Diagnoses We Treat, Including Female Sexual Pain Syndromes, Incontinence, and Other Pelvic Floor Issues

At Femina Physical Therapy, we specialize in treating these conditions that are all too often misunderstood by the medical community. What sets us apart from other physical therapy offices is we provide one-on-one care by licensed physical therapists for 60-90 minutes. In certain circumstances we offer appointments over 2 hours. No unlicensed personnel are used at any time, making the quality of care we provide at the highest level.

In depth evaluations, manual therapy, exercise prescription, and many of the other services we offer will have their greatest impact on your recovery when done by skilled, licensed providers that also participate in ongoing continuing education. This practice model also allows us to quickly identify when changes in your treatment plan are needed, maximizing each treatment session. Make an appointment at one of our offices today to get on the path to healing tomorrow.

Diagnoses:

Orthopaedic and Sports Medicine

Our physical therapists all started out as Orthopaedic and/or Sports physical therapists and continue to see the common ailments here. With our one-on-one set-up, we are equipped to treat even the most stubborn of pain, dysfunction or loss of use. Give us a call today so you can be back to your favorite activities painfree tomorrow!

Details: Written by: Staff; Published: 01 February 2020; Last Updated: 28 August 2023; 24979 Views

image depicting discomfort caused by Abdominal Phrenic Dyssynergia — Photo by Alexander Krivitskiy on Unsplash

What is Abdominal Phrenic Dyssynergia?

Abdominal Phrenic Dyssynergia (APD) is a functional gastrointestinal disorder (FGID). This condition occurs when the brain cannot coordinate the correct movement of the diaphragm in relation to the fullness of the abdomen (abdominal muscles) via the phrenic nerve, causing uncomfortable abdominal distension and bloating.

The diaphragm is a dome-shaped muscle that divides the chest and abdomen, our bodies use this muscle to help us breathe. Normally when the stomach is full of food or gas, the diaphragm will relax and release upward, in order to give the organs in the abdomen extra room.

Is There Really a Connection Between TMJ Dysfunction and Pelvic Pain?

We all know the kids song the hip bone's connected to the thigh bone. What if there was a connection from your jaw to the pelvic floor? SPOILER ALERT: Read on for how they are, in fact, connected.

What is TMJ?

TMJ stands for temporomandibular joint.

This joint attaches your skull to your jaw and is located in front of your left and right ear. It opens and closes your mouth for activities like talking and chewing. A dysfunction in the TMJ can occur in the ligaments, muscles or joints and is referred to as TMJD.

Details: Written by: Heather Jeffcoat, DPT; Published: 16 October 2017; Last Updated: 25 September 2018; 16490 Views

“Urogenital prolapse occurs when there is weakness in the supporting structures of the pelvic floor allowing the pelvic viscera to descend and ultimately fall through the anatomical defect.”

- Bo, Kari, Berghmans, Bary, Morkved, Siv, Van Kampen, Marijke, Evidence-Based Physical Therapy for the Pelvic Floor, Elsevier Ltd., 2007.

Pelvic Floor Dysynergia, Dysynergic Defecation, and Chronic Constipation

Can pelvic floor therapy help with the various forms of constipation?

It's National IBS Month! We are continuing our bowel health series to help you achieve optimal pelvic health. Having bowel movements is something everyone must do, and sometimes it is difficult to have a bowel movement. While the causes for constipation can vary, today we want to talk about a particular dysfunction that pelvic floor therapy can greatly help with: dysynergic defecation.

What is dysynergic defecation and how common is it?

Dysynergic Defecation is a muscle coordination issue where you think you are relaxing your anal sphincter to defecate, but in reality you are actually contracting your muscles and closing off the sphincter. In short, your pelvic floor muscles are doing the opposite of what your brain is telling them to do. Dysynergic defecation is common; an estimated 40% of patients with chronic constipation also have dysynergic defecation, according to this study.

Incontinence is the inability to control bodily functions resulting in the loss of urine or feces.

Physical therapy treatments are important to restore the normal bladder and bowel functions through strengthening, use of behavioral modification strategies, correction of faulty patterns and habits and use of biofeedback and electrical stimulation as appropriate to enhance pelvic floor rehabilitation.

Types of incontinence include:

Symptoms We Treat to Ease Recovery After Surgery:

We can help with many of the various issues that can arise after surgery and help reduce the associated pain and discomfort. Our licensed therapists are experts in dealing with a variety of symptoms that can make recovery difficult. These include:

Symptoms of a Pudendal Neuralgia Diagnosis:

A Pudendal Neuralgia diagnosis has been described as throbbing or severe stabbing pain along the pathway of the pudendal nerve that runs through the gluteal, pudendal canal and perineal region. This pain typically increases during sitting and is reduced or relieved by sitting on a toilet seat.

Specialized Physical Therapy for Pelvic Cancer Treatment

Physical therapy for pelvic cancer can relieve pain with sex and general pelvic pain that results from gynecological cancer of the female reproductive organs.

