Tag: pelvic floor physical therapy - ATLANTIC PHYSICAL THERAPY

Pelvic Instability In Pregnancy

Dr. Michelle Friedman, DPT — Tue, 23 May 2023 22:30:38 +0000

What is Pelvic Instability?

Pregnancy is a beautiful and transformative journey, but it can also bring about various physical challenges. As the body adapts to accommodate a growing baby, many people experience discomfort and pain in the pelvic region. Pelvic instability encompasses a broad range of conditions that cause pain and discomfort in the pelvic region during pregnancy. It can involve a combination of SI joint dysfunction, Symphysis Pubic Diastasis (SPD), and generalized ligamentous laxity. Pelvic instability often leads to difficulties with mobility and impacts daily activities. Pelvic instability is usually caused by hormonal changes which increase ligamentous laxity in the pelvis. The laxity accompanied by the growing baby’s weight can contribute to pain in the pubic region, difficulty walking, and discomfort during certain movements. The ligamentous laxity in the pelvis is helpful during labor and delivery, but can cause a lot of discomfort in the preceding months.

Pelvic instability during pregnancy can lead to additional complications, such as sciatica and nerve irritation. The pelvic region houses a network of nerves, including the sciatic nerve, which extends from the lower back down the legs. When the pelvis becomes unstable, it can put pressure on the nerves, leading to symptoms such as shooting pain, tingling, or numbness along the sciatic nerve pathway. This condition is commonly referred to as sciatica.

It is crucial to seek professional guidance from a physical therapist or healthcare provider if you experience symptoms of sciatica or nerve irritation during pregnancy. They can assess your condition, provide appropriate interventions, and guide you through exercises and stretches that will help alleviate nerve-related discomfort.

Remember, everyone’s experience during pregnancy is unique, and the severity of symptoms may vary. The key is to address pelvic instability and associated nerve issues promptly and with the guidance of healthcare professionals to ensure a comfortable and healthy pregnancy journey.

Symphysis Pubic Diastasis (SPD)

Symphysis Pubic Diastasis (SPD) is a condition characterized by the separation or widening of the pubic symphysis, the joint located at the front of the pelvis where the pubic bones meet. Sometimes this condition is called, “lightening crotch” because it can cause sharp groin pain with positional changes. During pregnancy, hormonal changes, particularly the hormone relaxin, cause the ligaments in the pelvic region to loosen. This is a natural process that allows the pelvis to accommodate the growing baby and facilitates childbirth. However, in some cases, the pubic symphysis can become excessively lax, leading to SPD.

Symptoms of SPD: Women with SPD may experience a range of symptoms, including:

Pubic pain: Pain in the pubic area is the primary symptom of SPD. It can vary from mild discomfort to severe pain that radiates to the groin, lower abdomen, hips, or lower back. The pain may worsen with activities such as walking, rolling over in bed, climbing stairs, or spreading the legs.
Difficulty with weight-bearing activities: Women with SPD may find it challenging to perform weight-bearing activities like standing, walking, or getting in and out of a car due to the instability and pain in the pelvis.
Clicking or popping sensation: Some women may experience a clicking or popping sensation in the pubic area during certain movements or transitions.
Difficulty with certain positions: Activities such as getting in and out of a car or getting up from a chair may be uncomfortable or painful.

Management and Physical Therapy Interventions for SPD

Physical therapy plays a crucial role in managing SPD during pregnancy. A physical therapist specializing in pelvic health can provide tailored interventions based on the individual’s specific needs. Here are some common strategies used in physical therapy for SPD:

