, urinary urgency or leakage and inability to fully empty the bladder or rectum.

Pelvic organ prolapse is often associated with pelvic floor weakness, thinning of the vaginal tissue, poor bowel and posture habits, or a loss of structural support. A skilled pelvic floor physical therapist will provide conservative treatment that focuses on strengthening and patient education to minimize and manage your symptoms.