By Jandra Mueller, DPT, MS, PHRC Encinitas
Here at PHRC we regularly discover all sorts of new and cool products that are available for people’s pelvic health needs. I am amazed at some of the products available and that are being developed and am so thankful there are people that are creating these products because they are SOOO helpful!
Pelvic health physical therapists treat a multitude of conditions that can include, but are not limited to, urinary dysfunction, sexual dysfunction, bowel issues (aka pooping), as well as pelvic pain. Pelvic floor dysfunction is not a gender-specific disorder and can affect all people at different phases of their lives.
Over the next two weeks we will share a few of our favorite products we like to use for these various conditions and why we like them!
Products for Urinary Dysfunction
Urinary incontinence (leaking pee when you have an urge, cough or sneeze), dysuria, or pain with urination, or even just difficulty going pee are very common symptoms that we treat here at PHRC. Going camping or just don’t want to go in those nasty toilets? There are devices that can help that! Also, for more information on the importance of not hovering over the toilet please read our blog “Sit yo’ a$$ down! The importance of sitting on the toilet”.
GoGirl – This device is used for women so that we may be able to avoid those dirty porta-potties or less than ideal public bathrooms and not have to strain our pelvic floors by trying to gracefully balance ourselves over the seat of a toilet and strain our pelvic floor. These devices are available through Amazon, Target, Walmart, etc.
Poise Impressa – I love these! These look similar to tampons but they are for a different purpose, bladder leakage, and can help with some prolapse symptoms. Whether you are postpartum, an athlete, or you’ve suddenly noticed your panties have become wet (and not in the good way). There are devices known as pessaries that you need to be fitted for by a medical doctor or qualified nurse that are reusable. Poise impressa offers an alternative to this and are available over the counter so women can buy them and see if they are right for them. They are inserted into the vagina similarly to a tampon and provide support to the tissues that support our pelvic organs. These tissues can become lax after pregnancy and as a result of age-related changes and the hormonal insufficiencies of menopause. If women are using a bladder support or a pessary, they should ALSO be in pelvic floor physical therapy. These devices should be used as an aide to rehab to optimize the function of their pelvic floor muscles, not the solution.
Elvie Pelvic Floor Trainer – So, Kegels. Well, this device is pretty handy when you ACTUALLY do need to do Kegels, because yes, your pelvic floor should move – contract, relax and bulge. Studies show that given verbal instruction alone women cannot properly do a kegel. We advise seeing a pelvic floor physical therapist to assess if you need to do kegels and how to do them properly. Read Katie Hunter’s blog on movements of the pelvic floor for more details on these movements we need to do to maintain the normal functions of our body. We like the Elvie because out of all the “kegel” tools, it is a bit more accurate and interactive. It will tell you if you are doing what you are supposed to be doing, eliminating the mystery of if you are doing the exercise correctly or not. You can link it to your smart phone and based on your strength, it will create a program for you to help strengthen. It is definitely one of the more “fun ways” to do these exercises.
Products for Bowel Dysfunction
Squatty Potty – It is old news that american toilet seats are not optimal heights to allow the needed pelvic floor relaxation for stool evacuation. The squatty potty is a stool that fits around your toilet. When you prop your feet up on it the squatty potty puts your pelvic floor in the optimal position to do your business and limits the unwanted pushing and straining that some experience. EVERYONE SHOULD HAVE ONE! They also come in travel folding ones as well as fancy bamboo!
Natural Calm – To go with your squatty potty, if you’re one that tends to have a harder time going to the bathroom or harder stools, this is a great, natural remedy you can use at night. Magnesium is a micronutrient that honestly, many people are lacking in their diet. It is used to relax smooth muscles (like your anal sphincter), helps you sleep, and also helps your regulate your bowels. The type of magnesium in this is magnesium citrate.
Femmeze Vaginal Trainer – This product was designed for women that suffer from prolapse, specifically a rectocele (where the rectum protrudes into the back wall of the vagina), and causes women to have a difficult time using the bathroom or requires them to use their fingers to help evacuate stool. This device inserts in and puts pressure to help realign the anatomy to make pooping much easier!
The products listed next can be used for general pelvic health throughout and/or after your treatment and are more focused on pain relief!
Intimate Rose Pelvic Wand – Many patients ask us, “so how can I do this on my own?” Well, the pelvic wands offer just that. With the S-shape meant to help with your ergonomics of gripping, this slides right in and allows you to access the muscles of your pelvic floor. With the tapered end, it’s great for trigger point release. They also offer a wand with a vibrating feature as well.
Theraseat – This foam cushion is meant for those that suffer with pain while sitting down. They offer a variety of options for cut outs, as well as a DIY cutout for those that can’t quite find the exact right fit. They can be used in the car, at home, work, or restaurants and have a nice handle so it’s easy to carry around!
IntelliRoll – Courtney from PHRC – LA recently did an entire blog article with video instruction on how to use it for pelvic pain relief! You can check it out here. Why is this one so special? Courtney states: “My personal favorite and recommendation to every patient is the IntelliRoll because of a groove built for the spine and curves on each end that contour around the body. The grooves improve the comfort of foam rolling and allow great access to tissues around the spine and tailbone – a HUGE bonus for our pelvic pain patients.”
She also taught all of us about it in one of our inservices and you can watch it here.
The Stick Roller – a good follow-up to the product above. The stick roller is handheld and is a little better when needing to get to some awkward body parts, like your inner thigh at the very top of your leg! Sometimes we have to get in weird positions to get those spots on the foam roller so this makes it a little easier, it also allows you to control the pressure a bit more for those extra sensitive spots.
Serola Belt – This belt is used for those who have sacroiliac joint laxity, this is especially common in pregnancy and in our postpartum population. It is used to compress the two joints together in the back to provide extra stability. You can adjust each side individually to provide a more individual fit.
If you have ever been a patient here at PHRC or visited our office, you may recognize these products because we really do use them all the time! If you have feedback about these products we’d also love to hear so feel free to comment below and share some of your favorites! Next week we will get into dilators, lubricants, and other things to help with pelvic pain so stay tuned!
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
Thanks for the information