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The Femina Physical Therapy Blog

Featuring original articles by our staff about current events and trends

With emphasis on vaginismus, pregnancy and postpartum best practices, treatments for incontinence, and other topics related to the health of your pelvic floor.

Featured From the Blog:

Introducing The Origin Fund - Helping Women in Need

Helping Women in Need With Our Community in Mind

The Origin Fund is dedicated to facilitating access to services that address a person’s physical, emotional and medical needs. Our focus is on individuals with pelvic health dysfunctions, and we are dedicated to improving the biopsychosocial aspects of each person as a whole. Through education, outreach and providing access to these services, we can support individuals on their journey to address their pain and dysfunction—linking patients to our network of referrals that provide these services.

Therapeutic Breast Massage in Lactation (TBML)

Therapeutic Breast Massage in Lactation | Image Courtesy of Mehmet Turgut Kirkgoz via Unsplash

Therapeutic Breast Massage in Lactation Can Help Make Breastfeeding Less Painful

Breastfeeding is widely accepted as the normal standard for providing nutrition to newborns, however, many women who do not reach their breastfeeding goals. US national data stated that breast pain was a commonly reported reason for women weaning less than 1 month postpartum. Within that segment, 29% of women who participated in the study stated that “breastfeeding was too painful” to continue.

In the same study, 24% of women reported “breasts feel(ing) too full or engorged” as another reason to discontinue breastfeeding prior to 1 month postpartum.¹ Currently, The American Academy of Pediatrics recommends exclusive breastfeeding of infants for the first six months of life. As physical therapists who treat patients with postpartum conditions, we are well positioned to make a big impact on patients with breastfeeding related pain and reduce barriers to continued breastfeeding!

Treating Bloating and Abdominal Distension: a Multi-Disciplinary Team

Why a Multi-Disciplinary Team is Best for Treating Bloating and Abdominal Distension

Bloating, abdominal distension, loose stools, constipation, abdominal or pelvic pain, fatigue, brain fog, weakness, nutritional deficiencies… these symptoms may be caused by a variety of gastrointestinal or pelvic conditions. If you are experiencing any of these symptoms, this article is a good place to start when deciding who to have on your care team, and what treatments can help!

The connection between your bowels and your pelvic floor

If you think about what is housed inside of the pelvic bowl, three important systems have to co-exist and share a limited amount of space:

Urinary System: the bladder and urethra
Reproductive Organs: Uterus, ovaries, fallopian tubes, and vaginal canal
GI System: sigmoid colon, rectum

Worried About Exercise and Urinary Incontinence?

Don’t let your New Year's workout make you leaky!

With new year’s resolutions, a lot of us will be starting new workout routines to shape up. While exercise is a cornerstone of physical health, a little talked about side effect of increased athletic training, particularly for those with female anatomy, is urinary incontinence. A comprehensive literature review published March 2018 in International Urogynecology Journal found that female athletes have an increased the risk for urinary incontinence.

Learn How Obesity Increases Urinary Incontinence and How Pelvic Floor Therapy Can Help

Urinary Incontinence is common, why suffer?

Urinary incontinence is the loss of bladder control. Urinary incontinence affects up to 1 in 3 women. The two most common types of urinary incontinence that affect women are stress incontinence and urge incontinence (also called overactive bladder, or OAB). Incontinence affects twice as many women as men. This may be because pregnancy, childbirth, and menopause are contributing factors to urinary incontinence. Urinary incontinence should not be considered a normal part of aging, and it can be treated.

A new article published in September, 2018 by Lamerton, Torquati, & Brown found that being overweight (BMI 25-30) increased risk of urinary incontinence for young and middle aged by 35% and obesity (BMI ≥30) almost doubles the risk at 95%.

A 101 on the credentials, training, and skills of a pelvic floor physical therapist

Two recently published articles, in the International Urogynecology Journal and in Neurourology and Urodynamics talk about the positive outcomes of treatment with trained pelvic floor therapists. Today is a basic rundown of what kinds of credentials, training, and skills a pelvic floor physical therapist has to offer you.

Credentials

Pelvic floor therapists are often physical therapists (PT), a discipline that requires academically rigorous coursework and covers topics from anatomy and kinesiology, to neuroscience, and the evaluation, treatment, and management of common diagnoses. They are also trained in a medical system, and are aware of "red flags" in signs and symptoms that patients may present with. These "red flags" will typically require additional medical referral to rule in or out (i.e. suspected masses, infection, etc).

