Cancer Treatments and the Pelvic Floor

Cancer treatments such as surgery, radiation therapy, and chemotherapy can have a significant impact on the pelvic floor muscles, leading to pelvic floor dysfunction.

Surgery for gynecological, colorectal, or urological cancers can damage the nerves and muscles that support the pelvic organs, leading to urinary or fecal incontinence, pelvic pain, and sexual dysfunction.

Radiation therapy can also damage the pelvic floor muscles, leading to scarring and fibrosis, which can cause bowel or bladder dysfunction. Radiation therapy can cause damage to healthy tissues in the area being treated, including the pelvic region. The extent of the damage depends on various factors, such as the type of radiation used, the dose, and the duration of treatment.

Radiation damage to the pelvic region can affect organs such as the bladder, bowel, uterus, and ovaries, as well as the nerves and blood vessels that supply them. This can result in a range of symptoms, including bladder dysfunction, bowel dysfunction, sexual dysfunction, and pelvic pain.

Chemotherapy can also contribute to pelvic floor dysfunction by causing nerve damage, muscle weakness, and fatigue. Chemotherapy can cause damage to healthy tissues in the body, including the pelvic region. The extent of the damage depends on various factors, such as the type of chemotherapy used, the dose, and the duration of treatment.

Chemotherapy can damage the nerves, blood vessels, and muscles that support the pelvic organs, leading to a range of symptoms, including urinary dysfunction, bowel dysfunction, sexual dysfunction, and pelvic pain.

It’s important to maintain good self-care during and after radiation or chemotherapy to help manage symptoms and promote healing. This may include drinking plenty of fluids, eating a healthy diet, getting regular exercise, and avoiding irritants such as caffeine and alcohol.

If you are experiencing symptoms of pelvic floor dysfunction following cancer treatment, it’s important to speak with your healthcare provider. Treatment options may include pelvic floor physical therapy, medication, or surgery.

Pelvic floor physical therapy can be a helpful treatment option for individuals who have experienced pelvic floor dysfunction following cancer treatment, including surgery, radiation therapy, or chemotherapy.

Pelvic floor physical therapy involves working with a specialized physical therapist who is trained to evaluate and treat the pelvic floor muscles. The therapist will assess the strength, tone, and coordination of the pelvic floor muscles and develop a personalized treatment plan based on the individual’s specific needs and symptoms.

Treatment may include exercises to strengthen and relax the pelvic floor muscles, manual therapy to release trigger points and tightness, biofeedback to help individuals learn to control the pelvic floor muscles, and education on bladder and bowel habits and posture.

Pelvic floor physical therapy can be effective in improving symptoms such as urinary or fecal incontinence, pelvic pain, and sexual dysfunction. It can also help individuals regain confidence and improve their quality of life.

It’s important to work closely with your healthcare team to determine if pelvic floor physical therapy is an appropriate treatment option for you. The therapist may work in collaboration with your oncologist, urologist, or other healthcare providers to ensure a comprehensive approach to your care.

Hydration and the Pelvic Floor

There is some evidence to suggest that adequate water intake may play a role in maintaining the health and function of the pelvic floor muscles.

The pelvic floor muscles are a group of muscles that support the bladder, uterus, and rectum. They are important for maintaining urinary and bowel control, as well as sexual function.

Dehydration can lead to a variety of problems, including constipation, which can put strain on the pelvic floor muscles. When the muscles are constantly strained, they may weaken over time and contribute to pelvic floor dysfunction.

Dehydration can also lead to changes in the bladder lining, which may increase the risk of developing urinary tract infections (UTIs) and other bladder problems.

When the body is dehydrated, it produces less urine, which can cause the urine to become more concentrated. This concentrated urine can irritate the bladder lining, leading to inflammation and discomfort. Additionally, when the bladder is not emptied regularly, bacteria can build up and increase the risk of UTIs.

In severe cases of dehydration, the bladder lining may become dry and irritated, leading to bleeding or damage to the bladder wall. This can be a serious medical condition and should be evaluated by a healthcare provider.

