SERVICES WE OFFER
At the initial evaluation, Anna obtains a detailed patient history and performs an examination, which includes a postural and biomechanics assessment, range of motion, muscle strength and flexibility testing, external and/or internal pelvic floor muscle exam. Pelvic floor muscle assessment provides important information about muscle tone and coordination, soft tissue extensibility, muscle strength and endurance. These findings are essential in creating a customised comprehensive plan of care.
As an expert in the field of pelvic floor rehabilitation, Anna is skilled in diagnosing and treatment of a variety of pelvic floor conditions including but not limited to:
- Menopause transition
- Hormonal changes during menopause cause the vagina to get drier and lose its elasticity. This can cause discomfort during sexual intercourse. Pelvic floor muscles can also atrophy, which can result in urinary incontinence. Pelvic floor physical therapy is a conservative and effective way to improve pelvic floor muscle strength, elasticity and control.
- Post partum rehab
- Diastasis recti is a common condition in post partum women, when abdominal muscle separates during pregnancy, causing a protruding abdomen. It can be improved with specific exercises.
- Perineal and c-section scars: scar tissue can cause discomfort during sexual intercourse and daily activities. PT can provide targeted treatments including manual techniques and specific exercises to facilitate proper soft tissue healing.
- Pubic symphysis dysfunction: pain or dysfunction at the pubic symphysis joint. This occurs due to changes in ligamentous laxity and increased pelvic pressure during pregnancy and causes severe pain with stair negotiation, walking and lifting.
- Painful sexual intercourse
- Painful sexual intercourse could be caused by hormonal changes, perineal trauma, pelvic floor muscle dysfunction, and psychological stress. Pelvic floor PT can help by providing specific manual techniques and exercises to the area.
- Urinary incontinence
- Stress urinary incontinence is urinary leakage with laugh, cough, sneeze or with increased physical activity. This can happen due to combination of hormonal changes and stretched pelvic floor muscles during birth. This condition can be improved with specific pelvic floor exercises.
- Constipation
- In general, constipation occurs when stool moves too slowly through the large intestine. If the stool moves slowly, the body absorbs too much water from the stool and it can become hard, dry and difficult to pass. The pelvic floor muscles need to have the ability both to contract and to relax in order to be able to pass stool from the rectum. Problems with weakness or coordination of these muscles can cause chronic constipation. Working with a physical therapist can help you learn to relax muscles and coordinate the use of muscles in your pelvis, rectum and anus.
- Low back pain and pelvic pain
- There is a close relationship between back and pelvic musculature. Pelvic floor dysfunction can be contributing to low back pain and the other way around. Improving the muscle balance between lumbar and pelvic musculature, can decrease pain and improve function.
- Fecal incontinence
- Fecal incontinence is accidental passing of solid or liquid stool. Very soft and very hard stools can lead to fecal incontinence. Fecal incontinence is more common in women, likely because of possible injuries during delivery. The risk of fecal incontinence is increased with long-term diseases that affect the intestines. Many people feel embarrassed about fecal incontinence resulting in anxiety or depression. They may try to hide the problem and avoid social situations. The skin around the anus is delicate and sensitive. Repeated contact with stool can lead to skin break down and a risk of infection. Exercises help strengthen the muscles of the anus, rectum and pelvic floor.
- Pelvic organ prolapse
- Descent of pelvic organs (bladder, uterus, and/or rectum) from the normal positions into the vagina. This usually happens due to weakening of the pelvic floor tissues and muscles. This condition could cause pain with intercourse, difficulty with urination and emptying the bladder, "feeling of falling out" with daily activities.
- Post surgical rehab
- We offer rehabilitation following a hysterectomy, c-section, bladder or rectal repair surgery.
TREATMENT TECHNIQUES
In addition to exercise instruction, patients receive education on pelvic anatomy and function. Extensive time is spent on restoring a proper breathing pattern to enhance pelvic floor muscle coordination and function. Often manual techniques such as soft tissue mobilization, massage and myofascial release are used to improve soft tissue extensibility.
Biofeedback is utilized when appropriate to facilitate patient's ability to become more aware of their pelvic floor muscles. Instruction on vaginal trainers such as dilators is provided to help patients increase their pelvic floor muscle length and elasticity. A great part of the treatment plan is devoted to creating a comprehensive home exercise program not only to address patient's current condition, but to help prevent re-occurance of the symptoms and to promote general wellness.