Pelvic Health

Why Choose Apex Wellness Providers?

Apex Wellness Providers adopts a holistic approach to healthcare. You are not just reduced to your injured body part – your health is a combination of body, mind, and spirit and is influenced by your habits, sleep, nutrition, and physical activity. These aspects of your overall wellbeing work together and affect each other very closely. When you see a pelvic health physical therapist at Apex, they will explain how these factors relate to your specific symptoms.

Just think about a new first time mother, a woman experiencing a wide range of menopausal symptoms, or a man undergoing a radical prostatectomy in his cancer journey. Their body is one that they do not recognize. Hormonal shifts, physical changes, emotional stress, and at times, pain. This is where pelvic physical therapy can help these patients navigate through these seasons of life. We can help them to understand the pathophysiology of their condition, how their body is responding to this stress, and start to outline the steps that need to be taken to return to wellness. Pelvic physical therapy is appropriate across the lifespan for men and women. Pelvic PT combines the tools utilized in general outpatient physical therapy, including manual therapy and exercise, with an in depth understanding of pelvic anatomy and its effects on every aspect of your health.

We feel there is a gap in service delivery and expertise in this space in our community and we want to be in the forefront of championing this bespoke service.

What is Women’s Health?

Women and men have very different physical bodies and hormonal make up, that when faced with specific demands or shifts, such as child birth or menopause, reacts in a way that is specific to women. This requires a tailored approach to rehabilitation that takes into account these differences in order to return the woman to full health and function.

Women’s health originally was aimed at post-natal and post-menopausal seasons of life. However, now the scope of practice has expanded to include all health issues that affect women in a unique way to men. This includes incontinence, pelvic pain, prenatal and postpartum dysfunction or pain, osteoporosis (brittle bones), rehabilitation following breast cancer, gynecologic cancers, reconstructive surgeries(including pelvic organ prolapse surgeries), education and prevention of these issues, as well as overall wellness and exercise. This section of healthcare and physical therapy now serves all females across their lifespan - from the young woman who wants to engage in sport, to the childbearing woman, all the way to the menopausal and elderly woman. All of these women can benefit from physical therapy that is targeted to their specific anatomy.

What is Men’s Health?

Men are not immune from pelvic floor dysfunction. 

Men are also susceptible to issues such as incontinence, constipation, urinary urgency and frequency, pelvic pain, and sexual dysfunction/ pain with intercourse. Many men experience these issues due to prostate cancer and a resulting prostatectomy (up to 40% of men report this symptom post surgery). 

The young athletic man can also experience pelvic pain and urinary dysfunction when they start to increase their training – and this can be due to tightness or overactivity of the pelvic floor. 

These problems respond very well to conservative treatment (physical therapy) and there is no need for surgery or medical intervention.

If you think you might benefit from this type of physical therapy, call today to speak to a PT about your specific case.

What are common symptoms of pelvic floor dysfunction?

What are common symptoms?

When the pelvic floor is not functioning properly, you can experience some of the following issues:

  • Urinary/fecal incontinence
  • Constipation
  • Pelvic pain
  • Pelvic organ prolapse
  • Post-partum issues / birth injuries
  • Urinary frequency
  • Sexual dysfunction
  • Urinary retention
  • Pain and urinary dysfunction from conditions such as Interstitial Cystitis or Endometriosis

Ask yourself these questions!

  • Do you avoid jumping on the trampoline with your kids because of fear you will leak or you feel like your pelvic area is vulnerable to this type of impact?
  • Do you always know where the toilet is because you think you have a “small bladder” and go to the toilet more often than other people?
  • Do you always make it to the toilet in time?
  • Do you have to wear a pad when you go for a run or take an exercise class?
  • Do you get poor sleep because you are getting up several times a night to go to the toilet?
  • Are you avoiding sexual intimacy or even postponing regular smears because of pelvic pain?

If you suffer from any of these issues or feel like you might benefit from this service, call or click to book an initial assessment.

Pelvic Health FAQs

Answers:

What is the pelvic floor?

The pelvic floor is made up of a group of 3 muscles called Levator Ani. The muscles connect from tailbone to the pubic bone (back to front) and from the two sit bones (side to side).

These muscles contract and relax, just as all the other muscles in the body. When the muscles contract/tighten, the pelvic floor shortens and pulls up inside the pelvis.

