Pelvic Health & Rehabilitation
Pelvic health physical therapy is a specialty area of PT that involves rehabilitation of dysfunctions related to the pelvis and surrounding areas that contribute to bowel, bladder, sexual health and pain complaints.
Pelvic floor physical therapy can improve the quality of life for patients of any age:
- During pregnancy, the pelvic floor is weakened from the added pressure of carrying the child or children. It can also be affected by any trauma induced during childbirth itself.
- Hormone changes in middle-aged women, especially around menopause, can cause laxity and thinning of the tissues of the pelvic floor and surrounding structures.
- Stress incontinence is common in the active population with exercising or exerting of oneself.
Signs & Symptoms
Pelvic floor physical therapy can benefit patients who experience any of the following:
- Urinary leakage with coughing, sneezing, laughing, exercise or lifting
- Frequent urination that is disrupting to lifestyle
- A sudden urge to go the bathroom that cannot be controlled
- Chronic pelvic pain/pressure or dysfunction after pelvic surgery
- Pain with intercourse
- Pelvic, lower back and/or hip pain following childbirth
- Pain, stiffness, or weakness due to pregnancy or post-partum
- Difficulty or dysfunctional voiding
These conditions may be caused by:
- Pelvic Organ Prolapse
- Abdominal separation (diastasis recti)
- Interstitial Cystitis (Painful Bladder Syndrome)
- Pelvic Floor Muscle Dysfunction
What to Expect
Physical Therapist
Jessica Gengler, PT, DPT
Jessica treats patients at the Pelvic Health & Rehabilitation Clinic, which is located within Mercy Urology Clinic. This allows for close collaboration and discussion with the physicians regarding patient care. Jessica has a unique skill set in that she is trained in pelvic floor internal assessment and treatment, which is a rare skill among physical therapists. It provides another level of treatment, and also opens up the door to treat pain-based conditions successfully.
The PT evaluation includes an extensive history and a thorough movement evaluation, which may include assessing the back, hips, pelvis and other structures. If indicated, it may also include an external and/or internal pelvic floor exam, which assesses the strength, endurance and coordination of the pelvic floor muscles; as well as palpation for tender and/or shortened muscles, which often are a source of pain.
Following the evaluation, a plan of care is developed to address the identified impairments. If a strength/endurance deficit is identified, treatment often involves more strengthening exercises for the pelvic floor and surrounding structures. Biofeedback can also be used to allow for visualization of how the muscles are working.
Pain is often treated with manual techniques such as stretching of hips and release of tight internal structures.
Many conditions have a significant education component on diet, proper breathing techniques, and behavior modification techniques.
Next Step
Patients need a referral from a medical provider such as physician, physician assistant or nurse practitioner.
