Metro Pelvic Floor Therapy

Long Island’s Premier Pelvic Rehab Centers, Specializing In Both Women and Men

Bethpage, Commack, Garden City, Hampton Bays, Hauppauge, Huntington, Mystic CT, Patchogue, Port Jeff Station, Ridge, Riverhead, Selden, Wading River, Westerly RI

 

Pelvic floor therapy is physical therapy specifically for the pelvic floor muscles. The pelvic muscles are the group of muscles that run from pubic bone to tailbone and they function to help  control bladder, bowel and sexual function. It also plays a big role in supporting your spine, organs, core, and hips. 

Just like regular muscles, pelvic floor muscles can be tight or weak and can cause discomfort. In patients with dysfunction in their pelvic floor it can present as sharp pain, burning, achiness, nerve pain, pressure, increased sensitivity,  in areas such as the vagina, vulva, urethra, clitoris, penis, testicles, rectum, lower abdominal area affecting bladder, bowel, and sexual function. Dysfunction in the pelvic floor can also contribute to symptoms like urinary urgency/frequency, urinary incontinence, fecal incontinence, constipation. All the pelvic physical therapists here at “Pelvic Restore” (Metro PT) have advanced training in pelvic floor therapy making them fully equipt to help patients with these conditions. During our assessment we work to figure out the causes of your symptoms and create an individualized plan of care. We work closely with other healthcare providers as pelvic floor therapy is a multidisciplinary approach. Some examples include, physicians, mental health therapists, nutritionists, acupuncture, yoga etc.

Initial Consultation: 

The first visit at “Pelvic Restore” is a one-on-one visit with a skilled pelvic floor therapist. It will include a comprehensive history with detailed discussion of your symptoms so we can understand what may be going on and how we can help you. 

We perform a physical examination which may include postural assessment, range of motion testing, strength testing, muscle tone assessment through abdomen, hips, back, pelvic floor, etc. 

With the patient’s permission we will perform a pelvic floor muscle assessment. For female patients, we will visually look at the vulva, assess the skin and the muscles and will do an internal vaginal exam with a gloved finger and lubricant. This exam will give the therapist the information they need to determine the tone of the pelvic floor (are the muscles tight? Are you able to relax them?, are the muscles weak?, do they function properly). For male patients, with their permission, we examine the external pelvic floor and examine the muscles determining where there might be some dysfunction and what could be contributing to their symptoms. For further examination for both male and female patients, we may also assess the pelvic floor rectally. Through this exam we would be able to assess muscle strength and coordination which could be affecting bowel function. Here we can also assess the prostate gland which, for male patients, which can affect urinary and sexual function. 

Based on our findings we will give the patient an in depth explanation of causes of symptoms. We will answer whatever questions the patient may have and will work with the patient in creating a plan of care that meets the patient’s goals. 

Future treatment sessions: 

This may include activity modifications, education on retraining muscles and habits that may be contributing to your symptoms. Manual therapy to address tight muscles, exercises to help with creating more appropriate muscle balance and coordination to allow for more efficient movement patterns and function. Biofeedback is also a tool that may be used to help visually restrain your pelvic floor muscles. 

 

What We Treat

 

  • Chronic pelvic pain is discomfort or dysfunction which may include rectal, genital or abdominal pain, urinary frequency &/or urgency as well as discomfort during and/or after sexual activity. May also be known as prostatitis, interstitial cystitis, isolated orchialgia, levator ani syndrome, proctalgia fugax, pudendal nerve entrapment syndrome, vulvodynia, urethral syndrome or related conditions.

  • A condition in which the muscles of the pelvic floor do not contract or relax properly. It may include muscle spasm, weakness or muscle incoordination.

  • The failure of pelvic floor muscles to relax, or a paradoxical contraction of the pelvic floor muscles, with defecation.

  • Chronic nonbacterial prostatitis causes long-term pain and urinary symptoms. It involves the prostate gland or other parts of a man’s lower urinary tract or genital area. This condition is not caused by an infection with bacteria.

  • A chronic medical condition in women caused by varicose veins in the lower abdomen. The condition causes chronic pain, often manifesting as a constant dull ache, which can be aggravated by standing.