You will often find a jumble of letters after your pelvic floor therapist’s name. Here is a breakdown of what those letters mean:

PT, MPT, MSPT, or DPT: These letters represent the degree that your pelvic floor physical therapist earned. For many years, physical therapists earned a bachelor's degree prior to becoming licensed. Later, schools transitioned to master's degree programs. The letters MPT or MSPT indicates a master's degree in physical therapy. Most programs today now train therapists for a DPT degree, which stands for doctorate of physical therapy.

What are the Links Between Menopause and Pelvic Health?

Menopause is a period of life transition for many of us. Today we will review what menopause is and how symptoms can negatively affect pelvic health, including bowel, bladder and sexual function.

What Happens During Menopause?

Menopause is an important life transition for those with female anatomy, marking the end of the regular menstrual cycle and the transition to life beyond the reproductive period.

Babies born with female anatomy have a set number of eggs which are stored in their ovaries. The ovaries make the hormones estrogen and progesterone, which control monthly periods and ovulation. Menopause happens when ovaries no longer regularly release an egg every month and menstruation stops.

Pelvic Floor Therapy May Be One of Your Best Painful Periods Treatment Options

Painful periods are common, but why suffer?

According to the American College of Obstetricians and Gynecologists, more than half of those who have periods suffer from “dysmenorrhea” (pain associated with their cycles) 1-2 days each month.

What causes the pain?

There are two main causes of the pain associated with menstruation:

Tightly Wound released on Iris!

Tightly Wound has been released, watch it today and share it with your loved ones and anyone else who may need more education on vaginismus and pain with sex.

Tightly Wound is a 15-minute animated short by Shelby Hadden. Our very own Heather Jeffcoat, DPT is one of the producers of film.

Learn All About Pilates and the Pelvic Floor

And How Pilates Can Strengthen the Pelvic Floor

A modified Pilates program can be a fantastic way to improve the strength of the pelvic floor muscles. A 2018 study by Lausen et al. had clients attend weekly one-hour Pilates classes over the course of six weeks. These classes used a type of Modified Pilates which consisted of Pilates exercises which had been modified and led by a physical therapist to specifically target the pelvic floor for the management of urinary incontinence. Those who attended the Pilates classes reported less leakage, improved self-esteem, decreased social embarrassment and lower impact of incontinence. Some of the women also reported improvement in their personal relationships after attending the classes.

In another 2011 study by Phrompaet et al., researchers found Pilates to be an effective treatment for instability in the low back and pelvis, which is a common contributor to pelvic pain and pelvic floor dysfunction.

Learn All About Pelvic Organ Prolapse and the Role of Yoga in Recovery

Yoga can help manage pelvic organ prolapse, but there are also some poses, movements and breathing methods that could make the condition worse.

What is a Pelvic Organ Prolapse?

"Prolapse" refers to a descending or drooping of organs. Pelvic organ prolapse (POP) refers to the prolapse or drooping of any of the pelvic floor organs, including: the bladder, uterus, vagina, small bowel, or rectum. These organs are said to prolapse if they descend into or outside of the vaginal canal or anus.

Read our previous blog for more information on prolapse and how pelvic floor therapy can help.

Which yoga poses will help and which poses will make it worse?

Yoga has been found to help women with urinary incontinence, but will it help with prolapse?

Do You Know the Difference Between Rectal Prolapse and Hemorrhoids?

We continue Pelvic Organ Prolapse Awareness Month by talking about Rectal prolapse and hemorrhoids, two conditions that are commonly mistaken for one another.

Rectal prolapse and hemorrhoids can both cause irritation, discomfort, and pain in the anal region. However the causes and treatment can be different for both conditions.

Hemorrhoids

Hemorrhoids are veins in the lower rectum that become swollen or stretched. They are similar to varicose veins in the lower legs. There are two types of hemorrhoids: internal and external.

Internal hemorrhoids are swollen veins inside the rectum. Sometimes these swollen veins begin to descend and come out through the anal sphincter.

External hemorrhoids: are swollen veins that can be seen and often felt under the skin outside around the anal sphincter. Usually they look like a small bulge and are the same color as the skin.

