You may have heard of pelvic health physical therapy (PH PT) in your post parum parent's group, from your social media group, or you may have read the recent article in Harper's Bazaar. However you have heard about our profession, you may still have questions. This post will cover what Pelvic Health Physical Therapists such as Dr. Julianne Simpson, PT, DPT treat.
We pelvic health PTs focus on helping the pelvis and its various functions work better. Dr. Julianne helps optimize the function of several systems in and around the pelvis: musculoskeletal, urinary, reproductive, and colorectal.
The muscles, joints, and bones of your body make up the musculoskeletal system. This includes the four joints of your pelvis -- the two sacroiliac joints, the sacroccygeal joint (sacrum-tailbone), and the one pubic symphysis joint -- as well as your hip joints, and lumbar spine. Common dysfunction in this system includes pelvic girdle pain, sacroiliac (SI) joint pain, pubic symphysis pain, and/or coccydynia (tailbone pain). The musculoskeletal system also includes muscles: the pelvic floor or levator ani, hip/ gluteal muscles, spinal muscles (erector spinae), the lats (latissimus dorsi) hamstrings, and quadratus lumborum. Muscle dysfunction could include pain, spasm/ tightness, weakness, strain (acute or chronic). Pelvic health physical therapists can diagnose and treat pelvic and pelvis adjacent musculoskeletal pain and dysfunction.
The urinary system in your pelvis includes your bladder and urethra. The rest of the urinary system, the kidneys and the ureters, are located in the abdomen and back body wall. Pelvic health physical therapists treat urinary system dysfunction including urinary incontinence. Urinary incontinence (UI) can be stress (SUI): leaking with coughing, sneezing, jumping, laughing, lifting, or vomiting; urge urinary incontinence (UUI): leaking with strong urge or on the way to the bathroom; or mixed (MUI): both SUI and UUI symptoms. Other urinary system issues pelvic health physical therapist treat are frequent urination (normal is every 3-4 hours during the day), nocturia (peeing at night more times than you'd like), incomplete emptying, difficulty initiating or maintaining a urine stream, and post-void dribbling (you think you're done and there's more when you stand up). We also treat pain associated with the urinary system including muscle and fascial dysfunction. With all of these conditions, there can be muscular, fascial, connective tissue, or motor control dysfunction; a pelvic health physical therapist can help improve urinary system function and make your life better! Watch the whole movie without a bathroom break, lift your kid without leaking, or sneeze without wishing you were wearing black pants!
Depending on your anatomy, your reproductive/ sexual system can contain your vagina, cervix, uterus, ovaries, penis, testicles, and/ or prostate. Pelvic health physical therapists can help with pain around arousal, with intercourse, or post-coital pain. A major source of reproductive system pain is endometriosis. 1 in 10 people with uteruses who are of reproductive age have endometriosis, a chronic painful condition with painful and / or heavy periods and cyclical pain. Pelvic floor dysfunction is almost always a co-condition with endometriosis. Treatment by a pelvic health physical therapist and endometriosis specialist such as Dr. Julianne Simpson, PT, DPT can help reduce pain and improve function. Vaginismus and dyspareunia can be part of endometriosis or be present on their own. Pelvic health physical therapy can help improve your pelvic floor length and function and (hopefully) be able to have the intercourse you'd like to have. Pelvic floor dysfunction is anatomy-blind and people with penises can also have pelvic floor dysfunction that causes sexual dysfunction. Pelvic health physical therapy can help reduce pelvic floor and fascial/ connective dysfunction and help you improve your sexual function.
The colorectal system in your pelvis consists of your colon and rectum, but the rest of the digestive system fills the abdomen and continues from the lips to the anus. Because of this anatomy, treatment of colorectal dysfunction includes treatment of both the pelvis and the abdomen. Colorectal issues can include incontinence, constipation, bowel urgency, excessively frequent bowel movements, pain with bowel movements (dyschezia), or difficulty fully evacuating bowels. The common theme with all these conditions is the pelvic floor -- excessive tightness (high tone pelvic floor) or excessive laxity / decreased pelvic floor strength can all contribute. Often colorectal dysfunction is associated with other dysfunctions such as the triad of constipation, endometriosis, and vaginismus or fecal/ gas incontinence plus urinary incontinence following vaginal delivery. Pelvic health physical therapy such as Dr. Julianne Simpson, PT, DPT at Circle Physical Therapy can help you reduce colorectal dysfunction and get you back to thinking about more fun things than the location of the bathroom.
Pelvic dysfunction can be life altering and can cause a lot of distress, depression, reduced self-confidence, and significantly reduced self-esteem. Pelvic health physical therapy can help you feel better and live your best life.
Dr. Julianne will use a variety of techniques to help move you towards your best self. For her techniques and treatment strategies, watch for an upcoming blog post and see here.
Circle Physical Therapy: Feel better. Move better. Live Better.