To maintain a healthy bladder lining, it’s important to stay well hydrated by drinking plenty of water and other fluids. It’s also important to empty the bladder regularly, especially after intercourse or other activities that may increase the risk of UTIs.

Drinking enough water can help to prevent dehydration and maintain healthy bowel habits, which in turn can help to protect the pelvic floor muscles. However, excessive water intake may also put strain on the bladder and contribute to urinary incontinence.

Adequate hydration is essential for maintaining good health. Water is necessary for many of the body’s functions, including regulating body temperature, transporting nutrients, removing waste, and lubricating joints.

The amount of water a person needs to drink each day can vary based on factors such as age, gender, activity level, and climate. In general, the Institute of Medicine recommends that women drink about 2.7 liters (91 ounces) of water per day and men drink about 3.7 liters (125 ounces) per day.

However, individual needs may differ, and a person’s water intake should also be adjusted based on factors such as exercise level, sweat losses, and urine output.

In addition to water, other fluids such as tea, coffee, and low-sugar fruit juices can also contribute to hydration. However, it’s important to be mindful of the sugar and caffeine content of these beverages and to limit intake accordingly as most of these are bladder irritants.

A bladder irritant is any substance that can cause irritation or inflammation of the bladder. This irritation can lead to symptoms such as increased frequency of urination, urgency, pain or discomfort during urination, and incontinence.

Some common bladder irritants include caffeine, alcohol, spicy foods, carbonated drinks, and artificial sweeteners. These irritants can irritate the bladder, cause discomfort, increase urine production, and increase discomfort.

If you are experiencing symptoms of bladder irritation, it may be helpful to avoid these irritants and drink plenty of water to help flush out the bladder. It is also important to rule out any underlying medical conditions that may be contributing to your symptoms.

It’s important to find a balance that works for you and to discuss any concerns about pelvic floor health with a healthcare provider. Additionally, practicing pelvic floor exercises and maintaining a healthy lifestyle overall can also help to support pelvic floor health. If you have been experiencing any of these symptoms or have any questions about this information, reach out to one of our pelvic floor therapists today!

Pelvic Floor Physical Therapy in the Postpartum Period

Physical therapy can be very helpful for women during the postpartum period to help them recover from the physical changes that occur during pregnancy and childbirth. There are a lot of ways pelvic floor physical therapy can help!

A pelvic floor physical therapist can educate you on pelvic floor exercises. Pregnancy and childbirth can weaken the muscles of the pelvic floor, which can lead to issues like urinary incontinence or pelvic organ prolapse. A physical therapist can teach you exercises to strengthen these muscles while first evaluating the length and coordination of your pelvic floor.

Many women try to start kegel exercises immediately postpartum in order to regain pelvic floor strength, but it’s not always a good idea! Some reasons you may not want to perform kegels include active infection, such as UTI, pelvic pain, being unsure of your technique, and overexertion, or too many kegels. Doing unsupervised pelvic floor strengthening could be making pelvic pain, incontinence, or infection symptoms worse. There are times it may not be appropriate to participate in pelvic floor exercises, and your pelvic floor physical therapist can aid in deciding what is appropriate for you as well as ensure you’re performing any exercise properly.

Pelvic floor therapists can provide diastasis recti treatment. Diastasis recti, or DRA, is a condition where the abdominal muscles separate during pregnancy, and it can make it difficult to regain abdominal strength after childbirth. A physical therapist can guide you through exercises to help close the separation and improve core strength with correct pressure management as the focus!

Some strategies for DRA treatment include core strengthening exercises with your physical therapist helping to guide you in strengthening the muscles of the abdomen to help close the separation and improve overall core strength. They can also educate on postural correction to aid in improved pressure management and decrease abdominal strain. Breathing exercises and education on breathing techniques can also help engage the abdominal muscles and improve their strength and function. Your therapist may also utilize manual therapy techniques such as massage and myofascial release in effort to reduce the tension and improve the flexibility of the abdominal muscles. Education on the proper body mechanics and techniques for lifting and carrying your baby to prevent further strain on the abdominal muscles will also be provided!