Learn How Yoga Reduces Urinary Incontinence in Older Women

A study presented at the annual meeting of the American Urological Association this past May of 2018 shows that a 3-month yoga intervention can reduce the frequency of urinary incontinence (UI) in women aged 50 years or older.

In the randomized trial completed by Dr. Alison Huang, MD and colleagues, a 3 month yoga therapy program was conducted with a group of 56 ambulatory women aged 50 years or older. These women had previously reported daily leaks and were not using any other clinical UI treatments.

The yoga program consisted of classes twice a week and one session of home practice weekly for three months. The therapeutic yoga classes were based out of the BKS Iyengar style of yoga.

After the three month trial, researchers saw a 74% decrease in daily leakage reported by the women in the yoga class. The women reported no negative outcomes related to the yoga practice.

Learn All About Body Mechanics and Posture for Prolapse

Do you feel a bulge or feel like you are sitting on a ball in the pelvic area? What should you do? Don’t freak out, there is help for you! Here are some things to get you started:

See your gynecologist

Not all prolapses are the same. They can vary based on which organ is descending and how far it has descended (grade).

Prolapse will be diagnosed based on which organ is descending:

Cystocele: The bladder falls backward into the front (anterior) vaginal wall, the most common type of prolapse
Urethrocele: A prolapse of the urethra (the tube that carries urine)
Uterine prolapse: A prolapse of the uterus
Vaginal vault prolapse: prolapse of the vagina
Enterocele: Small bowel prolapse
Rectocele: the rectum falls forward into the back (or posterior) vaginal wall

Details: Written by: Staff; Published: 12 June 2018; Last Updated: 25 February 2022; 14574 Views

What Are the Benefits of Treating Pelvic Organ Prolapse with Pelvic Floor Therapy?

Read on to find out.

It’s Pelvic Organ Prolapse Awarenesss Month. Today we talk about something that’s often not talked about and lay out ways prolapse can be avoided and treated with proper pelvic floor physical therapy.

What Is Pelvic Organ Prolapse?

"Prolapse" refers to a descending or drooping of organs. Pelvic Organ Prolapse (POP) refers to the prolapse or drooping of any of the pelvic floor organs, including: the bladder, uterus, vagina, small bowel, or rectum. These organs are said to prolapse if they descend into or outside of the vaginal canal or anus.

Prolapse is sometimes given these specific names to describe which organ is descending:

Cystocele: The bladder falls backward into the front (anterior) vaginal wall
Urethrocele: A prolapse of the urethra (the tube that carries urine) into the vaginal wall
Uterine prolapse: prolapse of the uterus
Vaginal vault prolapse: prolapse of the vagina
Enterocele: Small bowel prolapse
Rectocele: the rectum falls forward into the back (or posterior) vaginal wall.

Redefining Postpartum Care in the “Fourth Trimester” by Utilizing Pelvic Floor Physical Therapy

Last month the American College of Obstetricians and Gynecologists (ACOG) updated their position on postpartum care in the “fourth trimester” - the first 12 weeks after your baby is born. This is such a huge step for better healthcare and support for women after delivery. In other countries (France, Belgium, Northern Ireland and other European countries), postpartum physical therapy is a routine referral for women both in the hospital and for ongoing support when they are discharged.

The statement updates the previous recommendation of a 6 week visit, and instead supports a paradigm shift of postpartum care that not only adds contact with their Ob-Gyns within the first 3 weeks of delivery, but also address the need for ongoing care:

Details: Written by: Staff; Published: 02 May 2018; Last Updated: 22 February 2022; 13953 Views

Tips For Scar Management and Desensitization After C-Section

Also After Hysterectomy and Other Laparoscopic Procedures

After delivery via cesarean section, hysterectomy or other laparoscopic procedure, there will be an incision site that you will have to manage according to the directions of your doctors and nurses to keep the site from becoming infected. Although the incision site will close after about 2-3 weeks, scar tissue will continue to form. It is important to begin scar massage and desensitization techniques to help prevent scar tissue build up, puckering, and ongoing pain.

Managing Scar Tissue

A trained physical therapist can perform soft tissue mobilization and other modalities such as cold laser over the scar site. As a part of your treatment, your therapist will teach you skills to manage the scars at home for the following benefits: