What is the pelvic floor?
The pelvic floor is a dome-shaped muscular sheet that separates the pelvic cavity above from the perineal region below. This sheet is part of our deep core and is composed of fascia, connective tissue, and three layers of muscles. The pelvic floor helps control continence (both urinary and fecal), contributes to stability in our hips and pelvis, and aids in sexual arousal.
Why would you seek out pelvic floor physical therapy?
My doctor told me to do kegels.
Your doctor may be right or your doctor may be wrong.
A lot of people have heard of kegels but are not totally sure what they are and most women seem to think just doing kegels will solve all their pelvic floor problems. Pelvic floor PT is not just about kegels. In some cases, yes, strengthening the pelvic floor will help reduce symptoms, but that is definitely not always the case.
A kegel is a contraction of all three layers of the pelvic floor muscles, accompanied by a closing and lifting sensation in the pelvic floor. Sometimes it feels like your sit bones are being pulled together. The sensation of a close and lift needs to be followed by a relaxation/ dropping back down sensation. We also don’t want to be clenching our butts or thighs while we do the contraction.
When are kegels not appropriate? They are usually not appropriate for someone who is experiencing pain in the pelvic floor or any symptoms of pelvic floor tightness. These symptoms might include the inability to initiate urine flow or might include chronic constipation. Sometimes people actually leak urine when their muscles are tight, not weak. A good example of this is to make a tight fist and then try to squeeze your fist tighter. Not much will happen in that scenario, but if you relax your hand then try and make a tight fist you can squeeze a lot harder. This is what happens with a tight pelvic floor. It's already tight so it cannot contract to help control bladder incontinence.
Pelvic floor health physical therapists help people who have problems with sexual intercourse, urination, fertility, pregnancy preparedness, pelvic and/or tailbone pain, postpartum recovery, erectile dysfunction, and other conditions.
Depending on exam findings, treatment includes manual techniques, specific exercise prescription (a Kegel is not simply a Kegel!), and the use of electrical stimulation and/or biofeedback tools.
More confused than ever? Schedule a consult.
We often cannot avoid sitting for longer periods of time, and more often than not we wind up in a forward flexed posture that is very hard on our necks, backs, and shoulders. A couple of small adjustments can make sitting a little easier on our bodies. First thing, take a standing break as often as you can--at least every 30-45 minutes. Our brains tend to take a mental vacation from what we are working on around that time anyway so just add a 30 second standing break to help change the forces on your body. Additionally, small modifications to your work set-up can go a long way. Make sure that your screen is at eye level, your keyboard/mouse are at elbow level. Keep your back and hips scooted back to utilize the backrest and add a small lumbar support (like a small pillow or rolled towel) if there isn’t already one in your chair. Keep your feet flat on the ground, and sit in a chair where the hip height is slightly above the knee height. Practice keeping your ears in line with the base of your neck to prevent your head from migrating forward. Most importantly, remember that the best posture is the next posture and keep moving. AND, if you are still having neck/back or shoulder pain while working that doesn’t get better with some small changes, visit us at Life in Balance PT and we can help make an individualized treatment plan for you.
DO I NEED PHYSICAL THERAPY?
If you're asking the question, the answer's probably yes. But let's get specific.
Are you having difficulty doing your daily chores or work tasks due to pain, loss of range of motion (just can't reach that high shelf), or weakness? Then, yes.
Are you looking to minimize the risk of injury? Then, yes.
Are you having a musculoskeletal issue (muscle, ligament, nerve, tendon, bone) that's not resolving with time and your own efforts (ice, heat, over-the-counter drugs, trying the thing your neighbor did)? Then, yes.
How about a list?
Top Ten Reasons To Seek Physical Therapy:
1. You're in pain.
2. You're injured.
3. You want to avoid surgery.
4. You've recently had surgery.
5. You're about to have surgery.
6. You're not moving as easily as you used to.
7. You've fallen for no good reason.
8. You've fallen more than once in the last six months.
9. You hate asking for help when you're perfectly capable of doing it yourself, but for some reason you aren't capable right now.
10. You gardened fiercely over the weekend and now your—back, shoulder, neck, hip—is a wreck.
Injury occurs when load exceeds capacity. You've pushed too hard or worked too long and your body responds with aching, burning, stabbing, and/or throbbing sensations. Or your body responds with tenderness or abnormal tension. If you've really done yourself in, your body responds with an all-out inflammatory avalanche of swelling, heat, sensitivity, pain, and reduced motion. These are all signals that load is exceeding (or has exceeded) capacity, and you need to back off and better prepare yourself for the task no matter what it is.
Back to the questions.
Is there a physical reason you've stopped doing something you love to do?
Is there a physical reason making it difficult to do something you love to do?
Then yes, you need physical therapy.
Let's first start by defining what physical therapists (PT) are and do.
Physical therapists are experts in human movement, and help injured or ill people improve or maintain mobility and manage pain. Physical therapists evaluate, diagnose, and treat individuals across the lifespan. They are an important part of preventive care, rehabilitation, and treatment for patients with injuries and chronic conditions or illnesses. PTs evaluate each person and then develop a treatment plan with goals of improving movement, reducing and/or managing pain, restoring function, and delaying or preventing disability. PTs also help folks who simply want to become healthier--move better--and prevent future problems.
The work of physical therapists varies by type of patient, and thus you'll find PTs in
hospitals, nursing homes, workplaces, outpatient clinics, people’s homes, schools, and sports and fitness facilities. You've found this blog, which is affiliated with an orthopedic outpatient physical therapy clinic.
A DOCTOR OF PHYSICAL THERAPY (DPT) earns a doctoral degree, which includes training in all areas of human anatomy and physiology and musculoskeletal evaluation, diagnosis, and treatment, as well as doctoral-level research. A doctoral degree is a clinical degree focused on treating people. It differs from a PhD, where the focus is on research and generating original scholarly work. The DPT program is typically three years, following a bachelor's degree. All PTs must be licensed in the state in which they practice.
DPTs weren't always Doctors, but, because they are now a “doctoring” profession, DPTs have the ability to evaluate and treat patients via direct access, meaning without a physician referral.