Your physical therapist can help in overall pain management. Postpartum pain, including back pain and pelvic pain, can be common. A physical therapist can provide techniques for pain management, such as manual therapy, stretching, and lifestyle modification suggestions.

Pelvic floor conscious exercise prescription will be provided. Exercise can help women regain their strength and energy after childbirth. A physical therapist can provide guidance on safe and effective exercise programs, taking into account factors like the type of delivery and any other health conditions.

It’s important to note that every woman’s recovery in the postpartum state is different, and the course of physical therapy will depend on the type and severity of symptoms she is experiencing. One of our pelvic floor physical therapists can create a personalized treatment plan to help you regain your strength and function after childbirth.

Enhancing Fertility through Manual Pelvic Floor Therapy: Unlocking Reproductive Wellness

Fertility is a profound aspect of reproductive wellness, and for those trying to conceive, it can be an emotional and challenging journey. While there are various approaches to supporting fertility, manual pelvic floor therapy has gained recognition for its potential to enhance reproductive wellness. In this blog post, we will explore the role of manual therapy in improving fertility and optimizing overall well-being.

Understanding the Pelvic Floor and Fertility:

The pelvic floor, a group of muscles, ligaments, and connective tissues at the base of the pelvis, plays a critical role in fertility. These muscles provide support to the reproductive organs, including the uterus, fallopian tubes, and ovaries. They also help regulate blood flow to the pelvic region and contribute to the alignment and mobility of the reproductive organs. A healthy and functional pelvic floor is essential for promoting optimal fertility.

Common Fertility Challenges:

Numerous factors can contribute to fertility challenges in both men and women. Some of the common fertility issues include:

  1. Hormonal Imbalances: Imbalances in hormone levels, such as irregular menstrual cycles or disrupted ovulation, can affect fertility.
  2. Pelvic Pain and Tension: Conditions like endometriosis, PCOS, sacroiliac dysfunction or pelvic floor muscle tension can contribute to pelvic pain and interfere with fertility.
  3. Scar Tissue and Adhesions: Previous surgeries, infections, or pelvic trauma can lead to the formation of scar tissue and adhesions, which may impede the proper function of the reproductive organs.
  4. Lymphatic Congestion: Decongestion of the lymphatic system can help remove waste from the organs and thus help normalize their function.
  5. Stress and Emotional Factors: High levels of stress, anxiety, and emotional factors can negatively impact hormonal balance and fertility.

How Manual Pelvic Floor Therapy Can Support Fertility:

Manual pelvic floor therapy offers a specialized approach to address fertility challenges by focusing on the pelvic floor muscles and related structures. Here’s how manual therapy can support fertility:

  1. Enhancing Blood Flow and Nerve Function: Manual therapy techniques, such as visceral mobilization, myofascial release and trigger point therapy, can improve blood circulation and nerve function in the pelvic region. This increased blood flow can promote the delivery of vital nutrients to the reproductive organs, supporting their optimal function.
  2. Reducing Pelvic Muscle Tension: Manual therapy helps release tension and tightness in the pelvic floor muscles, which can improve overall pelvic stability and alleviate pain. By reducing muscle tension, the therapy can create a more favorable environment for conception and implantation.
  3. Addressing Scar Tissue and Adhesions: Manual therapy can effectively target scar tissue and adhesions that may interfere with the proper function of the reproductive organs. Through gentle manipulation, the therapist can help release restrictions, improve mobility, and enhance the likelihood of successful conception.
  4. Lymphatic Decongestion: Manual Lymphatic Drainage performed by a Certified Lymphedema Therapist can assist in proper drainage of the lymphatic system to ultimately assist in improved reproductive organ function.
  5. Hormonal Balance and Stress Reduction: Manual therapy can have a positive impact on hormone regulation by reducing stress and promoting relaxation. Stress management techniques incorporated into therapy sessions can help balance hormone levels and create a more conducive environment for fertility.
  6. Supportive Self-Care Practices: Physical therapy often involves providing education and guidance on self-care practices that can support fertility. This may include exercises, relaxation techniques, and lifestyle modifications to optimize reproductive health.

