Pelvic Rehabilitation

Coccydynia: This condition is often a result of a fall or injury affecting the coccyx or sacroiliac joint. It can also be a result of muscle imbalances in the pelvic region. Symptoms include pain in the coccyx while sitting and pain while transitioning from sit to stand.

Dyspareunia: This can be caused by pelvic floor muscle tightness, scar adhesions, or decreased lubrication. Symptoms include pain during sexual intercourse.

Interstitial cystitis: The cause of this condition is unknown. Potential causes include chronic infection, unknown neurologic disorder, ulcerations of the bladder, and autoimmune disease. Symptoms may include bladder and abdominal pain, frequent voiding, sleep deprivation, dyspareunia, and often corresponds with vulvar pain.

Vulvodynia: Contributing factors to this condition include: infections, dermatological conditions, chemical reactions, and vulvar trauma or surgery. Symptoms may include severe pain, and burning and stinging in the vulvar region. Usually, the patient is unable to wear tight clothing or use tampons secondary to increased pain in vulvar/vestibular region.

Manual pelvic floor therapy (external and internal vaginal or rectal treatments)

Therapeutic exercise

Biofeedback

Patient education on dietary considerations, vestibular irritants, and lifestyle changes

Home exercise program prescriptions

Surface electromyography (EMG)

Ultrasound is a deep heating modality which, in combination with manual therapy techniques, can decrease muscle and pain tension in their perineal, inner thigh, buttocks, and low back region.

Stress incontinence: Urine leaks out during exercise, while laughing, lifting, coughing/sneezing, or during any activity that suddenly increases abdominal pressure, thereby placing pressure on the bladder. This is common after pregnancy, pelvic surgery, and during menopause. Studies have demonstrated that approximately one in three people who have stress incontinence are unable to correctly contract their pelvic floor muscles.

Urge incontinence: There is a sudden uncontrollable urge to void and the individual is often unable to make it to the bathroom in time. Urge incontinence is often associated with urinary tract infections, certain medications, stress, spinal cord injuries, multiple sclerosis, and neurological diseases.

Mixed incontinence: This is a combination of stress and urge incontinence. Left untreated, urinary incontinence can get worse. However, it is estimated that a large percentage of urinary incontinence can be greatly reduced or cured using conservative measures.

Constipation: This condition can occur due to pelvic floor muscle spasms resulting in the inability to have normal bowel movements. Spasms can be caused by surgery, injury, fissures, or hemorrhoids. Constipation can be treated using methods to relax pelvic floor muscles.

Fecal incontinence: Inability to control pelvic floor muscles can result in fecal incontinence. This can be a result of childbirth or anorectal surgery. This can be treated in similar ways as urinary incontinence.

Pelvic floor muscle exercises, in which the patient contracts and relaxes specific pelvic muscles learns how to re-train the pelvic floor muscles appropriately.

Bladder and bowel retraining and education on behavioral modification techniques to reduce bladder and bowel symptoms.