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Pelvic Diagnoses



Urinary Incontinence



Urinary incontinence is the involuntary loss of urine. The three major types of urinary incontinence are stress incontinence, urge incontinence, and mixed incontinence.


Stress incontinence is a result of increased increased intra-abdominal pressure. Associated activities could be laughing, coughing, sneezing, jumping, or running.


Urge incontinence occurs when there is an urge to urinate and you are unable to prevent leaking. The sound of running water may also trigger urinary loss.


Mixed incontinence is a combination of stress and urge incontinence.


Frequency may be present with all types of urinary incontinence.



Pelvic Organ Prolapse



Pelvic organ prolapse is when the pelvic organ are no longer suspended appropriately within the pelvis. Chronic straining (like with having bowel movements), chronic coughing, repetitive heavy lifting (hard manual labor or weightlifting), and pregnancy may increase the risk of prolapse.


Common types of prolapse in women include a cystocele (the bladder), a uterine prolapse (the uterus), a vaginal vault prolapse (prolapse of the vaginal following a hysterectomy), an enterocele (the small intestine)and a rectocele (the rectum).


A rectal prolapse can occur in both men and women. A rectal prolapse occurs when the rectum prolapses out of the anus.



Pelvic & Abdominal Pain



Abdominal pain can be a symptom of other diagnoses such as constipation, bowel obstructions, or adhesions, to name a few. It is important to discuss abdominal pain with your physician so that the cause of the pain can be addressed.


Pelvic pain is similar in that pain is a symptom and not a diagnosis independent of itself. Some diagnoses that can cause pelvic pain are endometriosis, vaginismus, vulvodynia, and dermatologic conditions.


Physical therapy can help with pain management but the underlying cause of the pain will also need to be addressed.



Fecal Incontinence



Fecal incontinence may also be referred to as anal incontinence. It is the involuntary loss of feces or flatulence.


Some individuals may experience both fecal and urinary incontinence.


This may sound contradictory, but some individuals may experience fecal incontinence with severe constipation.



Constipation



Constipation is defined as having less than 3 bowel movements a week. Stool can be hard and difficult to pass or lumpy or small pellets. There are a couple of types of constipation that physical therapy can address: slow transit constipation and outlet dysfunction.


Slow transit constipation affects the large intestine and is a result of decreased peristalsis. The fecal matter moves slowly through the large intestine and may become dry and firm making it more difficult to defecate.


Outlet dysfunction constipation results from inappropriate contractions of the pelvic floor muscles during attempts to defecate.



Pregnancy & Postpartum



During pregnancy, a woman's body has to adjust and adapt to accommodate a growing fetus. The changes may produce joint pain, muscle pain, pelvic and/or abdominal pain, constipation and urinary and/or fecal incontinence.


The postpartum period can be just as challenging as pregnancy as a woman's body is trying to return to "normal". There may still be joint and muscle pain, postural dysfunctions, pain with intercourse, constipation, and urinary and/or fecal incontinence.


Every pregnancy and postpartum period is different and not equal. A woman may experience all of these symptoms or just a few.



Treatment Interventions





The following interventions may be used during your course of treatment.



Pelvic Floor Muscle Exercises



Performing pelvic floor muscle (PFM) exercises are the most common form of exercises during pelvic physical therapy. These exercises are commonly referred to as kegel exercises. Not is strengthening a component of PFM exercises, but also full muscle relaxation.



Hip & Core Strength & Stabilization



The pelvic floor muscles have a close relationship with the muscles of the hips and trunk. It is imperative to address the strength and stabilization of these muscles and then coordinate it with the strengthening program of the pelvic floor muscles.



Pelvic Floor Coordination & Timing Training



in some instances, the strength of the pelvic floor muscles is good however the coordination and timing of the contractions is off and results in bladder & bowel dysfunction.



Manual Techniques



Manual techniques to decrease fascial restrictions or mscles spasms/trigger points may be beneficial to facilitate proper muscle contractions.



Behavior & Nutritional Modifications



Addressing our bathroom behaviors is an important factor when treating bladder & bowel dysfunctions. understanding our diets and nutritional habits is important to facilitate all body functions, not just bladder & bowel.



Electrical Stimulation & Biofeedback



electrical stimulation is a modality utilized in physical therapy to decrease pain or facilitate muscle contractions. Biofeedback is a tool that can help facilitate muscle contractions or muscle relaxation.


Email: elizabeth@bellpelvichealthandrehab.com