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TLC/Pelvic Rehab

Pelvic Health

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Painful Tailbone

The coccyx / tailbone is a series of 3-5 vertebral segments at the end of the spine that has numerous ligament and muscular attachments. It is an important component of the pelvis and it suffer from coccydynia you realize that many routine movements during an average day can be extremely painful and debilitating. Most cases can be cured or improved with proper intervention.

Common Causes

  • Painful during or after sitting
  • Acute pain moving from sitting to standing
  • Sitting on a soft unstable surface
  • Deep ache around the coccyx
  • Falling on the coccyx
  • Cycling, rowing
  • Childbirth
  • Muscle Imbalance
  • Hysterectomy
  • Ligament Tear
  • Direct trauma to the coccyx

Evaluation and Treatment
On your initial visit, our therapist will assess the strength, coordination and integrity of the pelvic floor muscles, joint alignment, and areas of painful trigger points. A personal treatment plan will be developed to increase your pain-free movement. The following treatment approaches may be implemented:

  • Muscle strengthening and or relaxation exercises
  • Postural education
  • Muscle re-education
  • Soft tissue and joint mobilization
  • Spinal and pelvic malalignment corrections
  • Biofeedback
  • Ultrasound, heat, ice
  • Binders, cushions
Nerve Entrapment

Nerve entrapment is compression on a nerve as a result of physical pressure or due to swelling of tissue in a small space through which the nerve passes. The pudenal nerve is the nerve that primarily affects the muscles of the pelvic floor, sphincters and sensation of the genitalia of both male and female.

Common Causes

  • Shift in boney structures
  • Cycling
  • Long pushing stage of labor, constipation
  • Surgeries, muscle spasm
  • Scar adhesion
  • Stretching of the nerve

Typical Complaints

  • Pelvic heaviness
  • Aggravated by sitting, may be relieved by sitting on toilet seat
  • Vaginal or penile numbness or hypersensitivity
  • Voiding and bowel dysfunction
  • Erectile or ejaculatory problems

Evaluation and Treatment
Upon your first visit, our therapist will assess your joint alignment, strength, coordination, and integrity of your pelvic floor, abdominal,low back and leg muscles. Based on these findings, a personalized treatment plan will be established. Your treatment plan may include techniques such as:

  • Education and instruction of self care strategies
  • Spinal and pelvic realignment, postural education
  • Muscle re-education, strengthening and/or relaxation
  • Soft tissues mobilization and myofascial release
  • Manual therapy techniques
Constipation

Normal toileting habits vary widely. While many people evacuate once per day, normal ranges are from three times per day to one evacuation every three days. Constipation is defined as having a bowel movement fewer than three times per week and stools are usually hard, dry, small in size, difficult to eliminate and can be painful. Constipation is one of the most common gastrointestinal complaints, often causing a decrease in quality of life as a result. Often patients have symptoms for a long time without seeking treatment. Don't wait. There is help available.

Common Types

  • Constipation dominant Irritable Bowel Syndrome
  • Slow transit constipation - decreased intestinal motility
  • Dyssynergic defecation - pelvic floor dysfunction and/or weakness
  • Anismus - muscle spasm around the anal canal
  • Idiopathic constipation

Common Causes

  • Surgery, trauma, inflammation
  • Scar tissue, tumors
  • Medication, pain
  • Lack of physical activity
  • Genetic
  • Abdominal and pelvic floor muscle dysfunction, weakness
  • Muscular and sphincter incoordination
  • Metabolic conditions - Diabetes, Hypercalcemia, Hypothyroidis
  • Neurological conditions - Multiple Sclerosis, Parkinson disease, Stroke, Spinal cord injuries
  • Changes in life or routine

Typical Complaints

  • Straining during bowel movements
  • Lumpy or hard stool
  • Sensation of incomplete evacuation
  • Sensation of anorectal blockage / obstruction
  • Fewer than three bowel movements per week
  • Bloating, gas, decreased appetite

Evaluation and Treatment
Upon your first visit, our therapist will assess your strength, coordination, and integrity of your pelvic floor muscles, abdominal muscles and sphincter control. Based on these findings, a personalized program will be established.Your treatment plan may include techniques such as:

  • Muscle re-education, coordination, or relaxation
  • Sensory retraining
  • Manual therapy techniques
  • Biofeedback
  • Therapeutic exercise
  • Patient education
  • Bowel retraining and behavioral interventions
Anorectal Pain

Pain syndromes in this area may be due to local pathology, spasm of related musculature, fissures, abscess, fistula, hemorrhoids or local irritation of the skin. Pain may also be referred from organs, pelvic bones, from various spinal levels and sometimes from the lower extremities.

The following treatment interventions maybe be used to resolve the problem of hypertoncity or muscle spasms as a result of pain:

  • Biofeedback/ surface electromyography (EMG)
  • Muscle re-education, coordination and relaxation
  • Soft tissue mobilization and myofascial release
  • Postural alignment and education
  • Patient education
  • Manual Therapy techniques
Anal Incontinence

Anal Incontinence is the involuntarily loss of rectal contents, whether solid, liquid or gas. It is not uncommon for patients to present with combined fecal (stool) and urinary incontinence. Anal incontinence can be difficult to discuss, but even more difficult to endure. Fortunately, help is available. If you suffer from anal incontinence, you are not alone. Anal incontinence is an emotional and physical condition affecting many Americans, but often unreported because of embarrassment. Most cases of anal incontinence can be cured or improved with proper diagnosis and treatment.

If you suffer from anal incontinence, you are not alone. Anal incontinence is an emotional and physical condition affecting many Americans, but often unreported because of embarrassment. Most cases of anal incontinence can be cured or improved with proper diagnosis and treatment.

Causes of Anal Incontinence

  • Damage to the anal sphincter muscles
  • Pelvic floor muscle weakness and dysfunction
  • CTrauma from injury or obstetrical trauma
  • Radiation, surgery, medications
  • Damage to the nerves or muscles of the rectum
  • Fecal movement disorders - Irritable Bowel Syndrome, diarrhea, constipation
  • Loss of storage capacity in the rectum
  • Functional impairment, aging

Evaluation and Treatment
During your initial visit, our physical therapist will assess the strength, coordination, and integrity of your pelvic floor muscles, abdominal muscles and sphincter control. Based on these findings, a personalized program will be established. Your individualized treatment plan may include the following techniques:

  • Muscle re-education of the pelvic floor and sphincter control
  • Sensory retraining
  • Biofeedback
  • Therapeutic exercise
  • Patient education
  • Bowel retraining and behavioral interventions
  • Manual therapy techniques
  • Skin care
  • Functional retraining
  • Electrical stimulation

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