Types of Gynecologic Cancer

Cervical cancer begins in the cervix, which is the lower, narrow end of the uterus. (The uterus is also called the womb.)
Ovarian cancer begins in the ovaries, which are located on each side of the uterus.
Uterine cancer begins in the uterus, the pear-shaped organ in a woman’s pelvis where the baby grows when she is pregnant.
Vaginal cancer begins in the vagina, which is the hollow, tube-like channel between the bottom of the uterus and the outside of the body.
Vulvar cancer begins in the vulva, the outer part of the female genital organs.
CDC, 2020

Details: Written by: Heather Jeffcoat, DPT; Published: 03 October 2018; Last Updated: 16 December 2023; 103684 Views

Anorgasmia / Dysorgasmia - No Orgasms, Diminished Orgasms, Painful Orgasms

Anorgasmia / Dysorgasmia - Orgasm Related Problems and Solutions

Anorgasmia and Dysorgasmia are clinical terms whose symptoms include complete lack of orgasm, diminished orgasms, and even painful orgasms. Causes can include physical, mental, and emotional factors.

Dysorgasmia / Painful Orgasms

Dysorgasmia is defined as a painful orgasm, but without any prior pain during sexual intercourse. The pain often manifests as a cramping sensation in the pelvis, buttock(s) or abdomen. The duration of pain from dysorgasmia can last from seconds to minutes to several hours.

Details: Written by: Staff; Published: 14 March 2019; Last Updated: 17 June 2022; 23575 Views

Vaginismus Recovery - Diagnoses and Treatments

Vaginismus Recovery is Possible

Is it painful to insert a tampon, get through a gynecological pelvic exam, or engage in intercourse? Have you always just thought maybe it’s just supposed to hurt and began to shy away from it all? You’re not alone. There are many women who have felt and thought the same things. What you are feeling is real and the culprit may be a condition called Vaginismus.

What is Vaginismus?

The definition of Vaginismus has been debated over the years and was first introduced into the Diagnostic and Statistical Manual of Mental Disorders (DSM), Third Edition in 1980. It was defined as a “recurrent or persistent involuntary spasm of the musculature of the outer third of the vagina that interferes with sexual intercourse”.¹ And now in the DSM, Fifth Edition categorized as a disorder in which any form of vaginal penetration or insertion such as tampons, a digit, gynecological exams, vaginal dilators and intercourse is painful or impossible. Women have described it as “hitting a wall”. This disorder has been put under the umbrella of genito-pelvic pain/penetration disorder (GPPPD) in conjunction with dyspareunia (“recurrent or persistent genital pain associated with sexual intercourse”).²

Endometriosis and Chronic Pelvic Pain

How Endometriosis can cause or contribute to chronic pelvic pain, and what pelvic floor therapy can do to help alleviate it

What is Endometriosis?

Endometriosis is a condition where endometrial-like tissue grows outside of the uterus (endometrial tissue is tissue that usually grows inside of the uterus and sheds each month). The most common area for it to grow is in the abdominal cavity, where it can implant on the surface of other structures including the ovaries, bladder, rectum, and along the walls of the abdomen and pelvis.

The true prevalence of endometriosis is unknown since it takes a laparoscopic procedure to confirm the diagnosis, and many women either have no symptoms or seek no treatment (Signorello, Harlow, Cramer, Spiegelman, & Hill, 1997). However, up to 78% of women undergoing laparoscopic investigation for infertility and up to 82% of women investigated for pelvic pain were found to have endometriosis in one study (Schenken, 1996; Wellbery).

Actress Lena Dunham has been vocal about her experiences with endometriosis, most recently publishing an essay in American Vogue on electing to have a total hysterectomy after years of chronic pain due to the condition.

What Does Vulvodynia Treatment Include?

Vulvodynia means “vulvar pain” or pain of the external female genital region. Symptoms include burning, stinging, and irritation of the tissues in this region. Light touch or pressure can cause severe pain with sitting, walking, riding a bicycle, and sexual intercourse. Vulvodynia is a general term, and there are many subtypes, including vulvar vestibulitis (inflammation of the vulvar vestibule), vestibulodynia (pain in the vulvar vestibule) and clitorodynia (painful clitoris).

Physical Therapy Treatments for Pelvic Pain Syndromes:

Most pelvic pain syndromes such as vulvodynia are related to overactivity of the pelvic floor muscles.

Vulvar Vestibulitis/Vestibulodynia:

Vulvar Vestibulitis/Vestibulodynia is a form of vulvodynia with tenderness specific to the vulvar vestibule. This occurs with pressure to the site causing pain at the vaginal opening with touch or attempted penetration (provoked vestibulodynia) or can also present as constant or frequent pain, irritation, or itching of the vulvar vestibule (unprovoked vestibulodynia). Tissues may also be red or swollen at times.

Dyspareunia:

From Wikipedia:
"Dyspareunia is painful sexual intercourse due to medical or psychological causes. The symptoms are significantly more common in women than in men. The pain can primarily be on the external surface of the genitalia, or deeper in the pelvis upon deep pressure against the cervix. It can affect a small portion of the vulva or vagina or be felt all over the surface. Understanding the duration, location, and nature of the pain is important in identifying the causes of the pain."

Painful Bladder Syndrome / Interstitial Cystitis:

This pain or discomfort is perceived to be related to the bladder upon filling or often immediately after emptying. Symptoms include urinary urgency with pressure, burning and aching pain along with increased frequency, > 8 times per day, and > 3 months duration.