PerimenopauseMenopause Pelvic Floor Physical and Occupational Therapy

Menopause encompasses more than just hot flashes, night sweats, and mood swings. Despite being a common phase affecting roughly half of the population, menopause is often misunderstood, both by the public and many healthcare providers. This gap in knowledge can lead to unnecessary suffering, as many individuals are not fully informed about effective treatments.

Perimenopause, the transitional phase leading up to menopause, typically begins in a person’s 40s, with menopause itself usually occurring in the early 50s. While systemic symptoms like hot flashes and mood changes are well-known, many people also experience less obvious but equally impactful genitourinary symptoms. These can include painful intercourse, urinary urgency, frequent urination, leakage, burning sensations, recurrent vaginal and urinary tract infections, and vaginal dryness. Collectively, these symptoms are part of the Genitourinary Syndrome of Menopause (GSM). Additionally, many women experience pelvic floor dysfunction, which affects nearly 50% of women by their 50s and can overlap with GSM symptoms.

While systemic hormonal therapy is commonly used to manage menopause symptoms, it may not address the specific needs of those experiencing GSM. The North American Menopause Society recommends the use of vaginal estrogen as an effective treatment for alleviating GSM symptoms and improving quality of life.

Differential Diagnosis:
GSM or Pelvic Floor Dysfunction

Symptoms of pelvic floor dysfunction and Genitourinary Syndrome of Menopause (GSM) can overlap and include:

  • Urinary urgency, frequency, burning, nocturia
  • Feelings of bladder or pelvic pressure
  • Painful sex
  • Diminished or absent orgasm
  • Difficulty evacuating stool
  • Vulvovaginal pain and burning
  • Pain with sitting
Pelvic Floor Dysfunction

An experienced healthcare provider, whether a pelvic floor physical and occupational therapists or a medical doctor, can conduct several assessments to diagnose pelvic floor dysfunction, hormonal deficiencies, and pelvic organ prolapse. These evaluations include a vulvovaginal visual examination, a Q-tip test to pinpoint areas of pain, and a digital manual examination.

Without appropriate medical management, all women may eventually experience symptoms of Genitourinary Syndrome of Menopause (GSM). Many are unaware that a pelvic floor physical and occupational therapy evaluation can be highly beneficial for addressing the musculoskeletal issues contributing to their discomfort. Combining pelvic floor physical and occupational therapy with medical treatments can be crucial for improving sexual enjoyment and resolving urinary and bowel problems.

Virtual pelvic floor therapy for menopause—contact us to get started!

Why didn’t someone tell me?

This question is asked frequently. It’s important to note that the term “Genitourinary Syndrome of Menopause” (GSM) only became officially recognized in 2014. Advocacy from leading medical societies aimed to educate the healthcare community about the unique hormonal needs of the genitourinary tract. While pelvic floor physical and occupational therapy is gaining recognition, there remains a significant gap in awareness and the availability of qualified practitioners to support those experiencing these symptoms.

gentio-urinary 1
gentio-urinary 2

Hormone deficiency can lead to itching in the labial and vaginal areas. Additionally, other dermatological conditions, such as Lichen Sclerosus and cutaneous yeast infections, should also be considered.

During menopause, individuals are particularly susceptible to frequent vaginal and urinary tract infections due to:

  • pH and tissue changes
  • incomplete bladder emptying
  • pelvic organ prolapse compromising urinary function

Recurrent infections are a major contributor to pelvic floor dysfunction. It’s crucial to address these infections promptly, as ongoing visceral-somatic input from untreated infections can lead to increased pain and further dysfunction even after the infection has been resolved. Without appropriate hormone therapy, infections may persist, leading to severe consequences. Untreated infections can cause unprovoked pain, make sexual activity difficult or impossible, and undiagnosed urinary tract infections (UTIs) may progress to kidney issues and other serious complications.

We recommend consulting with a menopause specialist to effectively monitor, prevent, and treat Genitourinary Syndrome of Menopause (GSM) since these issues are both significant and manageable. It’s important to normalize discussions about GSM; there’s no need for embarrassment. With appropriate care, individuals can lead fulfilling lives. Combining virtual pelvic floor physical and occupational therapy with medical management is essential for optimal results.