The pelvic floor muscles have a very important job. The pelvic floor does the following:

  • Stabilizes the pelvis and hips
  • Helps to distribute abdominal pressure as part of the “core”
  • Supports the pelvic organs (bowel, bladder, uterus, vaginal vault)
  • Creates closure pressure around urethra to keep us continent (able to hold urine)
  • Supports sexual function for pain free and satisfying intercourse

What diagnoses does a pelvic PT treat?

When the pelvic floor is not functioning properly, you can experience some of the following issues:

  • Urinary/fecal incontinence
  • Constipation
  • Pelvic pain
  • Pelvic Organ Prolapse
  • Post-partum issues/birth injuries
  • Urinary Frequency
  • Sexual dysfunction
  • Urinary retention
  • Pain and urinary dysfunction from conditions such as Interstitial Cystitis or Endometriosis

What does an initial evaluation for pelvic floor involve? 

An initial appointment with a pelvic floor PT at Apex Wellness involves the following:

  • A detailed history taking, review of symptoms and other ongoing health conditions.
  • In depth education on pelvic anatomy as it relates to your specific symptoms.
  • Comprehensive assessment of  your posture, breathing patterns, core strength, hip and lumbar mechanics.
  • If it is appropriate and you are comfortable moving forward, a pelvic exam. This may involve any combination of the following: perineal observation (no touching), External pelvic/perineal palpation, Internal pelvic floor exam, external and/or internal anorectal exam. *Please note, the clinical relevance to these procedures is thoroughly explained to you in advance and consent is offered or denied by the patient. We will never ask you to do something you are uncomfortable with.*
  • Treatment during the exam, if appropriate. This may involve manual release of musculoskeletal structures, guided breath work, demonstration of proper mechanics or posture, etc.
  • Prescription of a tailored home exercise program to get you started on your pelvic rehab journey! 

Do I have to do the internal pelvic exam?

At Apex Wellness, you will never be told that you must engage in anything in the clinic that you are not comfortable with.

If the therapist deems it appropriate and helpful to perform a pelvic exam (internal or otherwise), this process will be thoroughly explained to you. You will understand how this exam gives the therapist information specific to your case and how it will help them tailor your treatment plan to your individual needs. However, if you are not comfortable with the type of exam that the therapist is suggesting, it is completely within your right to withhold consent. In this scenario, the therapist will offer alternatives to the type of exam they have initially proposed  so that you are, at all times, feeling comfortable and safe.

Even if you do consent to the exam, it is important to note that you are welcomed and encouraged to end the exam at any time throughout the process if you begin to feel uncomfortable or change your mind. 

What equipment do you use in pelvic floor PT? 

At Apex Wellness, we do not rely on any fancy equipment to assess or treat our pelvic patients. Usually treatment involves the patient, the therapist, and the treatment table. We do not use stirrups or a speculum for our internal pelvic exams.

We may suggest using equipment such as massage balls, theraband, kinesiotape, braces, etc. This is not much different than what is used in our other orthopedic physical therapy practice. 

Can I bring my child to my appointment? 

We understand it can be difficult to find childcare and there may be times that you need to bring your child to your appointment. This is completely acceptable to us. As pelvic PTs, we are used to children in tow. 

Can I bring my partner to my appointment?

You are welcome to bring your partner to any or all of the appointments. In fact, this can be very helpful!

Your partner can lend a hand to taking care of your child, if accompanying you, while you are being assessed. They can also serve as an extra pair of ears, as the first appointment can be quite education heavy.

For treatment of pelvic pain conditions, we often get the partner involved so that they can better understand your symptoms, triggers, and how to help perform home exercises or self care techniques.

How often do I have to come to pelvic PT?

This is on a case by case basis. On average, pelvic patients are not seen as frequently as orthopedic PT patients. For example, we may see you every 2-4 weeks, as opposed to 1-2x per week. Pelvic physical therapy can often go in episodes of care. We may see you for 4-6 treatments and then see you again months or years later when you are increasing your training demands or have another major life change such as additional pregnancies. 

Is pelvic floor PT coded the same as other types of physical therapy? (Will I be able to submit this to my insurance?)

Physical therapy evaluations and various treatments are the same across specialities. The codes are processed by insurance in the same way it would be as if you were seeking PT for knee or ankle pain.