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whats up down there

Have You Ever Asked "Whats Up Down There, Doc?"

Pelvic floor physical therapy is one of the best kept secrets in medicine.

I was on a recent plane flight and sat next to two women that were very chatty with one another. They quickly swept me up into their conversation. Inevitably, in situations like this, everyone asks “So what do you do for a living?”. My answer used to be “I’m a physical therapist”. The past couple of years, my standard response is “I’m a physical therapist, but let me tell you about what kind of physical therapist I am”. Then I go into the diagnoses I treat related to bowel, bladder and sexual health and, in general, how I treat them. Across the board, their reaction is a mix of astonishment and genuine interest. The follow up dialogue is always eye-opening for them, and more often than not, they will report either knowing someone close to them as having one of these pelvic floor issues, or they have it themselves.

These two chatty women on the plane were asking many questions. As it turned out, the early-20’s aged women sitting directly next to me had cervical cancer followed by a fertility-sparing procedure called a trachelectomy. Ever since her surgery, she has experienced painful intercourse. She hadn’t even mentioned this to her doctors, as she thought it was just the way it going to be. I told her about pelvic floor physical therapy and encouraged her to follow up with her doctor and ask for a referral. Needless to say, she was excited about the prospect of getting help for this pain that has plagued her for over two years.

A young couple sat next to me on another plane flight. They kept to themselves mostly. During the flight, I pulled out my laptop to work on some marketing for my book. I had a flyer on my lap and was typing away at the computer. This caught the eye of the woman that was sitting next to me. “So…”, she starts. “I don’t mean to peek, but what you are working on caught my eye”. So we chat for a bit about pelvic floor physical therapy, and specifically related to sexual pain and my book. After several minutes of chatting, she tells me that she is currently seeing a physical therapist in San Diego for vaginismus. She just started two weeks prior, and was still very uneasy about the whole thing. I gave her a lot of education and encouragement to continue. She couldn't believe how long it took her to get pointed in the right direction, after years of struggling with her inability to overcome her pain.

On a recent eye exam (for myself), I saw a new optometrist in the office. As soon as I found out she had a 7 month old and a 3 year old, I told her about my profession. She quickly remarked “Oh yeah—half my friends say they pee their pants every time they sneeze”. Her comment was so off-handed, that it took her a moment to realize through our conversation that this IS NOT NORMAL. Yes, they had a baby (or two or three) and have had urinary leakage ever since. But does that mean you just live with it? I hope that women will begin to tell their doctors “Of course not!”. As our conversation progressed, I began telling her about women I treat that have sexual pain and unconsummated marriages. She piped up “One of my friends got a UTI (urinary tract infection) eight months ago and she said her and her husband haven’t had sex since”. I told her a UTI is one of the most common precursors for my patients that have sexual pain. After picking her jaw up off the floor, she asked for a stack of my business cards.

...

Why did I share these stories? These are just three stories in as many months. In each case, women were literally blown away at the treatment options that were available to them and their friends. One had only recently began treatment and still was uncertain of how it would help her achieve her goals. I know there is some bias here, but PELVIC FLOOR PHYSICAL THERAPY IS ONE OF THE BEST KEPT SECRETS in medicine. The knowledge that women’s health physical therapists possess that encompasses evaluation and treatment of orthopaedic dysfunctions and how these contribute to chronic pain, pelvic pain, sexual wellness or other joint, tissue, neurologic or muscle dysfunctions is an invaluable adjunct to traditional medical care that everyone needs to know about. If you look at the numbers, it is clear that 1 in 3 women experience problems that we as women's health physical therapists can treat.

It is paramount that women be empowered with the knowledge that not only is a multidisciplinary approach the key to reducing their dysfunction, but a critical part of that team is a women’s health physical therapist. Women need to be offered real solutions for their problems, not just medication that acts as a bandaid and only provides a temporary fix. Or offered solely surgery, in the case of urinary incontinence, when the benefits of physical therapy have been proven through research time and time again to be a viable alternative.

All doctors need to know what pelvic floor physical therapy can do. All women need to know about pelvic floor physical therapy. Not to exclude men, as there is pelvic floor physical therapy for them, too. Is it the root of all your ailments? It’s hard to know without an evaluation. But I bet if you’ve been told “there is nothing physically wrong with you” and you are experiencing ongoing pain or dysfunction, it should be the next place you look.

Looking for help with your own pelvic floor issues? Schedule an appointment with one of our therapists today!

What Our Patients Have to Say

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Testimonial by Jamie M.

I have been going to see Heather for a while now, and I can't tell you enough how much she has improved my quality of life. Heather specializes in issues like pelvic floor, but I see her for other orthopedic issues.

I have a lot of chronic joint pain and dysfunction issues (back, hips, neck) that require that have ongoing physical therapy maintenance. The effects of my problem joints/areas overlap and interconnect with each other in complex ways, so helping me requires really having a complete understanding of the entire skeletal and muscular system. Pain does not always appear where the problem actually is, the human body is a twisty, many-layered puzzle. I have an exercise program I do at home and I am very functional, but there are just something things I need a PT to help me out with.

Read more: Testimonial by Jamie M.

Testimonial by M.N., age 28

A personal journey and testimonial from one of my patients:

I was diagnosed with vaginismus 4 years ago. I never heard of such medical condition until after I got married. At first my husband and I didn't know what to do, we didn't know what the issues were or how to overcome it. Being born and raised in Armenia and being Christian I wasn't that open about talking to sex with others and so it wasn't easy to seek help. But eventually I went to an Ob-Gyn and luckily she knew about the medical condition (not many doctors know). She referred me to a physical therapist and I couldn't believe it and thought it's something I can handle myself. I ordered a kit from vaginismus.com and started practicing with dilators. There was some small progress but wasn't much helpful.

Read more: Testimonial by M.N., age 28

Testimonial by Jamie M.

I have been going to see Heather for a while now, and I can't tell you enough how much she has improved my quality of life. Heather specializes in issues like pelvic floor, but I see her for other orthopedic issues.

I have a lot of chronic joint pain and dysfunction issues (back, hips, neck) that require that have ongoing physical therapy maintenance. The effects of my problem joints/areas overlap and interconnect with each other in complex ways, so helping me requires really having a complete understanding of the entire skeletal and muscular system. Pain does not always appear where the problem actually is, the human body is a twisty, many-layered puzzle. I have an exercise program I do at home and I am very functional, but there are just something things I need a PT to help me out with.

Read more: Testimonial by Jamie M.

Testimonial by Jackie W.

I was in multiple car accidents a decade ago, and I have been to many physical therapists through the years without success. They found the root of my lower back pain problems and after nearly a decade of barely being able to walk I finally can again without pain. They are also the best pelvic floor pts and the only ones who found the connection between my pelvic floor and lower back problems. If you need help with physical pain, they are your answer.

-- Jackie W., 1/19/17 via Yelp!

Testimonial by T.H.

I started seeing Heather in October 2014. For more than two years, I had been suffering from painful urinary tract infection type symptoms after my bartholins gland surgery which included constant burning and urinary frequency sensation that led to more and more painful intercourse. I had made multiple visits to internist, obgyn and urologist's offices, went through a range of treatment with UTI and bladder frequency medication that included antibiotics, vesicare, estrogen cream, but nothing worked.

Read more: Testimonial by T.H.

Testimonial by R.S.

I wanted to thank you so much for helping me get through something I thought I may never be able to. We have achieved pain-free intercourse and this has really solidified our marriage. We are so grateful to you for all the work you do! Thank you!!

-- R.S.

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