Conditions We Treat

Bladder Dysfunction

Interstitial Cystitis (IC), also known as Painful Bladder Syndrome (PBS) –   Suprapubic/abdominal pain that may occur with urge to urinate or after urination. Often associated with urinary urgency, frequency, nocturia, and/or incomplete emptying of the bladder.

Prostatitis – nonbacterial inflammation of the prostate associated with pelvic pain and voiding symptoms. Often associated with urinary urgency, frequency, nocturia, and/or incomplete emptying of the bladder. 

Urinary frequency – urinating more than 8 times during waking hours. 

Urinary urgency – urination with urgency. 

Nocturia – nighttime urination greater than 1 time per night.

Incontinence – leakage of urine due to muscle weakness or tightness. Can be related to a strong urge to urinate (urge incontinence) or with an increase in abdominal pressure such as coughing or running (stress incontinence), or may be a combination of both urge and stress incontinence (mixed incontinence).

Urinary retention – Difficulty emptying the bladder when urinating or a feeling that you don’t empty your bladder. May be caused by pelvic floor dysfunction, typically due to tightness or incoordination of pelvic floor muscles.

Bowel Dysfunction

Constipation – Difficulty having a bowel movement, which may be worsened or caused by tight pelvic floor muscles and impaired coordination of pelvic floor and abdominal muscles.

Incomplete emptying – Feeling of incomplete emptying after having a bowel movement, may result in straining and/or multiple attempts to have a bowel movement throughout the day. May be due to tightness, weakness, and/or poor coordination of pelvic floor muscles.

Bowel frequency/urgency – May be related to constipation, diarrhea, irritable bowel syndrome or incomplete emptying.

Bowel Pain – Pain with bowel movements or after having a bowel movement.

Incontinence – Leakage of stool from the rectum, with or without urgency or awareness. 

Irritable bowel syndrome (IBS) – A condition characterized by abdominal pain, bloating, and constipation or diarrhea.

Sexual Dysfunction

Painful intercourse (dyspareunia) – Pain during or after sexual activity due to nonrelaxing, uncoordinated, and/or tight pelvic floor muscles. Pain may be at initial or deep penetration and may be associated with muscle spasms or involuntary contraction of pelvic floor muscles.

Pain with ejaculation – May be a result of weak and/or nonrelaxing pelvic floor muscles.

Vaginismus – Involuntary spasm of pelvic floor muscles that does not allow/limits penetration.

Persistent Genital Arousal Disorder (PGAD) – Uncontrollable sensation of unwanted sexual arousal without sexual desire. 

Premature Ejaculation – When a man ejaculates earlier during intercourse than he or his partner would like.

Erectile Dysfunction – Difficulty achieving and maintaining an erection that sustains sexual intercourse. 

Pain with or after orgasm – Pain associated with achieving an orgasm or pain that remains after orgasm.

Pelvic Pain

Pudendal neuralgia – The pudendal nerve provides both sensory and motor innervation to structures in and around the pelvic floor. It provides motor control of the external anal sphincter, sphincters of the bladder, and pelvic floor muscles. When the pudendal nerve is injured, a variety of sensory and motor changes may occur in any of the structures that the pudendal nerve innervates. This may result in pelvic pain with sitting, bladder or bowel symptoms, and/or painful sex.

Levator ani syndrome – Tightness, spasms and tension in the levator ani muscles (deep muscles of the pelvic floor) may cause pain in the sacrum, coccyx, rectum, and/or vagina. Pain may worsen with certain activities and may radiate into the abdomen, groin, hip, buttocks or legs. Often associated with bowel, bladder, or sexual dysfunction.

Endometriosis – A condition where tissue similar to tissue found lining the uterus (endometrium) is found outside the uterus. This results in cyclical pelvic pain related to the menstrual cycle. Symptoms depend on where the endometrium tissue is located and may result in pain during sex, urination, and bowel movements. 

Coccydynia – Coccyx (tailbone) pain can occur in a variety of ways, including after a fall directly on the tailbone, during the process of childbirth, or due to athletic injury. Pain is usually present with sitting or when coming to a standing position after sitting for a period of time.

Pelvic girdle pain – Pain anywhere in the pelvic girdle. This may include joint and/or muscle pain. Includes pain in sacroiliac (SI) and pubic symphysis joints.

Vulvodynia – Burning, irritation, and discomfort of the vulva that may interfere with wearing of tight clothing, sitting, and/or sexual intercourse.

Hip pain – Unexplained pain in the hip joint can often indicate pelvic floor issues.

Lower back pain – Unexplained pain in the lower back may indicate pelvic floor issues.

Postsurgical Recovery

Hernia – Rehabilitation post inguinal hernia, sports hernia, femoral hernia, epigastric hernia or umbilical hernia is focused on the goal of reducing recurrence rate and returning to prior level of function.

Hysterectomy – Rehabilitation after a hysterectomy is focused on returning to prior level of function with reducing the risk of pelvic floor strain and pelvic organ prolapse. Also addressed is scar mobility and general conditioning and recovering abdominal and pelvic floor strength.

C-section – C-section recovery can be hampered by a painful and/or immobile scar and rehabilitation focuses on abdominal muscle function as well as postpartum recovery that may also include pelvic floor rehabilitation.

Prostatectomy – The removal of the prostate usually due to a diagnosis of prostate cancer can result in urinary and sexual dysfunction that can be greatly improved with pelvic floor physical therapy.

Prolapse

Pelvic Organ prolapse When the organs of the pelvis (bladder, uterus, and/or rectum) descend into the walls of the vagina as a result of weakened muscle and connective tissue structures in the pelvic floor. This may result in feelings of heaviness or fullness in the vagina, and can also be associated with bowel and/or bladder dysfunction. Causes include pregnancy and childbirth, straining, genetic predisposition, and/or hormonal changes in menopause.

Rectal prolapse – When your rectum or part of your intestine comes out through your anus. Causes include straining and chronic constipation.

Prenatal & Postnatal Conditions

Pregnancy-related pelvic girdle pain, also known as pubic symphysis dysfunction or sacroiliac joint dysfunction – Any pain that begins in pregnancy or postpartum that occurs from the lower back to the buttocks and hips.  

Postnatal rehabilitation – General rehabilitation of the postpartum body, whether it is 6 weeks after the first delivery (vaginal or C-Section) or many years past the last. Every postpartum body could benefit from a course of rehabilitation. 

Diastasis recti – A separation of the muscles in the abdomen that results in a feeling of weakness, a hernia, and/or limited functional mobility.

Painful scars – Whether from Cesarean-section, episiotomy, perineal tear, or surgical incision, all scars should be able to glide over muscle and fascia without restriction or pain and to be touched without sensitivity.