Pelvic Health Physical Therapy

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Pain, pressure, muscle weakness, bladder leakage, bowel dysfunction, and painful intercourse are just a few things that can happen during pregnancy and in the months to years after delivery, no matter what your delivery story.  We specialize in treating these issues while also educating you on preventative techniques during pregnancy and delivery and how to optimize your recovery after.  

Postpartum rehabilitation is one of Kali's passions as it is important for women to get their bodies functioning optimally so they feel good and can care for their baby.   There are many symptoms that occur when the muscles and ligaments in the abdomen and pelvis are not recovering correctly.  Through education and receiving treatment as early as possible after delivery, many symptoms like back pain, urinary incontinence, and persistent vaginal pain can be eliminated.  Because these symptoms have been normalized in our society by advertising showing how cool celebrities look in their pads and diapers, many women do not receive treatment at the appropriate time.  Without treatment, these symptoms are very likely to get worse or return later in life. 

Optimizing Fertility:

If you are having difficulty getting pregnant, it is also important to have a physical therapy evaluation to address the potential musculoskeletal issues that can contribute to infertility.  Also, during infertility treatments, many women experience side effects from the medications and hormones that cause pain and bladder dysfunction.  These, too, can be addressed with pelvic health physical therapy.

Return to Running Postpartum:

At 6 weeks, women are often "cleared" for returning to normal activities.  However, research is showing that not all women are ready at that point.  Kali performs a complete assessment of your body, with specialized tests for runners, to see at what level of exercise and running you are ready to return.  She also creates a customized return to running plan for you so that you can reach your running goals without pain, bladder, or bowel dysfunction. 

Many men and women have pelvic pain for years and are told it is "uterine cramps" or  a "prostate infection" when actually they are experiencing pain from pelvic floor muscle spasms.  If you have these type pains and you find medication either helps a little, then the pain returns, or the medications don't help at all, there might be an underlying musculoskeletal dysfunction that needs to be addressed. 

Pelvic Pain can also have many different sources.  It is important to have a thorough physical therapy examination to assess the pelvic girdle, hips, lumbar spine, sacroiliac joints, abdominal, thoracic, neck and so much more!  Pain can be from a muscle spasm, impaired relaxation, impaired muscle activation, muscle weakness, impaired coordination or a combination of all of these neuromuscular dysfunctions.  On the opposite end,  abdominal, back, hip or leg pain can be originating from a pelvic floor muscle issue!  A thorough orthopedic and pelvic health evaluation may be necessary to help find the solution. 

Kali specializes in treating kids with bladder and bowel dysfunction.  This includes an extensive history and symptom profile initially, followed by an orthopedic evaluation, and a pelvic floor evaluation using interactive external biofeedback when the patient is ready.  Treatment is individualized and may included any of the following: behavioral modifications, biofeedback, individualized exercises usually integrated into play or sports, stretches, bladder training, bowel training and routines, dietary considerations, and much more!  The biofeedback technology used is specialized for pediatrics so they feel like they are playing a game when they are training their pelvic floor muscles!

After a neurological incident, many people are in therapy for months or years to address their legs, arms, and brain function; however, the bladder and bowel get neglected from treatment.   The pelvic floor can be affected in a stroke or spinal cord injury just like the rest of the body, and the pelvic floor needs to be rehabilitated, too.  Multiple sclerosis is another neurological disorder that can affect the pelvic floor, bladder, and bowels and many patients benefit from pelvic health physical therapy treatment. 

Surgeries such as prolapse repair, hysterectomy and prostatectomy are common, but that doesn't mean that the recovery is easy.  Surgery can cause muscles to stop working correctly, result in muscle spasms, decrease bladder function, and anesthesia can cause constipation and straining which causes even more pelvic floor dysfunction!  Even if there are no symptoms before a surgery, the pelvic floor muscles were most likely not working ideally.  Then when you add surgery, this person can be predisposed to have even more problems after the surgery if not properly addressed.  

Before having one of these major surgeries, it is important to educate yourself about the following:

• the pelvic floor - how it works 
• what happens during surgery
• what symptoms are common after
• how to prepare your muscles to prevent these common symptoms post-op 
• what to do right after surgery
• when to know you need a physical therapy evaluation.  

A pelvic health physical therapy evaluation before or after surgery can help your outcomes and recovery. 

Pelvic health physical therapy can help with any of the following: 

• Urinary Incontinence
• Leakage with coughing, sneezing, jumping
• Incontinence in runners
• Leakage with running water
• Urinary Urgency - "key in lock" urge, sudden severe urge
• Frequent Urination (sooner than every 2 hours)
• Neurogenic Bladder
• Bladder Prolapse (Cystocele, Urethrocele)
• Difficulty Voiding
• Painful Bladder
• Pediatric incontinence and prolonged night wetting

Pelvic health physical therapy can help with any of the following: 

• Fecal Incontinence
• Constipation
• Pain with bowel movements
• Difficulty voiding
• Chronic hemorrhoid management
• Dyssynergic Voiding
• Rectal Prolapse and Rectocele
• Rectal Pain and Spasms

Pelvic health physical therapy can help with any of the following: 

• Endometriosis management and post-surgical treatment
• Coccyx Pain
• Painful Intercourse
• Post-Radiation Pelvic Pain
• Post-Hip Replacement unresolved pain and bladder dysfunction
• Hip and Groin pain unresolved with general PT
• Persistent Piriformis Syndrome and Sciatica
• Scar Pain
• Pelvic Organ Prolapse

• What happens on my first visit?  ---   An extensive history is taken and a complete musculoskeletal exam is performed.  This means looking at strength, how you move, and what causes your symptoms.  There may or may not be a pelvic floor exam on the first visit.  A pelvic floor exam is an external or internal exam, external exams can be performed over clothing or on the skin.  This is an examination to assess your muscle function. You are in control the whole time and together we determine what kind of exam works the best for you.  I educate every one of my patients to every single step before we do any part of the exam; this ensures understanding of what is happening and why it is medically necessary.  Ultimately you make the call on what happens each and every session.
• Is this normal?  ---   Many things like urinary incontinence or pain during pregnancy or postpartum are common, but that does not make them normal.  These are signs that muscles are not working correctly and if you continue not treating the underlying issue, more problems are more likely to occur down the road (i.e. urinary incontinence gets worse).    

Call or text (225) 421-4005. Give your name, number, and a brief description of what is going on.  If you have seen a physician, they can fax a referral to (949) 404-6721.  You can also text (225) 421-4005 or email kaliphysicaltherapy@gmail.com a picture of your referral .  Referrals are not required for an evaluation.