Post Surgical Care followed by Hysterectomy or Bladder
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What is Diastasis Recti, and how is it treated?
Diastasis recti is defined as a separation, or spreading apart of the right and left halves of the rectus abdominus muscle. This can occur in pregnant women due to stretching of the uterus and pregnancy hormones which soften the connective tissue. Risk factors include: being over the age of 35, high birth weight, a multiple birth pregnancy, and multiple pregnancies. Following pregnancy and delivery a diastasis can resolve or improve on its own, but in some women it may persist. If left untreated it can lead to poor posture, altered pelvic alignment, and chronic low back pain. This can be due to excessive abdominal fat, repetitive straining, and/or incorrect form when performing traditional abdominal strengthening exercises.
Abdominal crunches do not work to correct diastasis recti! In fact, many traditional abdominal strengthening exercises such as crunches and some basic Pilate’s maneuvers (if done incorrectly) can actually worsen a diastasis. Even the simple act of how a person gets out of bed every morning can potentially worsen an already existing diastasis. Diastasis recti has been shown to improve or reduce with physical therapy, specifically with exercises that emphasize transverse abdominus muscle strengthening. The transverse abdominus is a deep core muscle that acts as a muscular brace to support internal organs, stabilize the trunk, and connect the pelvis to the rib cage. Learning to identify and use the transverse abdominus while maintaining proper postural alignment during functional activities is the key to reducing and improving the diastasis.
Our Pelvic Health Physical Therapists are fully trained to evaluate and treat this problem. We teach and supervise proven, appropriate, and safe core strengthening exercises that encourage healing, reduction of the separation while addressing any associated back pain, as well as flattening of the belly.
It will be our pleasure to guide you in reducing your diastasis recti.
How Can Pelvic Floor Physical Therapy treat Outlet Dysfunction Constipation and Fecal Incontinence?
Irregularity is not normal! One commonly accepted medical definition of constipation is having a difficult bowel movement fewer than three times a week. Constipation can be a source of bladder control problems, frequent urinary tract infections and can lead to other serious problems. Likewise fecal incontinence (inability to prevent the loss of stool or gas) can be an emotionally and functionally disabling problem.
Pelvic floor muscles play an important role in bowel and bladder function. Problems can result from pelvic floor muscle weakness and/or abnormal muscular coordination. For example, sometimes with chronic or severe constipation the pelvic floor muscles can ‘misbehave’. Instead of opening and relaxing to allow effective defecation, the muscles may tense, tighten and spasm. Further straining may only increase this abnormal response further impeding the passage of stool. This ineffective straining may cause a prolapse of the bladder, bowel, uterus, rectum and/or intestine pushing push down into the vagina.
Lastly, pelvic floor muscle weakness may result in a poor ability to contain stool and result in leakage of stool. Common treatment interventions include: • Education: pelvic floor anatomy and function, how to “find” your pelvic floor muscles. • Pelvic floor muscle re-training: learning how to relax, strengthen and coordinate the pelvic floor muscles. • Biofeedback: an extremely helpful modality used to improve patient understanding thereby improving and normalizing motor control of pelvic floor musculature. It is painless and non-invasive! • Behavioral strategies: toileting schedules, fluid/fiber intake, stool consistency monitoring, urge awareness and management. • Therapeutic exercises: Instruction in exercises that will enhance pelvic floor muscle relaxation as well as control. • Manual therapy techniques: hands-on treatment to help relieve muscle tension of supportive hip musculature, abdominal muscles, and/or pelvic; manual therapy techniques aimed at improving motility. Our female Pelvic Health Physical Therapists strive to make your experience as comfortable as possible to reach your goals.
What is Dysparunia?
Dyspareunia is persistent or recurrent genital pain that occurs before, during, or after intercourse. It is estimated that this problem affects 16% of women between the ages of 18 and 64. A woman with this condition typically has pain during sex and is often unable to achieve penetration. She may have pain during her yearly gynecologic exam and often cannot tolerate insertion of the speculum, or use tampons.
We are physical therapists specifically trained in treating all types of pelvic floor problems, including dyspareunia. As physical therapists we will evaluate the musculature and soft tissue. With the help of biofeedback we can train and normalize muscle relaxation and correct abnormal muscle behavior such as guarding and tension. Treatment typically includes gentle myofascial release techniques to release trigger and tender points and appropriate stretching, exercises, and relaxation techniques. Normalizing muscle function is the goal and precursor to achieving the ultimate goal of pain-free, enjoyable intercourse. All six female physical therapists at Core Plus Physical Therapy are comfortable and skilled in treating this condition and spend 55-minutes with each patient. Privacy is of utmost importance and all of our treatment rooms are private and sound-proof. We understand the sensitivity surrounding dyspareunia so we make sure every patient is seen by the same therapist from beginning to end. The vast majority of patients treated with physical therapy for this isolating but not uncommon problem will achieve excellent results and go on to experience a normal, fulfilling sex life.
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