  • Scar tissue is a common contributing factor to pelvic pain. The good news is: it’s an issue that’s highly treatable.

  • Fascial restrictions are areas of tension and tightness in the body’s fascia. Abnormal adherence of connective tissue to itself or to other tissues which impedes normal, fluid movement of tissues across each other. The Fascia is naturally very flexible, but certian fascia in the body can become tight and rigid with injury or stress. These restrictions and tightness in fascial and connective tissues can restrict the body’s movement, flexibility, and function. They may cause muscular shortness and tightness, which can cause pain by putting tension on muscles and/or joints. This can sometimes carry over and cause restrictions to blood flow, organ function, and nerves.

  • Myofascial pain often results from muscle injury or repetitive strain. When stressed or injured, muscles often form trigger points, like contracted knots, that cause pain and tightness.

  • Brings about a loss of mobility and motility because of the inefficient sliding of the organ on its surrounding structures. A visceral restriction occurs when an organ loses part or all of its ability to move resulting in a decrease in the mobility and motility of organs. They can be caused by adhesions, fixations, etc. A restriction, fixation or adhesion to another structure may result in functional impairment of the organ and/ or pain.

  • This is a painful condition in the anorectal region. It typically causes a dull vague ache in the perineum and anus, occurring for longer periods, and more frequently than in Proctalgia Fugax. The pain is usually caused by a spasm or dysfunction in the striated or voluntary muscles of the pelvic floor.

  • Pain in and around the region of the coccyx (tailbone); the coccygeal region is usually markedly tender. This condition can be one of the many causes of pelvic muscle spasm and dysfunction.

  • Pelvic fracture is a disruption of the bony structures of the pelvis. … of fatal pelvis fractures also included blast injury and penetrating trauma.

  • Dysfunction in the sacroiliac joint, or SI joint, is thought to cause low back and/or leg pain.

  • This refers to a disorder of vulvar pain, burning, and discomfort that interferes with the quality of life. The term is used in 2 ways:

    1. In dysaesthetic vulvodynia: Spontaneous, diffuse pain in the vulva of a (speculatively) neurological origin or of a neuralgic nature. (Hence also called pudendal neuralgia, as the pudendal nerve may be involved). Intercourse may or may not be painful.

    2. As an overall term for any kind of vulvar pain. Eg. Vulvar vestibulitis is a subtype of vulvodynia, where there appears to be redness or focal areas of inflammation in the vulvar vestibule.

  • A localized form of vulvodynia with pain in or around the clitoris.This sometimes manifests as an uncomfortable constant low level of sexual stimulation.

  • Entrapment is a bit of a catch all term. Stretching or rubbing of the pudendal nerve can also cause pudendal nerve entrapment. Muscle spasm or tightness along the path of the nerve can compress the nerve and cause dysfunction. In all cases the result is nerve irritation, which causes improper functioning of the nerve. An entrapped nerve misreports pain and causes organ dysfunction such as urinary, defecation, and sexual problems. Now, what causes entrapment? PNE is usually precipitated by prolonged sitting or trauma to the sitting area. The most common diagnoses are: prostatodynia, nonbacterial prostatitis, idiopathic vulvodynia (idiopathic means unknown cause), idiopathic orchialgia, idiopathic proctalgia, idiopathic penile pain, Levator ani syndrome, and coccydynia. “The reason for these many diagnoses is that the pudendal nerves innervate urogenital and anorectal tissues, cutaneous (skin) tissue, and many small but very important muscles in the perineum. Irritation of the pudendal nerves can cause muscle spasms in one or more of those muscles. Spasm of the external anal sphincter can cause constipation. Similarly, spasm of the external urethral sphincter can cause urinary hesitancy, mimicking prostatic problems. Spasm of any of the other muscles can cause discomfort and a feeling of tightness, cramping, etc.

  • A chronic condition that usually affects one area of the body. One may experience intense burning or aching pain along with swelling, skin discoloration, altered temperature, abnormal sweating and hypersensitivity in the affected area. Changes in hair and nail growth, joint stiffness, swelling and damage, muscle spasms, weakness and loss (atrophy) and decreased ability to move the affected body part may ensue.