It's an important part of the human anatomy that is underestimated. The role it plays for both men and women is worth protecting. The pelvic floor, also called the core, is a group of muscles that spans the base of the pelvis. They support the bladder and bowel, and the uterus in women. When the pelvic floor muscles are firm and strong, they contribute to healthy bladder and bowel control and enhanced sexual sensation and function. For an expectant mother, they help support and cradle her baby.
But what happens when these muscles weaken or trigger pain? What are the causes? What are the consequences?
Symptoms emerge for a variety of reasons, said Tracy Thorson, DPT, physical therapist, Gundersen St. Elizabeth's Hospital and Clinics. Pregnancy, chronic cough, high impact exercise, weightlifting, surgery, radiation therapy, age and menopause can stress the pelvic floor and weaken the muscles. Common symptoms include urge or stress urinary incontinence, constipation, pelvic pain and other more serious conditions.
"These symptoms are often left untreated because they are topics that are not easy to talk about – even with a healthcare provider," Thorson said. "Many think their condition is an ordinary part of aging or a natural aftereffect of pregnancy. But that's not true. There are treatments and therapies that can recondition the pelvic floor so normal functioning can return. That's where physical therapy comes in."
With extensive experience in women's health issues and pelvic disorders, Thorson works with men and women to reverse the progression of their symptoms by strengthening, retraining, and activating core muscles.
"We start with a thorough evaluation," Thorson said. "I listen to gain an understanding of their symptoms and concerns, then complete a physical assessment of the pelvic structure. We also talk about lifestyle habits and patterns - what they eat and drink, and physical activity routines. This all plays into the development of a treatment plan that is tailored to the needs of each patient."
Therapies vary and focus on the specific malfunction. To stimulate weakened muscles, manual manipulation techniques and electrical stimulation may be used. Biofeedback helps patients learn how to tighten and relax pelvic muscles and is often recommended to address chronic constipation. Behavior and lifestyle modification, mindfulness training, breathing techniques and pelvic floor muscle exercises are additional tools and therapies that aid in bolstering the pelvic floor and retraining muscles to perform as intended.
Once a care plan is created, physical therapy sessions execute the recommended treatments and provide education and instructions for additional follow up at home. Each session builds on the last, working toward improved quality of life. Often, these less invasive treatments can reduce, delay or eliminate the need for medications or surgery.
Tracy works with patients to strengthen the pelvic floor of prenatal and postnatal women, treat urinary incontinence of aging women and men, improve pelvic health and reduce pain of athletes, caring for men with prostate issues and care for women experiencing sexual dysfunction. Sessions may continue for up to 12 weeks and, in most cases, are covered by insurance.
"I think it's so important to stress that while these conditions are common, they are not normal," Tracy said. "Breaking the silence to openly talk about these concerns and seek help can set the stage for lasting healing and success. I don't think people realize there are many options and tools in our physical therapy toolbox to improve what can lead to increased confidence, freedom and well-being."
If you believe you can benefit from Tracy's services, call Gundersen St. Elizabeth's Rehabilitation Services directly at (651) 565-5558 or talk with your primary care provider. Patients do not need a physician's referral to receive physical therapy services.
Tracy Thorson received her doctorate in physical therapy from Northwestern University. She has completed numerous classes and coursework in pelvic health rehabilitation. Prior to joining Gundersen St. Elizabeth's, she worked at Winona Health and Olmsted Medical Center. She is one of six therapists that offer a broad range of therapies.
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