Treatment:

How We Can Help You

pelvic pain rehab

If you’re experiencing sexual dysfunction, it’s beneficial to consult a pelvic floor physical and occupational therapists online. They can assess whether any issues with your pelvic floor are contributing to your symptoms. During your initial virtual evaluation, the therapist will review your medical history, including previous diagnoses, treatments, and their effectiveness. They understand that many patients feel frustrated by the time they seek help.

The therapist will examine your nerves, muscles, joints, tissues, and movement patterns. After the assessment, they will discuss the findings with you and set both short-term and long-term therapy goals. Typically, physical and occupational therapy sessions occur once or twice a week over a period of approximately 12 weeks. Your therapist will also coordinate with other specialists on your treatment team and provide you with a personalized home exercise program. Our goal is to support your recovery and help you achieve the best possible quality of life.

Get virtual pelvic floor therapy for menopause. Book your online consultation today!

A girl with writting Board

Treatment:

How We Can Help You

Related Blogs:

By PHRC Admin Team

 

Did you know that the Pelvic Health and Rehabilitation Center 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 and occupational therapists locally to help them. Other times people have a pelvic floor physical and occupational therapists but for some reason are not getting better or feel stuck in their treatment plans. Others just want another opinion from trusted experts. 

 

pediatric telehealth

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 virtual services

Jandra Mueller, DPT, MS offers virtual services (for pelvic pain and endometriosis). Jandra has a special interest in endometriosis and pelvic pain and has her Master of Science in Integrative Health and Nutrition. 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.

 

Stephanie virtual

liz virtual

 

 

 

 

 

 

 

 

 

 

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.

 

 

Over the last 2 years we have been honored to assist hundreds of people from around the world who were struggling with pelvic health 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

 

______________________________________________________________________________________________________________________________________

Are you unable to come see us in person in the Bay Area, Southern California or New England?  We offer virtual physical and occupational therapy appointments too!

Virtual sessions are available with PHRC pelvic floor physical and occupational therapistss via our video platform, Zoom, or via phone. For more information and to schedule, please visit our digital healthcare page.

Do you enjoy or blog and want more content from PHRC? Please head over to social media!

Facebook,

 YouTube Channel

Twitter, Instagram, Tik Tok

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 and occupational therapy?

Pelvic floor physical and occupational therapy is a specialized area of physical and occupational therapy. Currently, physical and occupational therapistss 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 and occupational therapy curricula. The Pelvic Health and Rehabilitation Center provides extensive training for our staff because we recognize the limitations of physical and occupational therapy education in this unique area.

What happens at pelvic floor therapy?

During an evaluation for pelvic floor dysfunction the physical and occupational therapists will take a detailed history. Following the history the physical and occupational therapists will leave the room to allow the patient to change and drape themselves. The physical and occupational therapists 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 and occupational therapists 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 and occupational therapists 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 and occupational therapists 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 and occupational therapy plays a crucial role in identifying the mechanical impairments that are affecting the nerve. The physical and occupational therapy treatment plan is designed to restore normal neural function. Patients with pudendal neuralgia require pelvic floor physical and occupational 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 and occupational therapy as first-line treatment for Interstitial Cystitis. Patients will benefit from pelvic floor physical and occupational 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 and occupational therapistss who work at PHRC have undergone more training than the majority of pelvic floor physical and occupational therapistss 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 and occupational therapistss 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 and occupational 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.

By PHRC Admin Team

 

October is National Breast Cancer Month, a time to raise awareness about this deadly disease that affects millions of people across the globe. Approximately one in eight women will be diagnosed with breast cancer in their lifetime, making it the most common form of cancer among women in the United States .

 

This month is an opportunity for everyone to join forces and work together to support those affected by breast cancer as well as promote education, research and early detection. It’s also an important reminder that there are more survivors than ever before due to advances in medical technology and treatments over the years.

 

One way to get involved during National Breast Cancer Month is to wear pink ribbons or donate money towards breast cancer charities like National Breast Cancer Foundation (NBCF). NBCF has provided funding for screenings, diagnostic testing, patient navigation and survivor support services since 2003. Participating in walks or runs such as Susan G. Komen’s Race for the Cure® are also great ways to show support while raising funds for research into causes, prevention and cures .