Manual therapy: Therapists may use gentle manual techniques to help realign and stabilize the pubic symphysis. These techniques can include gentle mobilizations, soft tissue massage, and myofascial release to reduce pain and improve joint function.
Pelvic floor muscle exercises: Strengthening the pelvic floor muscles can provide additional stability to the pelvis. Physical therapists provide guidance in performing appropriate exercises that engage the pelvic floor muscles, such as Kegels.
Stabilization exercises: Targeted exercises are prescribed to strengthen the muscles surrounding the pelvis, including the hip abductors, glutes, and core muscles. These exercises help improve overall pelvic stability and reduce strain on the pubic symphysis.
Pain management techniques: Therapists may utilize various pain management modalities, such as heat or cold therapy, or TENS (Transcutaneous Electrical Nerve Stimulation), to alleviate discomfort and promote healing.
Education and activity modification: Physical therapists educate women about proper body mechanics, postural alignment, and strategies to modify daily activities to minimize stress on the pubic symphysis. They may recommend techniques such as using a pillow between the legs while sleeping, avoiding activities that exacerbate symptoms, and providing guidance on safe movement patterns during pregnancy.
Stability belt recommendations: Stability belts, also known as maternity support belts or belly bands or Serola Belts, are external devices designed to provide additional support to the abdominal and pelvic region during pregnancy. These belts can help alleviate pressure on the SI joints, reduce pubic symphysis separation, and provide support to the growing belly.

It is important to note that the severity of SPD can vary among individuals, and treatment plans should be tailored accordingly. In some cases, the use of assistive devices, such as crutches or a pelvic support belt, may be recommended to reduce stress on the pubic symphysis and provide additional support.

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Pelvic Organ Prolapse: Understanding the Different Types and PT Solutions

Dr. Michelle Friedman, DPT — Tue, 02 May 2023 12:41:40 +0000

Pelvic organ prolapse can be a real pain in the…well, you know where. If you’re not familiar with this condition, let me break it down for you. Pelvic organ prolapse occurs when the muscles and tissues that support your pelvic organs weaken, causing one or more of those organs to drop down into the vagina. It’s not exactly a fun time. The good news is that it’s very treatable!

There are three types of pelvic organ prolapse: cystocele, rectocele, and uterine. Let’s take a closer look at each one.

Cystocele: This occurs when the bladder drops down into the vagina, causing a bulge in the front wall of the vagina. It can cause urinary problems, like leakage or the constant feeling of needing to pee.
Rectocele: This occurs when the rectum pushes into the back wall of the vagina, causing a bulge. It can cause constipation and difficulty emptying your bowels.
Uterine prolapse: This occurs when the uterus drops down into the vagina. It can cause a feeling of heaviness in the pelvis, as well as back pain and discomfort during sex.

So, how can pelvic floor physical therapy help? Well, the goal of pelvic floor physical therapy is to strengthen the muscles and tissues that support your pelvic organs. Your therapist might use techniques like Kegels, biofeedback, and dilator training to help you regain strength and control.

There are a variety of exercises that a pelvic floor physical therapist may recommend for pelvic organ prolapse. Here are some examples:

Squats: Squats are a great exercise for building strength in the glutes and thighs, which can help support the pelvic organs. Your therapist may recommend doing squats with a resistance band around your thighs to help engage the glute muscles even more.
Bridges: Bridges are another great exercise for building strength in the glutes and hamstrings. To do a bridge, lie on your back with your knees bent and feet flat on the floor. Lift your hips up toward the ceiling, squeezing your glutes and engaging your pelvic floor muscles as you lift.
Abdominal exercises: Strong abdominal muscles can help support the pelvic organs and prevent prolapse. Your therapist may recommend exercises like planks or bird dogs to strengthen your core.
Pelvic tilts: Pelvic tilts are a gentle exercise that can help improve pelvic floor awareness and strengthen the muscles in the lower back and pelvis. To do a pelvic tilt, lie on your back with your knees bent and feet flat on the floor. Flatten your lower back against the floor by gently tilting your pelvis upward.
Deep breathing exercises: Deep breathing exercises can help improve pelvic floor relaxation and reduce tension in the pelvic muscles. Your therapist may teach you techniques like diaphragmatic breathing or progressive muscle relaxation to help you release tension and improve pelvic floor function.

