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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 over 2 hour appointments. 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 either our La Cañada or Sherman Oaks office 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:

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.

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.

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.

“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.

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.

Cancer Rehabilitation

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

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.

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.

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."

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).

Some links to more information:

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

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.

Anorgasmia (No Orgasms)

Anorgasmia is the persistent inability to achieve orgasm despite responding to sexual stimulation. The Mayo Clinic further defines as the lack of orgasms distresses you or interferes with your relationship with your partner:

By definition, the major symptoms of anorgasmia are the inability to have an orgasm or long delays in reaching orgasm that's distressing to you. But there are different types of anorgasmia:

  • Lifelong anorgasmia. You've never had an orgasm.
  • Acquired anorgasmia. You used to have orgasms, but now have difficulty reaching climax.
  • Situational anorgasmia. You're able to have an orgasm only in certain circumstances, such as during oral sex or masturbation or only with a certain partner.
  • Generalized anorgasmia. You aren't able to have an orgasm in any situation or with any partner.

What They Say About Us

  • Testimonials

    • Testimonial by S.B.

      As someone who suffered the debilitating physical and emotional effects of vaginismus (as well as a complicated history of back injuries) for more than 15 years, I thought a "normal" life was just a fantasy. Then I found Heather.

  • Testimonials

    • Testimonial by M.N., age 28

      A personal journey and testimonial from one of my patients: I was diagnosed with vaginismus 4 years ago. I never heard of such medical condition until after I got married. At first my husband and I didn't know what to do, we didn't know what the issues were or how to overcome it. Being born and raised in Armenia and being Christian I wasn't that open about talking to sex with others and so it wasn't easy to seek help. But eventually I went to an Ob-Gyn and luckily she knew about the medical...

      Read more Testimonial by M.N., age 28

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