Here are some more questions for our upcoming Alliance for Pelvic Pain Interview with Amy Stein on The Pelvic Messenger! Don’t forget to call in on Thursday, January 30th, at 6:00 PM EST. Please feel free to call in and ask questions! To access the live interview next Thursday, please click the link below at that time:
http://www.blogtalkradio.com/pelvicmessenger/2014/01/30/alliance-for-pelvic-pain–interview. Don’t forget, Alliance members will be giving away free copies of their books, videos, and CDs to people who call in with questions!
4. What about patients who have already tried physical therapy but it hasn’t helped, or even exacerbated their symptoms?
At Beyond Basics Physical Therapy, we often encounter patients who have previously been treated unsuccessfully by other physical therapists. There are a variety of reasons why any given patient may respond better to one practitioner versus a different one.
The first factor involves the amount of experience and training of the physical therapist. Very often, a patient may present with urinary incontinence and automatically be told to perform Kegels, pelvic floor strengthening exercises. However, this may worsen the problem! The physical therapist may inaccurately assume that weakness= incontinence, therefore strengthening seems like the appropriate course of action. HOWEVER, we have often seen patients present with incontinence due to OVERACTIVE or SHORTENED pelvic floor muscles. These patients require manual therapy and downtraining of the pelvic floor muscles, not uptraining and strengthening. In fact, very often the weakness naturally resolves by correcting the shortened muscles and restoring normal resting tone.
Another factor is that if a patient doesn’t connect well with their physical therapist or if there is poor communication, the healing process will be hindered. For example, if a patient feels nervous with the therapist or uncomfortable with any aspect of the treatment, their muscles will respond and reflect that fear by tightening. This may be due to a personality difference, or it can be that they need to include some type of mental health therapy such as Mindfulness Based Stress Reduction. Another example could be that the physical therapist is not asking the right questions or enough questions to obtain the information that they need to properly treat the patient.
Furthermore, the therapist may not be looking at the body as a whole. They may not be trained or forget to incorporate treatment of the external musculature or the internal rectal and/or vaginal trigger points. They also may not be incorporating relaxation techniques that are essential to their healing. Another example is that they may not be trained in treating nerve pain (ex. pudendal neuralgia).
Also, the patient may not have gotten better because they might not have been receiving specific integrative treatment. For example, a patient with fertility issues might be experiencing infertility due to visceral restrictions. Such an individual would benefit from visceral manipulation treatment to restore mobility of the organs and to eliminate abdomino-pelvic cavity restrictions. Very few therapists, even pelvic floor physical therapists, have advanced training in this technique. Fortunately, Michele McGurk, a practitioner at Beyond Basics Physical Therapy who is highly trained in visceral mobilization, will be attending the retreat and available for one on one sessions.
STAY TUNED for additional information on this topic in future blogs!
5. How will this year’s retreat be similar to last year’s retreat? How will it be different?
The retreat will be similar in terms of its goals. The goals of Alliance for Pelvic Pain are to teach “pelvic 101†to patients from the perspective of physicians, physical therapists, mental health therapists, and other integrative therapies. Similar to last year, we want to unite people who have pelvic pain to help build a support network. Unfortunately, too many people suffer in silence and think that they are alone. The retreat offers people the opportunity to discover that that is NOT the case and that there are others who can relate to their challenges. The ongoing goals of the Alliance are to provide education and awareness about pelvic pain, to provide support, and to provide self care techniques to initiate the healing process immediately.
The retreat will be different in that we are addressing male pelvic pain. We will also be joined by new practitioners who are very experienced in treating pelvic pain in men and women. Some of these practitioners include: Dena Harris, MD, Jaclyn Bondar, MD, Michele McGurk, PT, Roseanne Cruz Schoen, DPT, Paula Haberman, PT, MS, LAc, Mindy Pickard, MS, LAc, Dana Reed, MS, CNS, and Galen Fou, health chef. For more information of the Alliance for Pelvic Pain and the aforementioned health care providers, please refer to http://www.allianceforpelvicpain.com/upload/AFPP%20Program%20Schedule%202014_updated%201_15_14.pdf.