 

Aside from donating money or raising awareness through events, individuals can look out for their own health by getting screened regularly for breast cancer. Early detection is key when it comes to successful treatment against this disease so make sure you keep up-to-date with your mammograms if you are over 40 or follow your doctor’s screening advice if you have a family history of breast cancer.

 

National Breast Cancer Month serves as an important reminder about how far we have come in the fight against this horrible disease thanks to increased awareness and funding going towards research into its causes and treatments. We should take every moment of October to celebrate all those who have survived breast cancer while striving forward towards a cure.

If you or someone you know has been diagnosed with breast cancer, there are several resources available to help navigate the journey.

 

For information and support, organizations like Susan G. Komen provide a wealth of resources such as access to a breast cancer helpline as well as helpful information about options for treatment, financial assistance and insurance coverage. They also have online discussion boards and chat rooms where survivors can talk with others who have gone through a similar experience.

 

The American Cancer Society is another great resource that provides free educational materials and support services like coaching programs and free rides to medical appointments through their Road to Recovery program. Additionally, the ACS partners with more than 200 local cancer organizations across the country so that individuals can find support services close to home.

 

Other organizations such as BreastCancer.org are dedicated specifically to providing accurate and up-to-date information about breast cancer diagnosis, treatments and care for those affected by it. You can also find many nonprofit foundations that fund research into causes, prevention and cures for breast cancer like the Breast Cancer Research Foundation (BCRF) or the Avon Foundation for Women which provides grants to support screenings, diagnostic tests and treatment options for underserved communities.

 

No matter your needs during this difficult time, make sure you reach out for help – whether it be from family members or professional resources – because knowing you are not alone in this fight is invaluable when facing breast cancer head on.

 

Resources:

  1. The American Cancer Society (ACS): Provides resource lists for free or low-cost mammograms and financial assistance.

  2. National Breast Cancer Foundation: Offers various resources to help spread awareness during Breast Cancer Awareness Month.

  3. World Health Organization (WHO): Provides resources to increase support for the awareness, early detection, treatment, and palliative care of breast cancer.

  4. Breast Cancer Now: Focusses on raising awareness around secondary breast cancer.

  5. Commission on Cancer (CoC) and National Accreditation Program for Breast Centers (NAPBC): Offers resources to promote Breast Cancer Awareness Month.

  6. CDC’s National Breast and Cervical Cancer Early Detection Program: Offers free or low-cost mammograms to women who have low incomes and are uninsured.

  7. Breast Cancer Foundation: Provides a range of targeted materials approved by its Medical Advisory Committee, available free of charge.

  8. CancerCare: Provides breast and cervical cancer resources.

  9. Susan G. Komen Patient Care Center: Your go-to source for timely, accurate breast health and breast cancer information, services, and resources.

______________________________________________________________________________________________________________________________________

Are you unable to come see us in person in the Bay Area, Southern California or New England?  We offer virtual physical and occupational therapy appointments too!

Virtual sessions are available with PHRC pelvic floor physical and occupational therapistss via our video platform, Zoom, or via phone. For more information and to schedule, please visit our digital healthcare page.

Do you enjoy or blog and want more content from PHRC? Please head over to social media!

Facebook,

 YouTube Channel

Twitter, Instagram, Tik Tok

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 and occupational therapy?

Pelvic floor physical and occupational therapy is a specialized area of physical and occupational therapy. Currently, physical and occupational therapistss 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 and occupational therapy curricula. The Pelvic Health and Rehabilitation Center provides extensive training for our staff because we recognize the limitations of physical and occupational therapy education in this unique area.

What happens at pelvic floor therapy?

During an evaluation for pelvic floor dysfunction the physical and occupational therapists will take a detailed history. Following the history the physical and occupational therapists will leave the room to allow the patient to change and drape themselves. The physical and occupational therapists 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 and occupational therapists 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 and occupational therapists 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 and occupational therapists 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 and occupational therapy plays a crucial role in identifying the mechanical impairments that are affecting the nerve. The physical and occupational therapy treatment plan is designed to restore normal neural function. Patients with pudendal neuralgia require pelvic floor physical and occupational 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 and occupational therapy as first-line treatment for Interstitial Cystitis. Patients will benefit from pelvic floor physical and occupational 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 and occupational therapistss who work at PHRC have undergone more training than the majority of pelvic floor physical and occupational therapistss 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 and occupational therapistss 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 and occupational 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.

