What is Pelvic Floor Physical Therapy?

The Pelvic Floor is the set of muscles lining the pelvis. Problems with the pelvic floor affect bladder, bowel and sexual function and can be a source of pain. The problems may be weak muscle tone, torn muscles, hypertonicity of muscles, trapped nerves, scar tissue affecting organ function or movement, and poor coordination/communication between nerves and muscles.  Treatment of pelvic floor dysfunction in Physical Therapy includes an internal pelvic exam, which will help your therapist and yourself determine if the muscles are weak, uncoordinated, hypertonic (tight/tender). This evaluation is the basis for an individual manual therapy and exercise program.

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How can Physical Therapy help with Sexual Dysfunction?

Sexual problems in women can include:

  • Lack of sexual desire
  • Inability to become aroused
  • Lack of orgasm, or sexual climax
  • Painful intercourse

This may be caused by physical or psychological influences. We work with sexual counselors, psychologists and medical doctors as part of a team approach to restore normal function and awareness to the pelvic floor.

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What is Urinary Incontinence and what can Physical Therapy do about it?

Urinary Incontinence is the involuntary loss of urine. You are not alone in this condition, it is estimated that 1 in 3 women experience some form of incontinence. Despite this being common, it is by no means necessary or normal!

Stress incontinence: loss of urine with sudden increase in physical stress on the bladder, such as cough or sneeze, etc.

Urge incontinence: sudden loss, usually of large amounts of urine, preceded by a strong urge to urinate

Treatment options include:

  • Internal pelvic floor evaluation to assess muscle function, tone, sensory awareness, coordination and check for strength.
  • Specific pelvic floor treatment which will include strengthening if/when you are able to selectively isolate the pelvic floor muscles. The traditional Kegel exercise has a place but there is much more to the pelvic floor. We will design a program based on your own function and functional needs.
  • Biofeedback may be helpful
  • Bladder training which starts with completing a bladder diary and education in what is normal.

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What is Pelvic Organ Prolapse and what can PT do about it?

Prolapse is a general term for a type of hernia in which a pelvic organ (uterus, vagina, bladder, small bowel, or rectum) has lost its structural support and falls or protrudes into the vagina or through the vaginal opening. Often, more than one organ is involved in prolapse. We will work with your physician in helping you restore function. Some times, despite the best of exercise re-education and excellent bowel and bladder habits there is still a need for surgical repair. There are excellent surgeons in the Chicago area and we will work with them and with you to assist in the best recovery to restore your pelvic function and confidence.

Treatment options include:

  • Internal pelvic floor evaluation to assess muscle function, tone, sensory awareness, coordination and check for strength.
  • Specific pelvic floor treatment which will include strengthening if/when you are able to selectively isolate the pelvic floor muscles. The traditional Kegel exercise has a place but there is much more to the pelvic floor. We will design a program based on your own function and functional needs.
  • Biofeedback may be helpful
  • Bladder training which starts with completing a bladder diary and education in what is normal.
  • Adaptations of exercises to limit pressure in the abdominal area to avoid downward pressure onto the organs from poor exercise or breathing form.

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What is fecal incontinence and what can PT do about it?

Fecal incontinence is the involuntary loss of bowel contents, including gas, liquid stool and/or solid feces.

Treatment Options:

  • Internal pelvic floor evaluation to assess muscle function, tone, sensory awareness, coordination and check for strength.
  • Specific pelvic floor treatments, which will include strengthening if/when you, are able to selectively isolate the pelvic floor muscles. The traditional Kegel exercise has a place but there is much more to the pelvic floor. We will design a program based on your own function and functional needs.
  • Biofeedback may be helpful
  • Bowel training that starts with completing a diary and education in what is normal form and function.

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I’ve been to PT before and it didn’t help, what makes you think this clinic is any different?

  • We think that we can either be the last PT clinic you need, or one more in a string of providers you see as you search for something to help you regain your function and return to optimal activity.
  • Our persistence in keeping up with the latest science as it applies to Physical Therapy, attending high quality continuing education and international conferences gives the therapists at Entropy Physiotherapy an ability to offer treatment options and education that has the highest probability of being effective. This is the bare bones of “science based medicine” and “evidence based medicine”.
  • We are prepared to abandon favorite or popular techniques that have been found through good research to be a waste of your time. For example: you will not find an ultrasound machine at our clinic as the research consistently shows it has no more benefit that exercise in reducing pain or improving tissue health. Exercise has many additional benefits. We think those 8 minutes are better spent with manual therapy and exercise.
  • Our goal is to teach you to be independent and not need us. How many places aim to get you well enough to not need their help? Tune ups are always lovely and that’s what our Wellness Program is for.
  • We are also prepared to admit that recovery is a process. Applying the right techniques at the right times is imperative. As therapists, we are willing to learn from what hasn’t worked in the past.

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I’m having pain during pregnancy (either new, or old pain that is getting worse), and everyone tells me it will go away.

While we agree the human body is amazing in its ability to heal itself, it is not entirely likely that your pain will magically disappear. It is important to learn that while pain during pregnancy is common, it is not normal. There are several different things that can be done during pregnancy to reduce or eliminate pain. Even better, it may prevent it from getting worse!

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Chronic Pain Conditions are tough, what can PT or the Wellness Program do for me?

  • Chronic pain is tricky. There is good reason to believe that you can change your ability to move and return to those things in life that are important to you. You might need to modify things. In general we will work with you to understand the biology and complex changes that happen when a body has been in pain for over 3 months. All treatment is not the same, and your history and lifestyle matter in what the final program will involve. In general treatment will follow some basic principles:
  • We will do a careful evaluation of your motion, movement patterns, strength, sensitivity (where do you hurt and what makes it better or worse).
  • We will work with you to devise a movement and education plan that works for your life and priorities.
  • We will use a variety of manual therapy techniques that we think help to make the process easier to tolerate and that helps you to move with more ease.

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Why do I need a doctor’s prescription to come to PT?

The State of Illinois continues to require an MD, DO, PA, or DC referral for Physical Therapy. Changing this will require a change in the state law regulating the practice of Physical Therapy. Please contact your state Representative and Senator and let them know it is time for Illinois to allow Direct Access to Physical Therapy as provided by licensed Physical Therapist.

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How long does a typical session or series of sessions last?

A typical session is 60 minutes.  We know that it takes roughly 8 weeks for muscle strength to develop. Plan on 8 to 10 visits, but we will adjust those up or down as needed given the complexity of your own condition.

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What should I expect at my first visit?

  • Wear comfortable clothing and shoes.
  • Be prepared for a physical examination of movement, strength and sensitivity (pain). This may be multiple body parts as we look at helping you restore function and allow for a return to your favorite activities.
  • The first visit has many more questions and discussion that the subsequent sessions as we need to learn about you and your specific needs.
  • There will be time for treatment and developing the beginning home program.

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