Tag Archives: Conditions

How Physical Therapy Can Help with Inflammatory Bowel Disease

Inflammatory bowel disease (IBD) affects 1.6 million Americans1, with as many as 70,000 new diagnoses each year. The cause is relatively unknown, though it is certainly related to an immune system deficiency. There are two conditions that are included in the IBD diagnosis; Crohn’s Disease and Ulcerative Colitis. Each condition impacts the body in different ways, and both can be treated by a well-trained pelvic rehabilitation practitioner. Andrea Wood, PT, DPT, WCS, PRPC explains more in her recent post on The Pelvic Rehab Report.

Source: Wikimedia

A colon affected by ulcerative colitis

What are the symptoms of Inflammatory Bowel Disease?

According to Dr. Wood, “common complications experienced by patients with IBD include fecal incontinence, fecal urgency, night time soiling, urinary incontinence, abdominal pain, hip and core weakness, pelvic pain, fatigue, osteoporosis, and sarcopenia.”

What is the difference between Crohn’s Disease and Ulcerative Colitis?

While either condition is considered Inflammatory Bowel Disease, there are some differences between the two. Ulcerative Colitis affects the innermost lining of the colon exclusively, and it produces internal ulcers and open sores. Patients with Ulcerative Colitis will have inflammation and tissue damage throughout the inner lining of the colon.

Crohn’s Disease is a chronic inflammation anywhere in the digestive tract, though it most commonly impacts the bowel and colon. The bowel wall will be affected, and patients may experience patches of inflamed intestine interspersed with healthy areas of the intestine.

Both conditions can be life-altering for patients who suffer from them.

Can Inflammatory Bowel Disease be treated?

The cause of IBD may not be known, but the symptoms certainly are. A skilled pelvic rehabilitation practitioner, like a Pelvic Floor Physical Therapist, can help patients overcome symptoms like fecal incontinence, urinary urgency, sarcopenia, fatigue, or pelvic pain. According to Dr. Wood, these are some of the treatments that an IBD patient might be offered in her clinic:

Fecal Incontinence
– Identify primary cause
– Apply manual therapy
– Biofeedback training to improve rectal pelvic floor muscle endurance and strength
– Instruct in proper toileting posture and techniques
– Rectal balloon training to better understand fecal urgency
Urinary Incontinence– Urge suppression techniques
– Bladder diaries and voiding intervals
– Decrease usage of bladder irritants
Sarcopenia– Weight training
– Abdominal training that doesn’t increase intra-abdominal pressure
Fatigue– Short bursts of cardiovascular exercise
– Training in proper bowel movement timing to improve sleep
– Diet and nutrition recommendations to improve sleep
Pelvic Pain– Manual therapy externally and internally if needed
– Home yoga program instruction
– Meditation instruction

Where can I find help?

Our directory of pelvic rehabilitation professionals can help you find a pelvic floor specialist today. Visit www.pelvicrehab.com to find a pelvic health practitioner near you, and get treatment for conditions like Inflammatory Bowel Disease.


1. Crohn’s and Colitis Foundation. 2019. What is Crohn’s Disease. Retrieved from: http://www.crohnscolitisfoundation.org/what-are-crohns-and-colitis/what-is-crohns-disease/

Common Female Pelvic Floor Disorders

There are many conditions that can afflict the pelvis, pelvic floor muscles, and pelvic girdle. The following pelvic floor disorders affect hundreds of millions of women globally. As awareness of pelvic floor dysfunction continues to increase, the ability to find a pelvic rehab therapist becomes more important. This list is not comprehensive, and trained pelvic floor rehab therapists will be able to diagnose and treat conditions not listed here.

Diastasis Recti Abdominis

Female Pelvic Floor AnatomyOften colloquially called “mummy tummy”, “baby belly”, etc, diastasis recti abdominis occurs when the abdominal muscles are separated vertically, along what’s called the linea albia. Clinically you would be diagnosed with diastasis recti if you have more than 2cm of separation while doing a hook lying curl exercise.

Typically diastasis recti abdominis is the result of a growing fetus putting pressure on the abdominal muscles and causing them to separate. Of course, there are other ways that this type of pressure can happen, so we shouldn’t only associate the condition with pregnancy. While the majority of sufferers are postpartum women, DRA can also occur in men. It’s related to aging, weight fluctuations, weight lifting, or other circumstances that result in high pressure within the abdominal wall.

The condition is treatable, and women who experience diastasis recti abdominis can get pelvic rehab by finding a trained pelvic rehab practitioner.

