Happy New Year!

In Pelvic Floor Physical Therapy by Stephanie Prendergast2 Comments

By: Stephanie Prendergast, PHRC Cofounder

January is often the time to reflect on the past year and set goals for the future. So, in that spirit, we thought it would be fun to dedicate this post to a few top Pelvic Health and Rehabilitation Center events of 2018….and a peak forward to 2019. In no particular order, here’s what happened and what’s going on.

Four New Locations, Five New Clinics!

2018 was a year of geographic growth for PHRC:

  • Melinda Fontaine of PHRC Berkeley opened PHRC Walnut Creek, CA in May
  • PHRC Cofounder Elizabeth Akincilar opened PHRC  Bedford, NH in June
  • Katie Hunter of PHRC LA opened PHRC Westlake Village, CA in August
  • PHRC Los Angeles moved down the hall into larger space in November
  • Shannon Pacella of PHRC Lexington opened PHRC Natick, MA

With 9 clinics in 3 geographic regions, we needed more help and welcomed the following people to our team.

New Additions to the PHRC Team

  • Julia Zaitsev, DPT, Lisa Thompson, DPT, Maryssa Steffan, DPT, Hien Phan, & Lisa Topete joined PHRC Berkeley!
  • Kim Buonomo, DPT joined PHRC Lexington!
  • Rachel Daof, DPT joined PHRC Los Angeles!
  • Julia Barten, DPT joined PHRC Los Gatos!

We are thrilled with our new team members and by the way, we are hiring physical therapists in San Francisco, Los Gatos, and Los Angeles! Check out the Career Center section of our website for more information.

2018 was not just about new faces and new offices…..

New Website

Thank-you to Ben Fung and the crew at UpDoc Media for taking us on and hustling to redesign our website and our blog! Ben’s day just wouldn’t be complete without 18 messages from me via Slack, email, and text, all of which he answers patiently.  We are excited about our new look and the ability to be in better touch with people viewing our website. Check it out and reach out to us at www.pelvicpainrehab.com!

New Blog

In 2013, Liz and I revamped the Pelvic Health and Rehabilitation Center blog, As The Pelvis Turns. Our goal was to publish reliable, evidence-based information about pelvic floor disorders for our patients and colleagues. As PHRC grew, As the Pelvis Turns grew with us and became a team effort. All of the physical therapists of PHRC and many of our valued colleagues contribute to our weekly blog. This year, the blog got a new look and by the end of 2018, our blogs collectively averaged 25,000 reads per week and it has grown to 7,804 of subscribers!

We knew there was a need for reliable information about pelvic health but we never imagined our little blog would generate so much interest. We are grateful to our readers for their thoughtful comments, questions, and suggestions for future posts. Please keep them coming and thank-you for your support!

 

Spreading the Word

The physical therapists of PHRC regularly lecture at community and professional events to help spread the word about pelvic floor dysfunction and how we can help. This year Rachel Gelman and I also contributed to webinars, lectures, articles and podcasts. In case you missed them, here they are again.

Podcasts

Dan Savage Lovecast #547: Dr. Rachel Gelman- an actual pelvic health specialist with Rachel Gelman

Sex Ed with DB: Vaginal Lasers with Rachel Gelman

Katie’s Crib: All About the Pelvic Floor with Stephanie Prendergast

Hard Conversations: Pelvic Pain and No Hope? You need to know this expert with Stephanie Prendergast

Articles

Pelvic Floor 101: What to Look for and When to Seek Help w/ SP

This Pelvic Pro Says Kegels Aren’t Always Worth the Squeeze  w/ RG

Why Going to Pelvic Floor PT Transformed My Life w/SP

Cancer and Leaks: a Self-Help Guide w/ RG

Down for Whatever: All about the pelvic floor w/RG

Nine Women Get Real About Lube w/ RG

Webinars and Lectures

Painful Sex in Midlife with Rachel Gelman

Treating Male Pelvic Pain with Stephanie Prendergast, Jason Kutch, Joshua Gonzalez and Dan Kirages (Pelvic Pain Awareness Month event)

Pelvic Floor Physical Therapy for Sexual Concerns with Stephanie Prendergast

May 2018 was the second annual Pelvic Pain Awareness Month, an honorary month created by the International Pelvic Pain Society. The PHRC Los Angeles teamed with Femina Physical Therapy and hosted two fundraisers for Shelby Hadden’s film about vaginismus, Tightly Wound.

2018 was a great and busy year!  Here is a glimpse of new projects we are starting in 2019…

PHRC hits the road…

In 2006, Liz and I developed the first continuing education course on Pudendal Neuralgia and taught it over 40 times between 2006 and 2014. In 2014, I moved to LA to open PHRC Los Angeles and shortly thereafter Liz moved to the east coast to open PHRC Lexington, MA. We turned our focus towards the clinics and had to put teaching on hold. We loved teaching and do miss it, and we are excited to announce that we are coming back to teach an advanced course on the management of pelvic pain syndromes! Liz and the east coast PHRC team will teach the course on that half of the country while the west coast  PHRC team and I will teach on the western half of the US. Stay tuned for more information!

New Collaboration

PHRC is honored to be teaming up with a urology department here in LA to provide pelvic floor physical therapy for suffering men. We are excited about this opportunity to work on the floor with urologists and other medical providers to offer true interdisciplinary care. Stay tuned for more details!

As we kick off 2019 we are grateful to continue to help people recover from pelvic floor disorders.  We are excited to start new teaching projects and collaboration within our communities. We look forward to continuing to work hard to make managing pelvic pain easier for patients and providers. We wish everyone a Happy New Year and stay in touch!

 

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.

Comments

  1. Rachel meets the highest standards of professionalisn and compassion toward her patients.
    All you have to do is have the courage to show up.

  2. Thank you so much for this blog. This is the main reason I ended up in PFPT after countless specialists couldn’t help my random symptoms. Could you talk about different treatements or your opinion on what my specialist calls the triangle of death? Bulbospongious, Superficial transverse? I know PT can help, but struggling to get quicker relief than I expected.. I know this area is an issue for a lot of people and was wondering if you could do a blog on this? Thanks!!

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