By Elizabeth Akincilar, MPT, Cofounder, PHRC Merrimack
The pandemic has brought countless changes to PHRC and frankly, the world. In January 2020 PHRC had intentions of offering virtual health services sometime in 2020 to folks searching for information, answers, and hope with regards to their pelvic concerns. In March 2020 Covid19 hit all of us like a freight train and changed everything. In a matter of days PHRC launched its virtual health services platform and we began helping people around the world with their pelvic concerns.
Fast forward to January 2022 and our virtual program is thriving. PHRC now offers a variety of virtual health services. Often people do not understand their symptoms until they stumble upon our website, blog, or social media channels. Some people have a diagnosis but they do not have a pelvic floor physical therapist locally to help them. Other times people have a pelvic floor physical therapist but for some reason are not getting better or feel stuck in their treatment plans. Others just want another opinion from trusted experts.
PHRC Co-founders Elizabeth Akincilar, MSPT and Stephanie Prendergast, MPT primarily offer virtual consultations for complex pelvic pain syndromes such as pudendal neuralgia, vulvodynia, and endometriosis. Additionally, Elizabeth has a special interest in male pelvic pain/chronic nonbacterial prostatitis and neuropathic pelvic pain, whereas Stephanie has a special interest in menopause and Interstitial Cystitis/Painful Bladder Syndrome.
Melinda Fontaine, DPT offers virtual consultations specifically for the pediatric population with pelvic health concerns as well as folks looking for postpartum care or. post-prostatectomy care.
Jandra Mueller, DPT, MS offers both physical therapy and nutritional virtual services. Jandra has a special interest in endometriosis and pelvic pain and has her Master of Science in Integrative Health and Nutrition. Many people living in the United States have significant concerns related to diet and concomitant health issues affecting their gastrointestinal tract, including various disease states and medication use. It is estimated that greater than 20% of Americans suffer from Irritable Bowel Syndrome. Most conventional medical practices focus on symptom management, failing to address the underlying causes of the symptoms that significantly affect our health. Integrative or Functional Nutrition focuses on identifying the root cause(s) of disease and approaches treatment from an integrative systems perspective, relying on functional lab testing, dietary analysis, and thorough health history to determine the best approaches for lifestyle and dietary management. Many people suffering from pelvic pain also have underlying gastrointestinal concerns and nutritional deficiencies that are either causing or exacerbating their pain symptoms. Working with a provider that understands chronic pelvic pain and digestive health is ideal in making a full recovery back to health!
With the growing popularity of digital health, Jandra is able to offer these services to those throughout the United States as well as internationally. Therefore, she is able to help those that would otherwise not have access to a medical provider who can address both their physical complaints as well as underlying contributors to their pain.
Although most of us are more than ready for life to return to “pre-Covid” status, some changes that were forced upon us, such as accelerating our virtual health services platform, are welcome changes that are here to stay. Over the last 22 months we have been honored to assist hundreds of people from around the world who were struggling with pelvic health and/or nutritional concerns and were unable to receive care locally or in-person due to the pandemic. We look forward to continuing this program to help folks navigate their health concerns and spread the word about pelvic health.
If you think you would benefit from a virtual consultation with one of our experts, you can schedule an appointment directly via our website.
FAQ
What are pelvic floor muscles?
The pelvic floor muscles are a group of muscles that run from the coccyx to the pubic bone. They are part of the core, helping to support our entire body as well as providing support for the bowel, bladder and uterus. These muscles help us maintain bowel and bladder control and are involved in sexual pleasure and orgasm. The technical name of the pelvic floor muscles is the Levator Ani muscle group. The pudendal nerve, the levator ani nerve, and branches from the S2 – S4 nerve roots innervate the pelvic floor muscles. They are under voluntary and autonomic control, which is a unique feature only they possess compared to other muscle groups.
What is pelvic floor physical therapy?
Pelvic floor physical therapy is a specialized area of physical therapy. Currently, physical therapists need advanced post-graduate education to be able to help people with pelvic floor dysfunction because pelvic floor disorders are not yet being taught in standard physical therapy curricula. The Pelvic Health and Rehabilitation Center provides extensive training for our staff because we recognize the limitations of physical therapy education in this unique area.
