Prolapse

Do you feel a heaviness or pressure in your pelvis? Do you have low back pain? Or have trouble using the bathroom? You may have a pelvic organ prolapse.

A pelvic organ prolapse can occur when the nerves, muscles, ligaments or fascia are no longer doing their job of supporting the pelvic organs. This causes the organs to bulge into the vaginal wall. You can have a bladder, uterine or rectal prolapse of varying severity.

Childbirth, pelvic surgery, chronic constipation, menopause, genetics and obesity are some of the risk factors of developing a prolapse.    

Although a pelvic organ prolapse can bring anxiety to an individual there is hope in treatment. A pelvic floor physical therapist will help you navigate lifestyle changes to help manage the symptoms of the prolapse. They will teach you positions to alleviate the feeling of heaviness and assist you in strengthening your pelvic floor in order to help support the pelvic organs better. Another aspect that a physical therapist will work on is breath work. This may be the most important part of prolapse management. Understanding how your breathing can control the pressure of your abdominal cavity and pelvic floor is important in order to relieve the symptoms and potentially reducing the severity of the prolapse. A pelvic floor physical therapist is an essential piece of empowering you to manage your prolapse.

If you have these symptoms and want to get help give me a call or email me. centeredpt@gmail.com or 714-580-1111        

Diastasis Recti

Diastasis Recti (DR) is a fancy term for the separation of the rectus abdominis muscle. The rectus abdominis muscle is the muscle that is located at the front of your abdomen. Think the six pack muscle! It has two muscle bellies that are held together by the linea alba. During pregnancy the rectus abdominis separate, stretching out the linea alba in order to accomodate for the baby which can lead to an appearance of a gap or bulge post-partum. It was found that by 6 months post-partum around 40% of women still have diastasis recti. I find moms are concerned with the look of their tummy due to the DR because it can make the tummy look to have a bulge. But even more concerning, most people are unaware of the fact that DR can lead to low back pain and pelvic floor dysfunctions such as urinary incontinence, fecal incontinence and pelvic organ prolapse.    

Recent research suggests that bringing back the two bellies of the muscle isn’t as important as being able to create tension on the linea alba in order to help stabilize the core. To create tension in the linea alba one must strengthen their transversus abdominis, which is a deep abdominal muscle and strengthen the muscles of the pelvic floor. Learning good breathing techniques is also essential.        

There is a lot of myths in the fitness world on the proper way to heal a DR, but it is not a one size fits all type of impairment. If you want to start to rehab your DR give me a call or email.

714-580-1111 or centeredpt@gmail.com

INCONTINENCE

It always makes me sad when I see moms not participating in activities with their children because they are afraid they might pee their pants. This blog is for all the moms in the corner at the trampoline park.

According to the International Continence Society, incontinence is a condition of involuntary loss of urine. By the time women are post menopausal 50% have symptoms of incontinence.  Incontinence is the leading cause of admittance into nursing home facilities in the elderly. Unfortunately, the majority of money “treating” incontinence is spent on non-treatment products (pads and medications) and evaluations. Do I have your attention yet?  Let us stop covering up the symptoms and start treating them!

Before I tell you the good news I would like to share some facts about incontinence. There are 3 main types: stress, urge and mixed incontinence. Stress incontinence is leakage of urine during physical exertion such as coughing, sneezing, laughing and exercising. Urge incontinence is when the bladder contracts involuntary. These are the ladies that are running to the bathroom at the first inkling of a need to pee. Mixed incontinence is the combination of stress and urge.

The good news is that physical therapy can help you! Incontinence is usually due to pelvic floor  muscle weakness especially after childbirth, therefore a symptom that is very treatable. Through the guidance of a physical therapist you can strengthen your pelvic floor and make behavior modifications so that next time you don’t have to sit out on all the fun.  

If you want to start playing with your children again and not being the mom that sits out give me a call or email me: 714-580-1111 or centeredpt@gmail.com.

WHAT TO EXPECT DURING A PELVIC FLOOR PHYSICAL THERAPY EVALUATION?

It is always good to know what you are getting yourself into, especially when you have an appointment for your pelvic floor. Any physical therapy evaluation should always start off with an extensive subjective evaluation. The subjective evaluation will consist of the patient talking about the reason they are seeking out physical therapy and the history involving that concern. It is imperative for the the physical therapist to understand the patient's goals at this time.The physical therapist should have a full understanding of your past medical history and the current concern in order to move forward with appropriate test and measures.

After the subjective examination you will then have a fully clothed exam assessing posture, muscle strength, hip mobility, diastasis recti or the separation of the abdominal wall, pelvic stability tests, as well as functional tests such as walking and jumping.

The internal exam is next. This is not always necessary and the pros and cons will be discussed at length with you. The patient will then give consent if she feels comfortable with the process and feels the information gained will be a benefit to treatment. The first part of the exam will be the physical therapist inspecting the outside of your pelvic floor, looking at the health of your skin, sensation, how much your pelvic floor moves as well as reflexes. The internal exam is next. It is not like an exam at the OBGYN office. It is done without stirrups or a speculum. It is a one fingered gloved exam. The physical therapist will then check the tone, strength or any trigger points of your pelvic floor muscles.

The physical therapist will now have enough information to come up with a plan of care. The plan of care will include how much and how long you should come to physical therapy, a detailed treatment plan and home management plan as well.

Please contact Lindsay Newlin with any questions: 714-580-1111 or centeredpt@gmail.com    

WHAT IS PELVIC FLOOR PHYSICAL THERAPY?

This is a broad question that encompasses many aspects of physical therapy. First of all it is important to note that a pelvic physical therapists is also called a women’s health physical therapist. Despite the nomenclature, pelvic floor physical therapists treat more than just the pelvic floor and some women’s health physical therapists can treat more than women.

Physical therapists that specialize in pelvic floor and women’s health have had extra training pertaining to unique issues that women experience throughout their life. We treat all the bodies systems (musculoskeletal, visceral, integumentary, nervous etc.)  while taking into consideration the physiological differences that are unique to women. We fully understand the effects of hormones on the body as well as different musculoskeletal changes that women go through in a lifetime, from the young female athlete to the postmenopausal woman and everything in-between.  Pelvic physical therapist also recognize the psychological aspect of treating such a sensitive area of the body. We strive to help each individual process the mental and physical components during treatments.

A large area of women’s health physical therapy concentrates on pregnancy and postpartum care, remembering once postpartum always postpartum. During pregnancy it is common to have increased back and pelvic pain due to the increase of hormones and the rapid increase in weight. We can also help guide you in preparing your body for labor and delivery to help with an easier delivery and postpartum recovery. After pregnancy some women have a challenging time getting their core muscles fully functioning, resulting in separation of stomach muscles, leaky bladder and pelvic pain to name a few. Women’s health physical therapists are the ones to assist you on your postpartum journey.   

Some other areas of expertise of a pelvic physical therapist are sexual pain, bowel dysfunction, breast cancer rehabilitation, back pain, hip dysfunction, post-surgical rehab, relaxation techniques as well as pelvic floor and abdominal strengthening programs. Pelvic physical therapists recognize that the whole body should be observed and they will have a close working relationship with all health professionals to come up with the best individualized plan of care.

Please contact Centered Physical Therapy & Wellness if you have any questions or need a quick email or phone consult to see if we have the services that can help you. 714-580-1111 or centeredpt@gmail.com