Month: April 2020

Pelvic floor dysfunction is a term used to describe the inability of the pelvic floor to function normally .This could be the disorder of muscles, nerves or both and the surrounding joints like the hips and sacroiliac joint.The pelvic floor muscles are the muscles around the genitalia .These muscles support the normal  bladder , bowel and sexual functions.Dysfunction of these muscles interfere with the  normal functioning of the aforementioned organ systems. 

A pelvic therapist is a physical therapist who has additional specific training to be able to evaluate and treat all complaints of pain and dysfunction in the pelvic floor area .

This has been the area of treatment mostly for women ,and it is called womens health but recently the term Pelvic health is used more in reference to Pelvic rehab to be inclusive of men as well.Some of the common diagnosis that men present with are as follows

• Incontinence ( stress and Urge Incontinence )
• Prostatitis (inflammation of the prostate)
• Pelvic pain 
• Interstitial Cystitis
• IBS
• Coccyx ( Tail bone ) pain 
• Constipation

Some of the diagnosis for women could include the following :

• Incontinence
• Pelvic organ prolapse ( can be bladder or rectum)
• Post and abdominal and pelvic floor surgery
• Pudendal Nerve dysfunction
• Sexual dysfunction -Dyspareunia ( painful penetration ) 
• IBS

Some diagnosis treated in children include 

• Bed wetting 
• Constipation

Hope this brings some clarity of what a pelvic floor therapist treats . Please leave your comments and questions below . 

Who should do the Kegel exercises ?

Kegels exercises are the most common exercises that are very often suggested to do when presenting  with symptoms of urinary leakage . When done properly these exercises are a very effective tool to minimize and eliminate bladder leakage and to strengthen the pelvic floor muscles .

People who have complaints of  urinary urgency , make statements similar to “ As soon as I feel the urge to urinate I have to run to the bathroom or else I may have an accident . I just don’t seem to be able to hold it . ”  This is generally indicative of a weak pelvic floor and there could be other factors but I will talk about in my future blog posts , for simplicity sake let’s just consider plain pelvic floor muscle weakness. These exercises are effective when the muscles have a moderate weakness .When a person has  very weak pelvic floor muscles  and  unable to elicit a minimal pelvic floor contraction upon attempting to do kegel exercises such people will require supervision of a pelvic therapist who could use different methods to help improve the muscle strength during a PT session .

How should the Kegels be done ?

1. First ,try practising these exercises while lying down on your back  , with knees bent.
2. Squeeze the muscles of the gential area as if you are trying to stop the flow of urine or trying to stop from stopping passing gas .Be careful to not squeeze the muscles of your belly , and inner thighs .
3. Contract for 3 seconds and relax for 3 seconds .Do 3 sets of 5 .
4. As the pelvic floor gets stronger one can progress to doing this in sitting or standing , and these can be done anywhere , sitting at the desk , doing dishes etc.
5. Caution : If you feel pain in the abdomen ,back or any pain  after you do kegels ,it’s a sign that Kegels are not being done correctly .Stop and seek medical advice.
6. To check to see if you are doing the exercise correctly ,place one hand on the lower abdomen and one hand on the inner thigh to feel if the muscles are  contracting when you are contracting pelvic floor muscles to do Kegels.Avoid contraction if you feel the abdominal and inner thigh muscles contract .

How long before one can expect to see results ? 

As with any exercise regime , results need consistent practice , it may vary person to person because many factors can influence the outcome, on an average approximately 2 to 3 weeks , better bladder control should be start to become evident .If Kegels seem ineffective after that time period , you may need further assistance to assess technique or if having difficulty with isolating the pelvic floor muscle contraction. 

So now you know what Kegels exercises and how to assess if you are doing them correctly  and the role in improving incontinence . I would love to hear of your experience at with Kegels .Please leave your comments below .

As far as physical therapy goes I do not follow the no pain no gain rule , pain means something is wrong and to stop doing what’s causing the pain .The sooner you treat pain ( rather than ignore or work through it ) the quicker it is likely to respond and have an overall better prognosis .

I have worked with hundreds of patient with all kinds of joint pain , but for today’s topic will be focusing on pelvic pain .Pelvic pain refers to the pain experienced  in the pelvic floor , which could originate from the hips , the sacroiliac joint ( SI joint which is the low back  ) or the muscles of the pelvic floor .Pelvic pain is generally described as “ It’s like sciatica but in my butt and crotch !”

