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whats up down there

Have You Ever Asked "What's Up Down There, Doc?"

Pelvic floor physical therapy is one of the best kept secrets in medicine.

I was on a recent plane flight and sat next to two women that were very chatty with one another. They quickly swept me up into their conversation. Inevitably, in situations like this, everyone asks “So what do you do for a living?”. My answer used to be “I’m a physical therapist”. The past couple of years, my standard response is “I’m a physical therapist, but let me tell you about what kind of physical therapist I am”. Then I go into the diagnoses I treat related to bowel, bladder and sexual health and, in general, how I treat them. Across the board, their reaction is a mix of astonishment and genuine interest. The follow up dialogue is always eye-opening for them, and more often than not, they will report either knowing someone close to them as having one of these pelvic floor issues, or they have it themselves.

These two chatty women on the plane were asking many questions. As it turned out, the early-20’s aged women sitting directly next to me had cervical cancer followed by a fertility-sparing procedure called a trachelectomy. Ever since her surgery, she has experienced painful intercourse. She hadn’t even mentioned this to her doctors, as she thought it was just the way it going to be. I told her about pelvic floor physical therapy and encouraged her to follow up with her doctor and ask for a referral. Needless to say, she was excited about the prospect of getting help for this pain that has plagued her for over two years.

A young couple sat next to me on another plane flight. They kept to themselves mostly. During the flight, I pulled out my laptop to work on some marketing for my book. I had a flyer on my lap and was typing away at the computer. This caught the eye of the woman that was sitting next to me. “So…”, she starts. “I don’t mean to peek, but what you are working on caught my eye”. So we chat for a bit about pelvic floor physical therapy, and specifically related to sexual pain and my book. After several minutes of chatting, she tells me that she is currently seeing a physical therapist in San Diego for vaginismus. She just started two weeks prior, and was still very uneasy about the whole thing. I gave her a lot of education and encouragement to continue. She couldn't believe how long it took her to get pointed in the right direction, after years of struggling with her inability to overcome her pain.

On a recent eye exam (for myself), I saw a new optometrist in the office. As soon as I found out she had a 7 month old and a 3 year old, I told her about my profession. She quickly remarked “Oh yeah—half my friends say they pee their pants every time they sneeze”. Her comment was so off-handed, that it took her a moment to realize through our conversation that this IS NOT NORMAL. Yes, they had a baby (or two or three) and have had urinary leakage ever since. But does that mean you just live with it? I hope that women will begin to tell their doctors “Of course not!”. As our conversation progressed, I began telling her about women I treat that have sexual pain and unconsummated marriages. She piped up “One of my friends got a UTI (urinary tract infection) eight months ago and she said her and her husband haven’t had sex since”. I told her a UTI is one of the most common precursors for my patients that have sexual pain. After picking her jaw up off the floor, she asked for a stack of my business cards.

...

Why did I share these stories? These are just three stories in as many months. In each case, women were literally blown away at the treatment options that were available to them and their friends. One had only recently began treatment and still was uncertain of how it would help her achieve her goals. I know there is some bias here, but PELVIC FLOOR PHYSICAL THERAPY IS ONE OF THE BEST KEPT SECRETS in medicine. The knowledge that women’s health physical therapists possess that encompasses evaluation and treatment of orthopedic dysfunctions and how these contribute to chronic pain, pelvic pain, sexual wellness or other joint, tissue, neurologic or muscle dysfunctions is an invaluable adjunct to traditional medical care that everyone needs to know about. If you look at the numbers, it is clear that 1 in 3 women experience problems that we as women's health physical therapists can treat.

It is paramount that women be empowered with the knowledge that not only is a multidisciplinary approach the key to reducing their dysfunction, but a critical part of that team is a women’s health physical therapist. Women need to be offered real solutions for their problems, not just medication that acts as a bandaid and only provides a temporary fix. Or offered solely surgery, in the case of urinary incontinence, when the benefits of physical therapy have been proven through research time and time again to be a viable alternative.

All doctors need to know what pelvic floor physical therapy can do. All women need to know about pelvic floor physical therapy. Not to exclude men, as there is pelvic floor physical therapy for them, too. Is it the root of all your ailments? It’s hard to know without an evaluation. But I bet if you’ve been told “there is nothing physically wrong with you” and you are experiencing ongoing pain or dysfunction, it should be the next place you look.

Looking for help with your own pelvic floor issues? Schedule an appointment with one of our therapists today!

What Our Patients Have to Say

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Testimonial by S.P., Age 26

I would like to start off by thanking Heather Jeffcoat for educating me and curing me of Vaginismus. I had been married for almost three years before I was referred to Heather. I never knew about Vaginismus until almost three years into my marriage. I knew something was wrong when I went on my honeymoon and came back a Virgin. I had always imagined how magical my first night would be but boy was I wrong.

Read more: Testimonial by S.P., Age 26

Testimonial by Amanda W.

Heather's unique physical therapy program literally changed my life! After years of struggling with vaginismus, a condition that made it impossible for me to have intercourse and very difficult to use tampons without pain, a gynecologist referred me to Heather. I was nervous for my first appointment, but Heather's professional and friendly demeanor put me at ease. She did a great job explaining each technique she was using to help my muscles relax. Heather uses a combination of internal and external stretches and exercises to relax the pelvic floor and build muscle strength. Her specially developed home program helped me quickly recover from an issue that seemed insurmountable before meeting Heather. She was optimistic about my progress and incredibly encouraging. Less than 6 months after my first session, I was able to have pain-free sex for the first time in my life! If you are suffering from vaginismus or any other pelvic floor issues, I highly recommend making an appointment with Heather and reading her book!

-- Amanda W., 2/15/16 via Yelp!

Testimonial by R.S.

I wanted to thank you so much for helping me get through something I thought I may never be able to. We have achieved pain-free intercourse and this has really solidified our marriage. We are so grateful to you for all the work you do! Thank you!!

-- R.S.

Testimonial by M.M.

My husband and I were married for 5 years and unable to have intercourse, but I never knew why. After numerous awful experiences at doctor’s offices (where many doctors told me I “just needed to relax”), a surgery that didn’t fix the problem, and a year of owning dilators that didn’t get me anywhere, someone finally referred me to Heather for Physical Therapy. I finally had answers and information from someone who knew exactly what I was dealing with!

Read more: Testimonial by M.M.

Testimonial by T.C.

While pregnant with my twins, Heather took care with keeping me on my feet and pain free. She saved my back, my sanity and the holidays! I would recommend her to every “mom” looking to stay on her feet during pregnancy and post-partum.

-- T.C.

Testimonial by R.S.

I wanted to thank you so much for helping me get through something I thought I may never be able to. We have achieved pain-free intercourse and this has really solidified our marriage. We are so grateful to you for all the work you do! Thank you!!

-- R.S.

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