UHS Offers Pelvic Floor Rehabilitation Services

(PRESSCONNECTS) -- We’re all familiar with physical therapy as it relates to recovering from an accident, injury or joint replacement. It’s easy to picture a rehab gym environment with weights and machines, and tables where therapists can apply ice or kinesiotape or move a muscle through its full range of motion. But what about therapy for important muscles you can’t see or feel easily?

PressConnects - October 30, 2020

It’s easy to picture a rehab gym environment with weights and machines, and tables where therapists can apply ice or kinesiotape or move a muscle through its full range of motion. But what about therapy for important muscles you can’t see or feel easily?

Your pelvic floor – the muscle group that closes the pelvic outlet – isn’t something you consider much unless it malfunctions. This muscle group has three separate jobs: helping with trunk stability, supporting urinary, gastrointestinal and reproductive organs; and assisting in bladder and bowel control and sexual activity. Like any other muscle group in the body, it can experience stress or injury. The difference? Unlike a strained knee or shoulder, the resulting difficulty probably isn’t something you’re comfortable discussing around the water cooler in the office.

UHS pelvic floor therapist Megan Gottlieb PT, DPT, WCS, a doctor of physical therapy, explained, “A strain or injury to pelvic floor muscles can result in urinary or bowel leakage or sexual dysfunction, any of which can feel embarrassing to address with a medical professional. But help is available -- pelvic floor physical therapy uses a variety of techniques to help patients recover as much normal function as possible. The main difference between ‘standard’ physical therapy and pelvic floor therapy is that the latter usually requires an internal component due to the anatomical location of the muscle group.”

Gottlieb is the only pelvic floor therapist in the UHS system, and has been offering her services to the region for more than a decade. She is board-certified by the American Physical Therapy Association, and stays current with the most up-to-date treatment modalities via continuing education. She sees about 40 patients per week, and due to the personal nature of these concerns, all sessions are one-on-one.

Who needs pelvic floor therapy? “I treat women of all ages,” said Dr. Gottlieb. “And pelvic floor dysfunction is not always related to a gynecological cause, such as pregnancy or childbirth. Someone may experience stress urinary incontinence purely as a result of trunk instability and poor core strength.” Dr. Gottlieb emphasized that it’s never too late to seek help, even if the issue is long-standing or the causative event happened years ago: “It’s so important for women to listen to their bodies and realize that urinary leakage, pain with intercourse or other pelvic concerns are not normal and that help is available.” Other reasons for pelvic floor therapy include separation of the abdominal wall muscles (diastasis recti), difficult or painful sexual intercourse (dyspareunia and vaginismus), chronic vulvar pain (vulvodynia), post-operative care following abdominal, pelvic, urinary, gastrointestinal or reproductive system surgery; pelvic organ prolapse; post-radiation care for patients with  pelvic-region cancers, or pain in the pelvic region, lower abdomen, low back, sacroiliac joint or coccyx.

In addition, the proliferation of advertising related to incontinence pads or disposable undergarments would lead the general public to believe that at a certain age, women can expect some urinary leakage as part of the aging process, and that the issue can’t be solved, only managed. “Urinary frequency, urgency and leakage – even just a few drops – are not age-related or part of the normal aging process. Talk to your primary care provider or gynecologist and ask for a referral for a therapy evaluation,” Dr. Gottlieb said.

At a first visit, Dr. Gottlieb asks the patient to complete a symptom questionnaire and then conducts a comprehensive external and internal examination of the musculature surrounding and attaching to the pelvis to determine the best treatment approach. She assesses strength, flexibility and muscle tone, and the visit usually takes about an hour.

Most insurance plans cover pelvic floor therapy, and patients generally have 30- to 60-minute appointments once or twice a week depending on diagnosis and severity of symptoms. Length of treatment depends on patient progress. In addition to working the pelvic muscles with professional guidance, some patients receive biofeedback and electrical stimulation to help re-train the pelvic floor muscles. The ultimate goal of pelvic floor therapy is to resolve pelvic pain and improve patients’ quality of life.

Although patients can make a direct appointment, Dr. Gottlieb recommends an initial visit with a primary care provider to rule out an easily-correctible issue (such as a urinary tract infection, for example) and obtain a referral. To schedule an appointment, call (607) 757-2600.  For more information visit nyuhs.org.

Pelvic floor therapy can benefit individuals with:

• Chronic pelvic pain
• Constipation or leakage of stool
• Diastasis recti
• Dyspareunia
• Pain in the pelvic region, lower abdomen, low back, sacroiliac joint or coccyx
• Pelvic organ prolapse
• Post-radiation care for patients with cancers of the pelvis
• Post-surgical care needs following abdominal or pelvic surgery or procedures involving the urinary, gastrointestinal or reproductive systems
• Pregnancy or postpartum pain, muscle imbalance or weakness
• Sexual dysfunction, including painful intercourse
• Urinary frequency, urgency, hesitancy or incontinence
• Vaginismus
• Vulvodynia

Members of the editorial and news staff of the USA TODAY Network were not involved in the creation of this content.

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