It’s important to note that the specific exercises recommended for you will depend on the type and severity of your prolapse, as well as any other pelvic floor issues you may be experiencing. Working with a pelvic floor physical therapist can help you develop a personalized exercise plan that’s tailored to your specific needs.

Another option for managing pelvic organ prolapse is the use of a pessary. This is a small device that’s inserted into the vagina to support the pelvic organs. It can be a helpful temporary solution for some women, but it’s important to work with your healthcare provider to determine if it’s the right choice for you.

Of course, prevention is key when it comes to pelvic organ prolapse. Here are some strategies that can help:

Practice good bowel habits. This means staying hydrated, eating a balanced diet with plenty of fiber, and avoiding straining when you go to the bathroom.
Maintain a healthy weight. Carrying extra weight can put extra strain on your pelvic floor muscles, so it’s important to maintain a healthy weight through a balanced diet and regular exercise.
Avoid heavy lifting. If you have to lift something heavy, make sure to use proper technique (bend your knees, not your back) and avoid holding your breath.

So, there you have it, folks. Pelvic organ prolapse can be a real pain in the pelvis, but with the help of pelvic floor physical therapy and a few prevention strategies, you can take control of your pelvic health.

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From Awkward to Awesome: How Pelvic Floor Physical Therapy Can Save Your Sex Life

Dr. Michelle Friedman, DPT — Mon, 01 May 2023 22:51:41 +0000

Today we’re going to talk about something that might make you blush a little bit, but don’t worry, we’re all friends here. We’re going to talk about how pelvic floor physical therapy can help with pain during sex. Yes, you read that right. Painful sex. Yikes.

But before we dive into the nitty-gritty, let’s start with the basics. What is pelvic floor physical therapy? It’s a specialized form of physical therapy that focuses on the muscles and tissues that support the pelvic organs. And let me tell you, those muscles are important. They help with everything from peeing to pooping to, well, you know.

Now, let’s get to the good stuff. If you’re experiencing pain during sex, pelvic floor physical therapy can be a lifesaver. A pelvic floor PT can help you determine the cause of your pain. Often the root cause of painful sex is tight pelvic floor muscles.

One of the techniques that therapists use is called dilator training. Don’t worry, it’s not as scary as it sounds. Basically, you use a series of progressively larger dilators to help stretch the muscles in your pelvic floor. It might sound a little weird, but trust me, it works.

Another technique that you will learn in pelvic floor physical therapy can be helpful is breathing exercises. I know, I know, you’re thinking, “Breathing? How is that going to help with sex?” But hear me out. When you’re feeling anxious or tense, your muscles can tighten up, making sex uncomfortable or even painful. Your pelvic floor muscles also run parallel to your diaphragm, so your pelvic floor gets a stretched when you take a big breath. By learning how to breathe deeply and relax your muscles, you can make sex a much more enjoyable experience.

But let’s be real here. The best part about pelvic floor physical therapy is the stories you’ll have to tell afterwards. Imagine going out for drinks with your friends and casually mentioning that you’re going to physical therapy to improve your sex life. Cue the awkward silence and then the inevitable barrage of questions.

“So, uh, what exactly do they do?”

“Do they, like, make you do Kegels?”

“Is it weird?”

And then there’s always that one friend who asks if the therapist is hot. Eye roll.

But here’s the thing. Pelvic floor physical therapy is nothing to be embarrassed about. It’s a legitimate medical treatment that can improve your quality of life. And let’s be real, if you can’t laugh about sex and all its weirdness, then what’s the point?

So, to all the folks out there who are struggling with painful sex, don’t be afraid to try pelvic floor physical therapy. It might feel a little uncomfortable at first, but trust me, it’s worth it. And who knows, you might just end up with some hilarious stories to tell at your next girls’ night out.

And on that note, I’ll leave you with this thought: if you can get through pelvic floor physical therapy, you can get through anything. So go out there and conquer the world, one Kegel at a time.

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