By Stephanie A. Prendergast, MPT, Cofounder, PHRC Los Angeles

Our muscles are hormonally sensitive structures and weaken over time as we experience hormonal decline. In addition, the prevalence of pelvic floor dysfunction rises and the combination of these two scenarios can cause people a fair amount of grief.

A recent study showed 95.3% of people with lumbopelvic pain also had either pelvic floor pain or pelvic organ prolapse upon digital examination! Some people had pain, some people had weakness, some people had both.

“Just do Kegels” was the solution in the 80s, thankfully we know much more now and we know pelvic floor contractions alone are not the solution. An evaluation with a skilled pelvic floor physical and occupational therapists will help people identify musculoskeletal impairments and a treatment plan for home and in the clinic to address them.

Even though people may experience the exact same symptoms the underlying causes of them are often different. There is no one-size-fits-all approach to pelvic health!

Understanding the Impact of Menopause on Pelvic Health

Menopause can significantly impact pelvic health, leading to conditions such as urinary incontinence, pelvic organ prolapse, and sexual dysfunction. The reduction in estrogen levels can cause the pelvic floor muscles to lose elasticity and strength, making them less supportive of the organs they cradle.

 

The Role of Pelvic Floor PT

Pelvic floor PT is a specialized form of physical and occupational therapy that focuses on strengthening the pelvic floor muscles and relieving associated symptoms. It involves exercises designed to improve muscle function, flexibility, and endurance. The therapy also includes education about lifestyle modifications that can support pelvic health.

 

The Benefits of Pelvic Floor PT in Menopause

  1. Improved Bladder Control: Pelvic floor PT can help manage urinary incontinence, a common issue in menopause, by strengthening the muscles that control urination.

  2. Reduced Pelvic Pain: Regular pelvic floor exercises (as prescribed by your pelvic floor pt) can alleviate discomfort caused by pelvic organ prolapse or sexual dysfunction.

  3. Enhanced Sexual Function: A functional pelvic floor can improve sexual satisfaction by increasing sensation and reducing pain during intercourse.

  4. Prevention of Future Issues: Even if you’re not currently experiencing pelvic floor issues, PT can be a proactive measure to prevent potential future problems.

 

Every one going through menopause deserves to live their life to the fullest, unburdened by pelvic health issues. Pelvic floor PT can be a powerful tool in managing the changes that come with menopause. It’s never too late to start – your pelvic health is worth it.

Remember, everyone’s journey through menopause is different, and so are their pelvic health needs.

Resources:

Want to read the study we referenced?

______________________________________________________________________________________________________________________________________

Are you unable to come see us in person in the Bay Area, Southern California or New England?  We offer virtual physical and occupational therapy appointments too!

Virtual sessions are available with PHRC pelvic floor physical and occupational therapistss via our video platform, Zoom, or via phone. For more information and to schedule, please visit our digital healthcare page.

Do you enjoy or blog and want more content from PHRC? Please head over to social media!

Facebook,

YouTube Channel,

TwitterInstagramTik Tok

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 and occupational therapy?

Pelvic floor physical and occupational therapy is a specialized area of physical and occupational therapy. Currently, physical and occupational therapistss 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 and occupational therapy curricula. The Pelvic Health and Rehabilitation Center provides extensive training for our staff because we recognize the limitations of physical and occupational therapy education in this unique area.

What happens at pelvic floor therapy?

During an evaluation for pelvic floor dysfunction the physical and occupational therapists will take a detailed history. Following the history the physical and occupational therapists will leave the room to allow the patient to change and drape themselves. The physical and occupational therapists 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 and occupational therapists 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 and occupational therapists 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 and occupational therapists 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 and occupational therapy plays a crucial role in identifying the mechanical impairments that are affecting the nerve. The physical and occupational therapy treatment plan is designed to restore normal neural function. Patients with pudendal neuralgia require pelvic floor physical and occupational 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 and occupational therapy as first-line treatment for Interstitial Cystitis. Patients will benefit from pelvic floor physical and occupational 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 and occupational therapistss who work at PHRC have undergone more training than the majority of pelvic floor physical and occupational therapistss 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 and occupational therapistss 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 and occupational 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.