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Abdominal Phrenic Dysynergia
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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.

With Abdominal Phrenic Dyssynergia, this coordination is dysfunctional and the diaphragm contracts instead of relaxing when there is abdominal fullness. When the diaphragm contracts the muscle moves downward, taking up space in the abdomen. This action forces the abdominal organs to move down and out, causing abdominal distention and bloating.

Symptoms

  • Abdominal bloating that does not resolve with changes in diet nor exercise
  • Distended belly that does not resolve with changes in diet nor exercise
  • Abdominal pain
  • Constipation

Often presents with pelvic floor dyssynergia (read more about dyssynergia in my previous blog post)

  • Constipation
  • Pelvic pain
  • Pain with sex

How Pelvic Floor Therapy Can Help

A trained pelvic floor therapist will conduct a comprehensive exam of the spine, pelvis, lower extremities, nerve function, viscera (organs) of the abdomen and pelvis, and also assess the tone and function of the pelvic floor and abdominal muscles. After the therapist gathers all the pertinent information, they will work with the client to create a treatment plan and goals. Read my previous blog post on what to expect at your first appointment for more information.

Treatment for Abdominal Phrenic Dyssynergia can include:

  • Manual therapy of the structures surrounding the diaphragm, improving movement
  • Manual therapy of the spine and pelvic girdle
  • Nerve Flossing
  • Visceral Manipulation
  • Exercises to improve respiratory diaphragm and abdominal wall function and coordination
  • Pelvic floor manual therapy
  • Mindfulness and breathing exercises
  • Intestinal and abdominal massage
  • Biofeedback
  • Surface EMG biofeedback
  • Neuromuscular re-training of the diaphragm, abdominal wall, and pelvic floor

Our team at Femina PT is specially trained in all these techniques, let us hep you! Give us a call to schedule a visit today.

Resources

Villoria, A., Azpiroz, F., Burri, E., Cisternas, D., Soldevilla, A., & Malagelada, J.-R. (2011). Abdominal Phrenic Dyssynergia in Patients With Abdominal Bloating and Distension. The American Journal of Gastroenterology, 106(5), 815–819. doi:10.1038/ajg.2010.408

Malagelada, J. R., Accarino, A., & Azpiroz, F. (2017). Bloating and Abdominal Distension: Old Misconceptions and Current Knowledge. The American Journal of Gastroenterology, 112(8), 1221–1231. doi:10.1038/ajg.2017.129

Sanders, L. (2013). Think Like a Doctor: The Gymnast's Big Belly Solved. New York Times Website: https://well.blogs.nytimes.com/2013/09/06/think-like-a-doctor-the-gymnasts-big-belly-solved/

 

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Testimonial by Jamie M.

I have been going to see Heather for a while now, and I can't tell you enough how much she has improved my quality of life. Heather specializes in issues like pelvic floor, but I see her for other orthopedic issues.

I have a lot of chronic joint pain and dysfunction issues (back, hips, neck) that require that have ongoing physical therapy maintenance. The effects of my problem joints/areas overlap and interconnect with each other in complex ways, so helping me requires really having a complete understanding of the entire skeletal and muscular system. Pain does not always appear where the problem actually is, the human body is a twisty, many-layered puzzle. I have an exercise program I do at home and I am very functional, but there are just something things I need a PT to help me out with.

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Testimonial by S.H., age 24

I just wanted to thank you for everything you've done for me for the past 19 months. I literally could not have reached my goals without you and your practice. You gave me the courage to keep moving forth with my treatment no matter how afraid and anxious I was. You were always there to answer questions and made this whole process so much easier than I expected it to be.

It's because of you that my marriage is on the right track, that I can get pregnant and that this part of my life is finally over. I really feel that Fusion Wellness is a team of people you can call family and are there to root for you and cheer you on until you reach your goals. There is nothing better than knowing I accomplished this with you guys by my side and as calmly and patiently as I needed. Thank you from the bottom of my heart for always being there and helping me reach my goals.

S.H., age 24

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 dilators with absolutely no advancements in my condition. However, that all changed when I went in for my first visit and Heather took the time to explain my condition and how we were going to work together to overcome it.

I remember leaving her office with a glimmer of hope that I could live a normal life. As my sessions continued I began to see immediate results. With only four sessions and a strict dedication to my home programs I was cured of Vaginismus. In the beginning of this process I was made aware that my health insurance company might not cover the costs, which was disappointing but today I can say one hundred percent that it was the best money I ever spent. Now thanks to Heather I am finally enjoying my life to the fullest with my husband. Thank you Heather, I can’t begin to tell you how much I appreciate all that you have done for me. I will never forget it. Those who are suffering from these types of conditions don’t be afraid because she makes you feel so comfortable and the end result is worth it. Good luck to you all and I hope you experience the success I have.
-- A.B.

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!

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Testimonial by Jackie W.

I was in multiple car accidents a decade ago, and I have been to many physical therapists through the years without success. They found the root of my lower back pain problems and after nearly a decade of barely being able to walk I finally can again without pain. They are also the best pelvic floor pts and the only ones who found the connection between my pelvic floor and lower back problems. If you need help with physical pain, they are your answer.

-- Jackie W., 1/19/17 via Yelp!

Testimonial by Mary L.

I started seeing Heather to treat my Interstitial Cystitis in November 2016. At this time, I was extremely miserable, in constant pain, and felt as though no one was listening or understood what was going on with my body. I have just finished my last appointment and I can honestly say that my life has completely changed for the better because of Heather and her team of PTs! I live almost completely pain free, and when I do have flare ups, I am able to treat them at home on my own. I am so grateful that this office was recommended to me a honestly cannot recommend them enough!

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