By: Stephanie Prendergast
On July 17th, 2006, Liz and Stephanie opened the doors to the Pelvic Health and Rehabilitation Center in San Francisco. Their mission was to improve the quality of life of their patients and to contribute to the dynamic growth of their employees and students. They aspired to educate the community and medical professionals about pelvic floor dysfunction with innovative and evidence-based practice. They strived to provide excellent customer service and improve the landscape of treatment for pelvic floor disorders.
Twelve years later, the mission of the Pelvic Health and Rehabilitation Center remains the same. PHRC grew from a team of two people in one office in San Francisco in 2006 to team of twenty-one people in eight locations!
The field of pelvic health has grown tremendously since 2006 but there is still a lot of work to do. In honor of our anniversary we thought we would take a look at some of the latest pelvic health news and share new resources to help increase awareness about the role of pelvic floor physical therapy.
2nd Annual Pelvic Pain Awareness Month in May
In 2017 the International Pelvic Pain Society designated May Pelvic Pain Awareness Month. This past May, PHRC helped raise awareness a few different ways. On May 9th USC hosted an event about male pelvic pain pain, otherwise known as Chronic Pelvic Pain Syndrome. The interdisciplinary panel consisted of neuroscientist Dr. Jason Kutch, urologist Dr. Joshua Gonzalez, and pelvic floor physical therapists Dan Kirages and Stephanie Prendergast. Dr. Kutch currently holds the largest NIH-funded grant in the United States to study male pelvic pain. PHRC is honored to collaborate with USC on this important project and support their research in community events. The lecture was a success and the NIH agreed to support patient events like this one again in 2019 and 2020! The event was recorded and you can view the lecture here.
PHRC, Femina Physical Therapy, Milli the first expandable dilator and Soul Source Dilators brought filmmaker and former pelvic pain sufferer Shelby Hadden to Los Angeles! We were proud to premiere Shelby’s animated short film, Tightly Wound, and help her raise money for the film’s distribution through two different fundraisers. Animation is a great way to make a difficult topic like pelvic pain easier to talk about. We commend Shelby for her bravery and creativity with the film! She still needs funding so please consider donating if her work inspires you the way it does us.
American College of Obstetrics and Gynecology Committee Opinion Update on Postpartum Guidelines
In May, the American College of Obstetrics and Gynecology released a position paper acknowledging the shortcomings of postpartum care in the United States. They suggested incorporating the concept of a “4th Trimester” to make sure new moms are getting the help they need. Pelvic floor physical therapy was included in their expanded list of resources that moms should be told about for stress and fecal incontinence. We were glad to see that PT was mentioned, we were disappointed, but not surprised that we were only mentioned to help with urinary and fecal incontinence. Recent studies have shown that 64% of postpartum women have sexual dysfunction at 1 year after birth and 25% of postpartum women still experience painful sex at 18 months postpartum, regardless of the method of delivery. Pelvic floor physical therapy can help with C-section and episiotomy scar pain, painful sex, urinary urgency/frequency, constipation and anal pain, pelvic organ prolapse, diastasis recti, pelvic girdle pain, orgasm changes, and ability to safely and effectively return to exercise. If you recently gave birth, give us a call! If you know someone who gave birth who is struggling, tell them about pelvic floor PT! We are here and happy to help.
Pelvic Floor Physical Therapy Open Access (FREE!) Journal Articles
As you can tell, the trend of this post is about awareness and education. People often ask us for our ‘go to’ articles to educate other medical professionals about pelvic floor dysfunction and pelvic floor physical therapy. Here are links to two we use often!
Physiotherapy for pelvic pain and female sexual dysfunction: an untapped resource
The role of pelvic floor muscles in male sexual dysfunction and pelvic pain
In addition to journal articles, podcasts and webinars are great ways to get the word out. This year we participated in a few, check them out, let us know what you think, and please share them!
Patient Resources: Podcasts and Webinars
- Stephanie Prendergast on Katie’s Crib: Get to know your pelvic floor
- Rachel Gelman with Myisha Battle’s: Down for Whatever Podcast “All About the Pelvic Floor”
- Rachel Gelman on the Genneve Webinar: an interdisciplinary panel talking about how to alleviate painful sex during perimenopause and menopause: Painful Sex Webinar
Other 2018 PHRC News
- Pelvic Pain Explained released in paperback!
As we enter our 12th year in business we are grateful for the continued support and trust from our patients, colleagues and PHRC team members. We are looking forward to many more years of pelvic health!
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.