How would an orthopedic Physical Therapist know when to refer a patient to a Women’s (and Men’s) Physical Therapist? This question came up on Twitter today and we think it is a great one.
Part of a routine orthopedic physical therapy examination should include checking for common Red Flags:
- Incontinence of bowel or bladder (Stress or Urgency/Frequency)
- Pain in the genitals
- Sexual dysfunction including pain with intercourse
- Unresolving Hip/SI pain in the absence of pathology
- Back/hip pain in pregnancy
- Heaviness or pressure in the perineum (Pelvic Organ Prolapse)
If a Medical Doctor has already seen the patient and pathology is ruled out, the next step should be referring this patient for a consultation or treatment with a Physical Therapist that specializes in pelvic health.
What is the difference?
A physical therapist who specializes in women’s and men’s health will be able to do an internal pelvic assessment that may include:
- Coordination of the pelvic muscles and the ability to contract and relax.
- Tissue mobility, the pelvic muscles should be non-painful.
- A detailed history of bowel and bladder function and habits.
- Assessing the ability to integrate the pelvic muscles in normal activities.
- Reassuring the patient that it is never normal to have pain during sex, incontinence can be helped by a well-designed program, and it is never normal to leak.
Where would you find a qualified therapist?
The American Physical Therapy Association and the Section on Women’s Health have locators to find qualified therapists in your area. There are growing lists in Canada, the UK and Australia as well. If there isn’t a qualified provider in your area it may be worth a phone call or consultation with the closest you can find.