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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.

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!

physical therapy for post surgery issues

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:

Read more: Post Surgical Conditions

Pudendal Neuralgia:

Pudendal Neuralgia 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.

Read more: Pudendal Neuralgia

Photo by Alexander Krivitskiy on Unsplash

What is abdomino-phrenic dyssynergia?

Abdomino-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.

Read more: Abdominal Phrenic...

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.

Read more: Incontinence

Pelvic Floor Issues and Services

Our experience solving a wide range of pelvic floor issues is unmatched in our field, including some less common issues that other therapies cannot always find answers for.

Read more: Other Pelvic Floor Issues

“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.

Read more: Urogenital Prolapse

pregnancy services at Femina Physical Therapy

We can help with a large range of pregnancy and post-partum related disorders. We also offer a post-hysterectomy recovery program and many other pregnancy and non-pregnancy related services.

Read more: Pregnancy & Postpartum...

Cancer Rehabilitation

We offer a comprehensive cancer survivor rehabilitation program, including Lymphaedema therapy.

Read more: Cancer Rehabilitation...

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.

Read more: Painful Bladder Syndrome /...

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.

Read more: Physical Therapy for...

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."

Read more: Dyspareunia Symptoms and...

Vulvodynia:

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.

These muscles may have a high resting tone, shortening of the muscle and exhibiit difficulty with relaxation. When muscles are short, this can also lead to overall muscular weakness. However, strengthening a muscle that is already short will only feed in to the pain cycle, so Kegel exercises (pelvic floor muscle contractions) are typically not indicated in the earlier states of rehabilitation for pelvic pain (including vaginismus, vulvodynnia, vestibulodynia, endometriosis, interstitial cystitis / painful bladder syndrome, and others).

Trigger points are commonly found when palpating these muscles. They contribute to the urologic and gynecological pain syndromes listed above, preventing painfree sexual intercourse and other painfree activities of daily living.

Physical therapy treatments play an integral part in restoring optimal muscle function with manual therapy interventions, stretching/strengthening exercises, pain management strategies, patient education, and home program instruction.

Biofeedback is often utilized when appropriate to restore the normal functioning of painful muscles.

Links to more information:

http://www.vulvodynia.com
https://issvd.org/wp-content/uploads/2015/09/concensus-terminology-of-Vulvar-Pain-V5.pdf

Resources:

Sex Without Pain: A Self Treatment Guide to the Sex Life You Deserve for immediate PDF download (helpful for painful intercourse and generalized vulvar pain)

Dilators - Sex Without Pain book and Dilators from Soul Source.

Vaginismus Recovery - Diagnoses and Treatments

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

Read more: Vaginismus Recovery -...

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.

Read more: Vulvar Vestibulitis...

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

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 can last from seconds to minutes to several hours.

Read more: Anorgasmia / Dysorgasmia -...

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What They Say About Us

  • Testimonials

    • Testimonial by A.B.

      Before I was referred to Heather Jeffcoat I was living in a nightmare. I had been married to my husband for three years and I was suffering from Vaginismus. That all changed when I visited my OBGYN and she said she knew of someone with a great success rate. To be honest I was hesitant at first because my first doctor had already told me that all I needed to do was order dilators from the internet and I should overcome my problem. She was wrong because I had followed the book on how to use the...

      Read more Testimonial by A.B.

  • Testimonials

    • 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.

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