The pelvic floor muscles are a group of muscles that form a bowl of muscles in the bottom of the pelvis ,which include the bladder , bowel and sexual function . Vast majority of the time I find that the cause of pelvic pain is due to a tight pelvic floor .Just like people develop “knots” in the shoulders due to stress ,people develop ” knots” in their pelvic floor muscles and  when left untreated for long the knots can become bigger  and can be the source of pain and part of pelvic floor dysfunction.

Is there a solution ? sure is ! That is pelvic physical therapy. Regular simple stretches for both hips and low back is a good place to start.

If stretches do not seem to relieve the pain , it might be time to visit a pelvic therapist to get a thorough evaluation and be treated  by the findings on the evaluation .In my experience pelvic floor therapy is very effective in treating pelvic pain with good relife .Have you experienced pelvic pain ? please leave a comment below , let me know your thoughts.

Why do I do what I do ? and what is the purpose of my blog be whole creation ? As a Physical therapist , I have been in the business of rehabilitation,its the most gratifying career one could ask for , where I get to be a part of my patients journey to recovery to a normal life again.

My Mission statement : Dr’s add years to your life , I add life to your years . After a few years of being an othropedic therapist , I was looking for ways to challenge my self more professionally . Meanwhile I had my 2 kids , and post partum had my own pelvic pain issues and needed pelvic therapy , but they are very few pelvic therapist and the one I found was very far away. So I ended up rehabbing myself successfully , with my knowledge of being a othropedic PT. .

This was when I realized how few of pelvic therapist are available and how essential a service they are . I started my education of further specialized certification and took my boards and passed them.

I started working as a pelvic therapist and quickly came to understand the dire lack of awareness of the role of a pelvic therapist ‘s even among MD’s .Many of my patient came to see me with skepticism about efficacy of pelvic therapy , not sure what therapy with me entails .The purpose of this blog is to help raise awareness and bring solution to suffering .

I believe healing of the body is incomplete without the healing of the mind and soul , and when all these 3 aspects are addressed is when true wholeness is achieved . Hence the name of my blog be whole creation . We are created to be whole and function at our optimal best when we take care of our bodies and my goal is to help people guide them in that direction in a holistic approach . I am passionate about teaching my patients and give them the tools to use for life long . I believe in teaching them to fish than fish for them.

I see so much suffering among women and men who think there is no solution to their suffering I plan to change that with awareness .

What is your first thought when you think of Pelvic therapist ? I would like to hear your thoughts please comment below .

Have you ever wondered if your bladder leakage issue would ever get better?Urinary incontinence is a very common but not a normal experience seen in both males and females .As a mother of 2 and a pelvic specialist I speak from personal experience. The solution to overcome this and live a normal life again ( and yes it’s possible ! ) is so simple that most of my patients when I teach them this technique respond saying “ That’s it?” . The key lies in the doing and being consistent with instructions given.

Bladder control is a complex synchronisation between the brain and pelvic floor .Urinary incontinence generally is seen in people with weak pelvic floor , characterised by frequent urination “ just in case “. Normal duration between urination ranges on an average from 2 to 3 hours .

Applying the  following technique which my patient’s report about 90% improvement in their symptoms when being constient .

When you feel the urge to use the bathroom to urinate .

1. Question yourself :”When was the last time I used the bathroom ?” If it was 30 min  ago , you have probably not formed enough urine to justify using the bathroom and the urge is  because you formed a habit.See if you can hold off for a little bit longer .The urge usually subsides .
2. After attempting to postpone the bathroom use for as long as you can comfortably and when the urge gets  stronger , practise 5 quick contractions of the pelvic floor either sitting or standing .
3. Proceed to the bathroom , but walk no running or hastening to the bathroom at all.If in midwalk you start to lose bladder control , stand wherever you are and perform 5 quick pelvic floor muscle contraction , and 5 deep breaths . The urge should subside adequately  to  safely reach the bathroom .

The loss of control can happen in any stage  of the journey to the toilet including even when undoing the clothes to be positioned on the toilet , at that time stop and do the 5 quick contractions and 5 deep breaths and this will not allow the pelvic floor to relax prematurely .

There may be times when you are not successful but do not give up , another chance is coming soon ! Incontinence usually is years in the making so be patient with undoing all those years .If there are no other underlying comorbidities ,this technique  I found to be very effective in retraining your bladder . Let the bladder know you are in control of the bladder and that the bladder is not in control of you.You got this .! You can start practising as soon as you finish reading this .Please share your thoughts in the comments section of my blog .