Pelvic floor dysfunction

• Underactive pelvic floor muscle – weakness, incontinence, prolapse, male and female

  • Specific PFM strengthening with and without biofeedback (EMG, pressure)

  • Proper abdominal muscle contraction, lifting

  • Bladder, bowel training

  • Electrical stimulation

• Overactive pelvic floor muscle – spasm & pain (levator ani, vaginismus, vulvodynia, dyspareunia)

  • Complete evaluation of primary & secondary musculoskeletal pelvic dysfunction

  • Treatment of joint dysfunction – lumbar, SI, pubic, coccyx, hip

  • Exercise for pelvic muscles to stretch and strengthen

  • Manual techniques to scars and tight tissues – pelvis, vagina, rectum – internal and external

  • Vaginal dilators

  • Pain reducing modalities – TENS, HP, CP, US

  • Education on self management

• Incoordination – Obstructed defecation, urinary retention

  • Similar to supportive dysfunction

  • Biofeedback – EMG

  • Visceral dysfunction – Endometriosis, interstitial cystitis, abdominal adhesions

  • Pain reducing modalities

  • Exercise to increase functional activity level
     

Swelling management and lymphedema

• Manual lymphatic drainage

• Multilayer compression bandages

• Pneumatic, gradient, sequential pump

• Measurement and fitting of compression garments

• Patient education on self care

• Orthopedic, peripheral vascular, wounds and lymphedema
   

Obstetrical physical therapy

• Prenatal and postpartum musculoskeletal pain (sciatica, low back, pubic symphysis, neck, wrist – carpal tunnel syndrome)

  • Therapeutic exercise to stretch tight muscles

  • Manual stretching of specific muscle spasms

  • Joint mobilization

  • Heat packs

  • Education on body mechanics, posture and self care

  • Support binders and straps
     

• High risk OB

  • Pain treatment as above

  • Establish maintenance exercise program