Conclusion:

Manual pelvic floor therapy offers a comprehensive and individualized approach to support fertility and reproductive wellness. By targeting the pelvic floor muscles, releasing tension, promoting blood flow, decongesting the lymphatic system, and addressing potential obstacles, this therapy can enhance the chances of successful conception. If you are on a fertility journey and seeking additional support, consider consulting with a qualified pelvic floor therapist who can provide personalized care to optimize your reproductive health. Remember, prioritizing your reproductive wellness can have a positive impact on your overall well-being.

The therapists at Magic City Physical Therapy in Hoover, Alabama, have extensive knowledge in manual therapy skills to support fertility and reproductive wellness.

Kramp, Mary Ellen. “Combined Manual Therapy Techniques for the Treatment of Women With Infertility: A Case Series” Journal of Osteopathic Medicine, vol. 112, no. 10, 2012, pp. 680-684. https://doi.org/10.7556/jaoa.2012.112.10.680

 

PFD and Headaches

Pelvic floor dysfunction (PFD) is a condition that occurs when the muscles, ligaments, and connective tissue in the pelvic region become weak, tight, or otherwise impaired. PFD can cause a wide range of symptoms, including urinary incontinence, bowel dysfunction, and sexual dysfunction. In some cases, PFD may also be associated with headaches.

Research suggests that there may be a link between PFD and certain types of headaches, including tension headaches and migraines. One theory is that the tension and strain in the pelvic floor muscles can cause tension and strain in other muscles throughout the body, including those in the neck, shoulders, and head.

Additionally, PFD can lead to an increase in sympathetic nervous system activity, which can trigger headaches. The sympathetic nervous system is responsible for the “fight or flight” response, and an overactive sympathetic nervous system can lead to increased stress and tension throughout the body.

Treating PFD can help to reduce the frequency and severity of headaches in some individuals. Treatment options may include pelvic floor physical therapy, relaxation techniques, and biofeedback. Additionally, treating any underlying conditions that may be contributing to PFD, such as endometriosis or chronic prostatitis, may also be helpful in reducing headaches associated with PFD.

The treatment for pelvic floor dysfunction (PFD) and associated headaches depends on the underlying cause of the condition. Treatment options may include pelvic floor physical therapy with a focus on relaxation techniques. This would involve exercises and breathwork to relax the pelvic floor muscles with techniques such as deep breathing, stretching, and specific movements. Behavioral modifications can also be beneficial such as sitting for long periods of time or straining during bowel movements or voiding. Simple changes such as standing to take breaks periodically when standing for long periods or getting a stool to elevate feet during bowel movements could help in reducing symptoms.

Working with a pelvic floor physical therapist to determine the most appropriate treatment plan for your situation could greatly improve your symptoms and decrease pain. With proper treatment, many individuals with PFD and associated headaches can experience significant improvement!

During pelvic floor physical therapy, a trained therapist will evaluate the strength, flexibility, and coordination of the pelvic floor and surrounding musculature. From that evaluation the therapist will work with you to determine an individualized treatment plan. That may include pelvic floor exercises to improve length, strength and coordination as well as manual therapy techniques that are hands on manipulation to release tension and trigger points in the muscles. Also as mentioned above, relaxation techniques will be used to reduce stress and tension that may exacerbate symptoms. Techniques such as deep breathing, progressive muscle relaxation, and relaxing body positioning can aid in reaching the overall relaxation needed to reduce tension and pain.

Pelvic floor physical therapy is a non-invasive, low risk treatment option that can be effective for many individuals with PFD and associated headaches. If you’ve been experiencing frequent headaches and feel you have any symptoms of pelvic floor dysfunction, reach out to one of our pelvic floor physical therapists today! Pelvic floor therapy could be a game changer for you!

