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Preoperative Pelvic Health and Orthopedic Assessment:
- Alignment, postural assessment and corrective exercises –
- Binding can lead to postural dysfunctions that in turn lead to neck and back pain.
- Tucking is associated with changes in bladder function due to long periods of delay/retention and puts you at increased risk of developing overactive pelvic floor muscles.
- Fascial mobility assessment – to help with skin graft harvesting
- Hip mobility assessment – decreased range of motion can lead to difficulty in positioning during the surgery, or increased pain postoperatively if hips placed into already restricted position due to extensive time spent in position during surgery (6-8 hours); Communication with the surgeon on these limitations for possible position alterations to decrease time spent in restricted or painful range of motion
- Functional core assessment: weakness, overactivity or incoordination of abdominal and pelvic floor muscles contributes to bladder, bowel and sexual dysfunction. Some of this dysfunction may be present preoperatively and should be assessed and treated to improve post-operative outcomes.
- Patient-specific education: This is an essential component of any physical therapy treatment plan
Postoperative Pelvic Health and Orthopedic Assessment:
- Continue to address postural and orthopedic dysfunction found preoperatively, and reevaluate for changes in status, including strength, muscle flexibility and joint range of motion
- Evaluation and treatment for bladder, bowel and sexual health when appropriate (urinary urgency, painful intercourse, perineal itching, burning sensation, incontinence or leakage or any other discomfort in abdominal, genital or perineal area that may be present).
- Scar tissue management and myofascial therapies for FtM chest masculinization surgery, FtM and MtF bottom surgery, MtF Feminizing Mammoplasty
- MtF--dilator training and support; sexual health and improve function
- FtM-sexual health and improve function
These people need the support of our community, and from a young age. Gender identity, gender expression and sexual orientation as portrayed by society may conflict with how men and women are perceiving themselves. This can have devastating consequences, including suicide. This population has an alarmingly high suicide rate – 41% at some point in their lives, compared with 4.6% of the general population (from American Foundation for Suicide Prevention and the Williams Institute). Providers need to educate themselves and be sensitive to these challenges that are faced.
At Femina Physical Therapy, while focusing on pelvic health, offer chronic pain therapies for the entire body. Our main goal is to create a healing and supportive environment that is welcoming to all. We look forward to hearing from you, and you can use this form if you would like to schedule an appointment with one of our licensed physical therapists.
**This information is for educational purposes only and is not intended to replace the advice of your doctor.
