“For sixty percent of women, a brochure on pelvic floor exercise is just not enough—“
Millions of women have an incontinence problem. Pelvic floor exercises can help, but only if they are done properly. If not, they may be ineffective or they could even make matters worse. Incontinence costs millions of dollars a year, and is a principal reason for entry into nursing homes. In recent years high-level research evidence has shown that physical therapy management of incontinence is more cost effective than conventional medical or surgical intervention.
New biofeedback research done in Australia indicates that six out of ten women with symptoms of incontinence or pelvic organ prolapse perform pelvic floor exercises incorrectly and therefore need individual training to achieve improvement to their symptoms.
Using a new approach with proven technology, transabdominal ultrasound was used to assess 104 women with urinary incontinence and prolapse. The women were asked to draw in and lift the pelvic floor muscles, and the results were monitored on the ultrasound screen. Only 38% performed the exercise correctly; 19% achieved no movement at all, and 43% actually depressed the pelvic floor instead of performing an elevating contraction.
By the patient watching her own efforts on the ultrasound screen, she can be taught how to correctly perform pelvic floor exercises in one or two treatment sessions. At Ascent Physical Therapy, the pelvic floor muscle training component of incontinence is addressed with the latest concepts and technology including transabdominal ultrasound imaging and video-animated biofeedback software.
*Ascent Physical Therapy is currently the only clinic in Nevada using the transabdominal ultrasound technology to evaluate the pelvic floor muscle contraction (a.k.a. the Kegel).
Pregnancy, labor, and delivery create many changes in a woman’s body – some slowly over several months, and some acutely due to trauma during labor and delivery. Every woman who goes through this amazing process changes the way they use their muscle system to stabilize the lumbopelvic region and transfer loads through their bodies. Ascent Physical Therapy’s Women’s Health program is designed to identify the non-optimal stability and movement patterns specific to pre and postpartum women, then promote and restore optimal form and function of the lumbopelvic region through education, exercise and changing movement patterns.
The goal of this program is to provide women with the knowledge and skills they need to restore optimum function of their low back and pelvis. The program specifically addresses the consequences which occur through the experience of pregnancy and delivery. The information delivered, as well as the exercises and movement behaviors taught, will help to restore optimal stabilization strategies for their low back and pelvic girdle. Optimal stabilization and movement strategies can potentially reduce the risk of future low back and pelvic pain, as well as prevent problems such as uterine prolapse and bladder dysfunction. This program puts an emphasis on promoting and/or enhancing physical health throughout a woman’s life span.
* Tammie Bigley, M.S.P.T. is currently the only therapist in Nevada certified to teach the “Post Partum Health for Moms” class.
The female pelvis is structurally unique from the male pelvis. This difference in structural design presents women with a challenge in load transfer and stability during high load/high level activities. Weaknesses and imbalances of the core muscles have been related to low back pain and lower extremity injuries in the female athlete. In addition, absence of hip strength and stability has also been shown to predispose female athletes to lower extremity injury by allowing excessive femoral adduction and internal rotation during lower extremity movements. During sports participation, this phenomenon occurs primarily during jumping and landing activities resulting in knee injuries. Through specialized training and experience, we are able to thoroughly evaluate and treat female athletes. By combining knowledge of movement dysfunctions with the tools of ultrasound imaging and surface EMG biofeedback, we are able to accurately identify contributing dysfunctional motor control patterns and prescribe corrective specialized exercises specific to each athlete. The result is a treatment plan that is tailored to meet the specific needs of each athlete with an emphasis on promoting and/or enhancing optimal movement patterns for their sport or activity. Core strengthening and prescriptive strengthening programs have been shown to be effective in reducing these types of injuries in the female athletic population and in improving their performance.
As a group the pelvic floor muscles are part of the “inner core” musculature which is responsible for stability of the lumbar spine and pelvis. The pelvic floor muscles also create a sling which supports the bladder, uterus, and rectum. Any type of change, alteration or dysfunction anywhere within this “inner core” system caused by either, muscle, joint, or nerve problems, can create tension, weakness or pain in the pelvic floor. The patient may have difficulty sitting, pain during intercourse, or pain in the hips or lower abdomen. Through Tammie Bigley’s extensive experience and knowledge along with most advanced computerbased Pelvic Floor Muscle Biofeedback training system and ultrasound imaging, she is not only able to better treat pelvic floor problems but also their underlying cause.
Tammie Bigley, M.S. P.T. is the area leader in utilizing and providing the most advanced and cutting-edge physical therapy treatments for women’s health issues.
URINARY INCONTINENCE IN MEN
Over 13 million Americans will experience involuntary loss of urine with one third of these individuals being men. Incontinence is a common symptom after prostate surgery. What is typically unknown is that physical therapy can help reduce or eliminate incontinence in men as well as women.
Treatment options offered at Ascent Physical Therapy include:
- Education regarding the anatomy and physiology of micturition
- Biofeedback to assess and train the strength, endurance and coordination of the pelvic floor muscles
- Real-time ultrasound to assess pelvic floor and transverse abdominus function and also give the patient visual feedback regarding the muscle contractions.
- Incorporation of the pelvic floor muscles into functional activities including work and sport specific activities i.e. golf, lifting
CHRONIC PELVIC PAIN
Pelvic pain, while again more prominent in women, can also affect men. While the origin of the pain may stem from diagnoses such as chronic nonbacterial prostatitis, levator ani syndrome, or pudendal nerve entrapment, secondary musculoskeletal issues may provoke symptoms. By performing a thorough assessment of the nervous and muscular systems involved with the pelvis, therapists at Ascent can make physical and biomechanical changes to decrease pain provoking dysfunction as the patient is taught new biomechanical patterns.