What happens at pelvic floor therapy?
During an evaluation for pelvic floor dysfunction the physical therapist will take a detailed history. Following the history the physical therapist will leave the room to allow the patient to change and drape themselves. The physical therapist will return to the room and using gloved hands will perform an external and internal manual assessment of the pelvic floor and girdle muscles. The physical therapist will once again leave the room and allow the patient to dress. Following the manual examination there may also be an examination of strength, motor control, and overall biomechanics and neuromuscular control. The physical therapist will then communicate the findings to the patient and together with their patient they establish an assessment, short term and long term goals and a treatment plan. Typically people with pelvic floor dysfunction are seen one time per week for one hour for varying amounts of time based on the severity and chronicity of the disease. A home exercise program will be established and the physical therapist will help coordinate other providers on the treatment team. Typically patients are seen for 3 months to a year.
What is pudendal neuralgia and how is it treated?
Pudendal Neuralgia is a clinical diagnosis that means pain in the sensory distribution of the pudendal nerve. The pudendal nerve is a mixed nerve that exits the S2 – S4 sacral nerve roots, we have a right and left pudendal nerve and each side has three main trunks: the dorsal branch, the perineal branch, and the inferior rectal branch. The branches supply sensation to the clitoris/penis, labia/scrotum, perineum, anus, the distal ⅓ of the urethra and rectum, and the vulva and vestibule. The nerve branches also control the pelvic floor muscles. The pudendal nerve follows a tortuous path through the pelvic floor and girdle, leaving it vulnerable to compression and tension injuries at various points along its path.
Pudendal Neuralgia occurs when the nerve is unable to slide, glide and move normally and as a result, people experience pain in some or all of the above-mentioned areas. Pelvic floor physical therapy plays a crucial role in identifying the mechanical impairments that are affecting the nerve. The physical therapy treatment plan is designed to restore normal neural function. Patients with pudendal neuralgia require pelvic floor physical therapy and may also benefit from medical management that includes pharmaceuticals and procedures such as pudendal nerve blocks or botox injections.
What is interstitial cystitis and how is it treated?
Interstitial Cystitis is a clinical diagnosis characterized by irritative bladder symptoms such as urinary urgency, frequency, and hesitancy in the absence of infection. Research has shown the majority of patients who meet the clinical definition have pelvic floor dysfunction and myalgia. Therefore, the American Urologic Association recommends pelvic floor physical therapy as first-line treatment for Interstitial Cystitis. Patients will benefit from pelvic floor physical therapy and may also benefit from pharmacologic management or medical procedures such as bladder instillations.
Who is the Pelvic Health and Rehabilitation Team?
The Pelvic Health and Rehabilitation Center was founded by Elizabeth Akincilar and Stephanie Prendergast in 2006, they have been treating people with pelvic floor disorders since 2001. They were trained and mentored by a medical doctor and quickly became experts in treating pelvic floor disorders. They began creating courses and sharing their knowledge around the world. They expanded to 11 locations in the United States and developed a residency style training program for their employees with ongoing weekly mentoring. The physical therapists who work at PHRC have undergone more training than the majority of pelvic floor physical therapists and as a result offer efficient and high quality care.
How many years of experience do we have?
Stephanie and Liz have 24 years of experience and help each and every team member become an expert in the field through their training and mentoring program.
Why PHRC versus anyone else?
PHRC is unique because of the specific focus on pelvic floor disorders and the leadership at our company. We are constantly lecturing, teaching, and staying ahead of the curve with our connections to medical experts and emerging experts. As a result, we are able to efficiently and effectively help our patients restore their pelvic health.
Do we treat men for pelvic floor therapy?
The Pelvic Health and Rehabilitation Center is unique in that the Cofounders have always treated people of all genders and therefore have trained the team members and staff the same way. Many pelvic floor physical therapists focus solely on people with vulvas, this is not the case here.
Do I need pelvic floor therapy forever?
The majority of people with pelvic floor dysfunction will undergo pelvic floor physical therapy for a set amount of time based on their goals. Every 6 -8 weeks goals will be re-established based on the physical improvements and remaining physical impairments. Most patients will achieve their goals in 3 – 6 months. If there are complicating medical or untreated comorbidities some patients will be in therapy longer.