Pelvic floor

Pelvic Floor Dysfunction

The pelvic floor is made up of the muscles, ligaments, and tissues that sit within the pelvis between the tailbone and the pubic bone. In women these muscles support the bladder, bowel, uterus and vagina. In men these muscles support the prostate, bladder and bowel. Pelvic floor disorders are common and many people experience symptoms that they may not have discussed with their health care providers or have not been offered effective solutions. Some are embarrassed to discuss these issues or believe that they are simply part of the aging process and need to be tolerated. However, suffering with pelvic floor dysfunction is not necessary and we know these issues can be evaluated and effectively treated. Kate specializes in gender inclusive treatment of the pelvic floor.

Symptoms of pelvic floor disorders can include:

  • Pain in the pelvis, perineum, genitals, pubic, or bladder regions

  • Pain with urination/defecation

  • Pain with intercourse

  • Urinary or fecal incontinence 

  • Urinary incontinence with impact/stress such as jumping, running, coughing, sneezing

  • Excess urinary urgency or frequency

  • Feeling of pressure, heaviness or sensation of the pelvic organs falling out

  • Low back, hip, buttocks, sacral or groin pain

  • Constipation or straining with defecation

  • Numbness or tingling in the pelvic region or legs

  • Coccyx (tailbone) Pain

Pelvic floor physical therapy has been found to be an effective treatment for pelvic floor dysfunction

Causes or contributory factors for pelvic floor dysfunction can include trauma, injuries, pregnancy and childbirth, surgeries, obesity, hormonal changes, age related changes, nerve involvement, diet and nutritional issues, incorrect bathroom techniques, bio-mechanical asymmetries, muscular imbalance, nerve irritation, and medical conditions such as endometriosis or following cancer treatment. Symptoms can arise gradually or suddenly and at times there is no specific cause.

Common diagnoses for Pelvic floor Dysfunction

  • Incontinence

  • Pelvic organ prolapse

  • Overactive bladder 

  • Interstitial cystitis/painful bladder syndrome

  • Vulvodynia

  • Vaginismus

  • Vestibulitis

  • Dyspareunia (pain with intercourse)

  • Pudental neuralgia

  • Chronic Prostatitis

  • Coccydynia

Kate brings an integrative and holistic approach to treatment of the pelvic floor

Kate Nickerson is a trained pelvic floor physical therapist and will provide individualized treatment for each patient based on a comprehensive history and physical evaluation. This may include assessment of posture, alignment, breathing, joint mobility, range of motion, flexibility, strength, soft tissue tone and any neurological symptoms. Examination of the pelvic floor can be performed depending on symptoms, patient comfort and consent. This can help to assess the soft tissue tension/tone, nerve and soft tissue irritation, check for pelvic organ prolapse, and to determine strength, coordination and endurance of the pelvic floor muscles.

Kate provides treatment of pelvic floor dysfunction with an integrative, compassionate and gentle approach. This can include education about causes and behavioral, dietary, and lifestyle modifications. Manual therapy may include fascial and nerve releases, soft tissue mobilization, myofascial release, manual stretching, massage, contract/relax, ASTYM, and joint mobilization. Manual therapy may be performed for the muscles of the pelvic floor if needed as well as for surrounding involved muscles, nerves, and fascia including those of the hips, legs, back, trunk, and abdomen.

Retraining of posture, body mechanics, breathing patterns, and alignment helps with managing symptoms and improve function with daily activities. Integrative exercises can be utilized for addressing underlying muscular imbalances and may include release work, stretching, breath work, alignment activity, body rolling, strengthening, yoga and pilates. Mindfulness based training can be helpful for addressing nervous system imbalance. Biofeedback can be utilized which is a method of assessing muscle activity using external sensors with feedback provided on a computer screen.

Individuals with excess tension in the pelvic floor and surrounding muscles can be instructed in techniques to down train the nervous system, release restrictions, and decrease over activity and tightness. Those with pelvic floor weakness can be taught how to strengthen and utilize the pelvic floor muscles, core and other muscles correctly during function and exercise. Some issues require a combination of release work and strengthening. Education in correct breathing techniques and intra-abdominal pressure management is often an integral part of treatment to restore optimal comfort and function.

Kate will coordinate treatment with current primary and alternative health care providers to ensure that patients get the highest level of treatment with a multi disciplinary care team. The goal is to allow each patient to return to living a full life and doing the activities that they love.