Hip Mobility Routine

Research shows that people start developing osteoarthritis, or joint wear-and-tear, as early as in their thirties. Arthritis is characterized by achy, stiff joints in the morning and after prolonged inactivity. Our society tends to be more sedentary during the day, and a prolonged sitting position can contribute to muscle shortening and joint stiffness.

Movement may be the last thing you want to do when you have pain, but activity is one of the best things you can do when you do have aches and pains. Most people have heard the saying, “If you don’t use it, you lose it.” Lack of activity promotes weakening of muscles and stiffening of joints, making it harder to move over time. Being able to rotate your hips fully and easily is not only important for many daily activities, including walking, getting dressed,  and putting on shoes and socks, but also for activities like walking, pickleball, and playing with grandchildren.

Try this hip mobility routine to improve flexibility of tight muscles, move the joints in directions they were designed to move, and improve blood flow to the joints to aid in decreased pain. During each stretch, take it to the point of mild to moderate discomfort. Practice deep, diaphragmatic breathing while holding each stretch. Hold each stretch for 30-60 seconds and perform on each side when applicable.

  1. Hamstring Stretch:
    1. Sit on the floor with both legs out straight and toes up towards the ceiling.
    2. Extend your arms and reach forward by bending at the waist as far as possible while keeping your knees straight. Try to keep a straight spine and do not slouch over.
    3. Alternative: Lie on your back and use a belt, towel, sheet, or dog leash looped around your foot and pull a single leg up straight until a moderate stretch is felt.
  2. Lunge hip flexor stretch:
    1. Elevate one foot up on a stair or step. Keep your opposite foot straight with the heel planted on the ground.
    2. Translate your weight forward until you feel a stretch in the front of your hip on the back leg, your glutes on the forward leg, and your calf muscles on the back leg. Step your back foot back further if you desire a deeper stretch.
    3. Keep your pelvis neutral by not arching your low back. Hold onto stair rails if needed for balance.
  3. Glute Stretch:
    1. Lie on your back. Bend your right knee knee back. Place your lateral ankle of the left leg on the right thigh. Your left knee should be bent and pointing out to the side.
    2. Place your hands behind your right thigh and bring this knee up to your chest until you feel a good stretch in the left glute.
    3. Repeat on opposite side.
    4. Alternative: Sit upright with good posture. Bend one knee, rotate it outwards, and place outer ankle on opposite thigh. Bend forward at the waist for a good posterior hip stretch.
  4. Frog Pose:
    1. Get on hands and knees. Spread knees out as wide as you can, feeling a moderate stretch. Your toes should be pointing outward.
    2. Rock your weight backwards until you feel a deeper stretch in your groin muscles and glute muscles.
    3. Place a rolled towel or blanket under your knees for comfort if needed.
  5. Side Sitting:
    1. Sit on the floor and bend one leg in front of your body with your knee pointing outwards. Position it so your lateral lower leg and knee are resting on the ground. Your leg should form a 90-degree angle.
    2. Position your other leg beside you with your hip rotated inward and your medial knee and ankle on the ground. Bend your knee so your leg forms a 90-degree angle. Your back knee should be in line with your hip, and your ankle should be neutral.
    3. Try to keep your back straight and resist the urge to bend to one side. Think about sitting into both hips equally.
    4. Bring back leg (internally rotated hip) forward for a less intense stretch.

If you are experiencing intense pain with these movements, or the pain and stiffness does not subside with these movements, I would encourage you to seek out further advice from a Physical Therapist. Physical Therapists can further assess the hips and surrounding joints and provide an individualized program for you. Physical Therapists can also perform hands-on techniques to improve joint mobility and decrease soft tissue restrictions, making these mobility exercises less difficult. Conservative care is always best!

Jennifer Self Spencer, PT, DPT, CLT, OCS, is the owner of Magic City Physical Therapy in Birmingham, Alabama. She is Board Certified in Orthopedics, a Certified Lymphedema Therapists, Certified Dry Needling Practitioner, and has advanced training in treatment of Pelvic Floor Dysfunction in women and men. You can find her on Instagram @magiccitypt.