Pelvic Health at Alpenstrong PT

What is Pelvic Health PT?

 

Pelvic floor physical therapy is a treatment approach that uses physical therapy principles and techniques to address problems in the pelvic region. The Academy of Pelvic Health Physical Therapy was founded in 1977 under the original name of the Section of Obstetrics and Gynecology, then re-named the Section on Women’s Health in 1995. The practice of pelvic health physical therapy has rapidly evolved ever since. Our scope of practice includes conditions related to the pelvic region including but not limited to urinary incontinence, pelvic pain, pre and post-partum pelvic dysfunction, menopausal issues, pelvic organ prolapse, and sexual dysfunction. We evaluate, educate, and treat women who are facing pelvic dysfunction throughout all stages of life with the ultimate goal of improving their quality of life. 

 

I decided to pursue pelvic floor physical therapy certification after learning about pelvic health in graduate school. I had struggled with running related urinary incontinence since high school and was relieved to know that there was treatment out there for my problems. When I attended my first pelvic floor course, my long term issues with urinary incontinence finally made sense. I was relieved to determine the cause, learn about treatment options, and was excited to help others who struggle with pelvic issues of their own. I have had negative gynecological experiences in the past and am determined to make others feel comfortable when seeking treatment for pelvic issues. My goal is to make every patient feel welcome, heard, and comfortable sharing about issues that are not often discussed but significantly impact a person’s daily and social life. At Alpenstrong PT we have a private treatment room where pelvic floor evaluation and treatments take place. You can even use our back “pelvic floor door” if you prefer! 

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What we treat:
  • Urinary incontinence (stress and urge incontinence)

  • Bowel and bladder dysfunction

  • Pelvic pain

  • Pelvic organ prolapse

  • Diastasis recti 

  • Post-partum pelvic dysfunction 

  • Prevention of pelvic dysfunction

  • Pain with intercourse

  • Intersticial Cystitis

  • Endometriosis

  • Menopause discomfort

  • Musculoskeletal dysfunction (hip, lumbopelvic, sacroiliac pain)

What to expect:

 

We take great care to make you feel comfortable before, during, and after your appointment. We will start with listening to your story and history as this is one of the most important elements of the initial session. Based on your history and consent, we may choose to perform an internal exam depending on your comfort level. The internal exam is the only way to get the most accurate information about your pelvic floor structure and function. It involves palpation via the vaginal canal where the pelvic floor muscles are located. The internal exam may not be appropriate for everyone, in which case we may choose to perform an external exam to evaluate lumbopelvic alignment, stability, and core strength which all influence pelvic floor function. We value your comfort and you will never be asked to do something you are not comfortable with. After the exam, you will be instructed through exercises to be completed at home which we will assist you with in order to monitor for accuracy, form, pain, and intensity. Modalities may be used to assist us at this time. We will progress your exercise program in accordance with your physical therapy goals and healing continuum.

What is the “Pelvic Floor”? 

 

The pelvic floor consists of many skeletal muscles, ligaments, and connective tissues just like what makes up your arms and legs. The pelvic floor is considered the “bottom of the bowl” and should provide a stable base for your organs, lumbar spine, pelvis, and hips.

 

Anatomy and Physiology:

  • Deep layer: coccygeus, leavator ani muscle complex (pubococcygeus, iliococcygeus, puborectalis) 

  • Superficial layer: urogenital diaphragm (bulbospongiosus, ischiocavernosus, superficial and deep transverse perineal muscles, fascial layers, and urethral and anal sphincters) 

  • Perineal body: central perineal tendon that connects the superficial pelvic muscles and sphincters

  • Additional muscles: obturator internus, piriformis 

  • Innervation: lumbosacral trunk, sacral plexus, coccygeal plexus, autonomic pelvic nerves


FAQs:
  • Question: I’m having my period. Should I cancel my PT appointment? Answer: We would still like you to come to your scheduled appointment. Your symptoms may be different (better, but more often worse) during menstruation and evaluation at this time may be useful . We can work in different ways to accommodate your comfort levels. 


     

Resources:

The Effects of an Exercise Program on Diastasis