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Advocacy and Research

Amy in London!

By Amy Stein, DPT

Yesterday, I was speaking in London with the well-known Fiona Lewis, vulvar dermatologist specialist, Peter Greenhouse, Maria Elliott and Fabrizio Bogliatto in London. It was a wonderful and informative seminar that Maria Elliott worked very hard at putting together, with an amazing group of people. Michelle Lyons and Jenny Burrell also attended.

My talk in London was well received with a mixed audience of beginner women’s health PTs and some physicians and also more advanced PFPTs like the host, Maria Elliott, Michelle Lyons and Andrea Dugan.

Peter Greenhouse was a very dynamic speaker and he disagrees with vestibulectomy, stating that there are other treatment options and the research of 61% is not strong enough to warrant a surgery. Other physicians may argue this.

Maria Elliott, the host, spoke on the importance of proper alignment and functional biomechanics. She mentioned the importance of having a happy gut. We both mentioned the importance of a home program and we discussed lubricants like Yes, and massage tools like EZ Magic and EZ fit.

The commonality amongst all five of us was that vulvar and pelvic pain require a multidisciplinary approach and most of the time there is not a quick fix.

I also mentioned attending #ipps16 in Chicago, October 2016, and IPPS’s world congress on abdominal and pelvic pain in DC in October 2017! I spoke to them about the Alliance for Pelvic Pain weekend patient retreat, as well, which is coming up in May 2016! I also discussed the importance of manual therapy both external and internal, and the need to assess and treat the rectal muscles. Even though it was a vulvar and pelvic pain seminar I did mention how male pelvic pain is also so prevalent and how necessary it is to help the male patients. Our practice is about 40% male pelvic floor dysfunction and pelvic pain.

Fiona Lewis discussed vi pat dermatoses and how you can have vaginal crones, lichens sclerosis, lichens planus and various other diagnoses. She also discussed how some Vulvodynia is not “seen” and therefore can be moe challenging to diagnose. She praised me on my presentation, stating that physicians are not taught in most European medical schools on how to assess he musculoskeletal impairments that can cause pelvic and vulvar pain. They are not taught how to palpate the pelvic floor muscles externally or internally, and she along with the other physicians are surprised by this because it is so important.

At the end of the evening, after an amazing job by Maria Elliott and Ilaina Brockman, of Icrelief.com, Maria took 12 of us to a lovely dinner in London and we celebrated her success over delicious food and wine!

See below for pictures!

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—FAQ

Frequently Asked Questions

Pelvic Floor Disorders and Treatment

What is pelvic floor dysfunction and why does it happen?

Pelvic floor dysfunction is extremely common and occurs when the muscles, tissues, or nerves of the pelvic floor are weakened, tightened, or injured by trauma, chronic strain, or overuse. Pelvic floor disorders can result from traumatic injury such as a fall, from sporting activity, surgery, or childbirth. They can also happen from more chronic issues, such as infection or chronic inflammation such as endometriosis. Pelvic floor disorders can be a consequence of poor alignment or posture, overuse, or improper movement. The pelvic floor muscles surround the urethra, rectum, vagina and prostate; therefore, if there is a dysfunction in these muscles it can result in urinary, bowel, or sexual dysfunction in people of all ages.

Who should I see to get a proper diagnosis?

Many healthcare providers don’t assess – or don’t know how to assess – the pelvic floor muscles and nerves, so it’s important to get a proper diagnosis from a practitioner who specializes in pelvic floor dysfunction and pelvic pain. Too often patients tell us that they’ve been to 10 different doctors and healthcare providers and their symptoms have not improved, or have worsened. Find a specialist right away and get on the path to healing as quickly as possible.

Why do healthcare providers miss (or misdiagnose) pelvic floor dysfunction?

Long story short, the medical practice is divided into areas of the body: Urology. Orthopedics. Gynecology. But the body itself doesn’t have walls; every system interacts with everything else. Sometimes providers are so laser-focused on what they treat that they miss the whole picture. 

As more and more research emphasizes the importance of physical therapy as part of a complete treatment regimen, more and more physicians are learning how to recognize and treat pelvic floor disorder. In the meantime, if you’re not getting relief from your current treatment, make an appointment with a pelvic floor specialist to learn more.

How does pelvic floor dysfunction affect sex?

Pelvic floor muscles have a huge impact on sex. Muscles that are shortened or tight and are unable to elongate will not allow for good blood flow into the genitals. This can result in pain, weaker erections, diminished sensation, inability to orgasm, and even decreased lubrication. Pelvic floor PT can help with these issues by enhancing blood flow and improving muscle function. 

How can pelvic floor dysfunction cause bloating?

Pelvic floor dysfunction, a condition characterized by the inability to correctly relax and coordinate pelvic floor muscles, can significantly contribute to bloating due to its impact on gastrointestinal functions. When these muscles are not functioning properly, it can impact the ease of emptying and make it difficult for your body to pass stool and gas through the intestines. This obstruction leads to an accumulation of waste and gas in the gastrointestinal tract, causing bloating and abdominal discomfort.

Is it true there’s internal massage?

There can be. We do perform internal soft tissue mobilization of the pelvic muscles that are inside your pelvis and are accessible only through the vagina or rectum. We never do internal treatment without your consent and understanding.

What makes someone a pelvic floor PT vs a regular PT?

All pelvic PTs get additional training in pelvic floor internal treatment through continuing education and at our clinic. 

We pride ourselves on the level of training we provide, not just at the beginning but throughout the time our therapists spend at Beyond Basics. We know that learning is a life-long process.  We also provide additional training in physiology of the GI system and urinary system as well as sexual health and function and nutritional training. Most PT programs and schools do not provide the depth and breadth of knowledge that we provide all our PTs at Beyond Basics.

Get help now from a pelvic floor therapist.

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