For more, see our post “What’s the Deal with Mommy Tummy?” on The Pelvic Rehab Blog.

Vulvodynia

Vulvodynia is chronic pain in the vulva with an unknown cause. Vulvodynia can be localized to specific locations in the vulva, or it can be generalized pain that impacts the whole vulva and is more constant. Pain in the vulva can be caused by touch (prolonged sitting, tightly-fitted pants, touch, medical exams, etc.), or the pain can occur chronically without a direct stimulus.
The National Vulvodynia Association is an excellent resource for women suffering from this condition, and you can find treatment for vulvodynia on our practitioner directory on www.pelvicrehab.com.

Dyspareunia

Dyspareunia is the experience of pain while engaging in vaginal intercourse, and it occurs in at least 8% of American women by age 40. Some potential causes of vulvar pain can be infectious, inflammatory, neoplastic, neurologic, trauma, iatrogenic, or hormonal deficiencies. Vaginal pain during intercourse can be frequently misdiagnosed, making it important for women who suspect they may have dyspareunia to find a pelvic rehab practitioner who is trained to recognize the condition. More information is available in our post “Why is it hard to get treatment for painful sex?” on The Pelvic Rehab Blog.

Urinary Dysfunction

Female urinary incontinence (the unintentional loss of urine) is very common, and it is often associated with weak pelvic floor muscles. Stress Urinary Incontinence is leakage resulting from any physical activity. Oftentimes women experience leakage when coughing, sneezing, laughing, or participating in more rigorous physical activity like exercising.

Endometriosis

Endometriosis occurs when tissue that should line the inside of the uterus forms on the ovaries, fallopian tubes, and other areas outside of the uterus. Endometriosis can lead to inflammation, scar tissue and adhesion formation and myofascial dysfunction throughout the abdominal and pelvic regions, and it can cause infertility in some cases. It affects up to 15% of women of reproductive age, and the severity of symptoms can vary greatly. Because endometriosis can be difficult to diagnose, it is important to find a pelvic health practitioner who is trained to treat pelvic rehab conditions.

Dysmennorhea

Dysmennorhea is the condition of experiencing pain with menstruation, and it afflicts as much as 50% of reproductive age women. Primary dysmenorrhea is related to menstruation, and often begins within a short period of time once menses occurs, whereas secondary dysmenorrhea is often related to a condition within the reproductive tract such as endometriosis or fibroids. There is strong evidence that pain with menstruation can be diminished with pelvic rehabilitation, making it all the more important that patients are able to find a pelvic rehab clinician near them.

What’s the deal with Mommy Tummy?

A condition called diastasis recti abdominis (“DRA”) afflicts millions of people globally every year. Studies differ on the exact number, but between 50% and 90% of all women who give birth wind up with diastasis recti.

What is diastasis recti?

Often colloquially called “mummy tummy”, “baby belly”, etc, DRA occurs when the abdominal muscles are separated vertically, along what’s called the linea albia. Clinically you would be diagnosed with diastasis recti if you have more than 2cm of separation while doing a hook lying curl exercise.

How does it happen?

Typically diastasis recti abdominis is the result of a growing fetus putting pressure on the abdominal muscles and causing them to separate. Of course, there are other ways that this type of pressure can happen, so we shouldn’t only associate the condition with pregnancy. While the majority of sufferers are postpartum women, DRA can also occur in men. It’s related to aging, weight fluctuations, weight lifting, or other circumstances that result in high pressure within the abdominal wall.

Should I get treatment?

Writing in The Pelvic Rehab Report, Dr. Ginger Garner highlights some of the complications that can come with DRA:

“Besides the obvious cosmetic and general strengthening concerns, why do we care about physical therapy care for a post-partum DRA? Spitznagle’s retrospective chart review of women presenting for gynecological care with a mean age of 52 found that 52% had DRA and 66% of them had a least one support-related pelvic floor muscle dysfunction. Those with DRA were more likely to have pelvic organ prolapse, urinary incontinence and fecal incontinence. Another study by Parker found a DRA prevalence of 74.4% among women with back or pelvic area pain who had delivered at least one child and sought [physical therapy]. They found a significant difference in pain levels in those with DRA and abdominal or pelvic pain compared to those without DRA.”

Where can I get help?

Think you may have diastasis recti abdominis? Want to put together a treatment plan? We know a few folks who can help. Check out the highly trained practitioners listed at www.pelvicrehab.com to find your local expert.

Can’t get to a clinician right away? Here’s an exercise you can try at home to try and improve DRA:

Diastasis Recti Exercise

 

 

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