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Pelvic Floor Awareness

The pelvic floor muscles are such an important part of our body for both men and women! Don’t forget about them!

If you don’t know much about them feel free to look us or give us a call to learn more 864-534-1780!

We would love to help you discover the world of pelvic floor wellness!

Make 2017 a Great Year Start by Thinking About Having Good Pelvic Floor Health

Having strong pelvic floor muscles gives us control over the bladder and bowel. Weakened pelvic floor muscles mean the internal organs are not fully supported and you may have difficulty controlling the release of urine, feces (poo) or flatus (wind).

Common causes of a weakened pelvic floor include childbirth, obesity and the associated straining of chronic constipation. Pelvic floor exercises are designed to improve muscle tone and prevent the need for corrective surgery.

What are pelvic floor muscles?

Pelvic floor muscles are the layer of muscles that support the pelvic organs and span the bottom of the pelvis. The pelvic organs are the bladder and bowel in men, and bladder, bowel and uterus in women. The diagram below shows the pelvic organs and pelvic floor muscles in women (right) and men (left).

The pelvic floor muscles stretch like a muscular trampoline from the tailbone (coccyx) to the pubic bone (front to back) and from one sitting bone to the other sitting bone (side to side). These muscles are normally firm and thick.

Imagine the pelvic floor muscles as a round mini-trampoline made of firm muscle. Just like a trampoline, the pelvic floor is able to move down and up. The bladder, uterus (for women) and bowel lie on the pelvic floor muscle layer.

The pelvic floor muscle layer has hole for passages to pass through.There are two passages in men (the urethra and anus) and three passages in women (the urethra, vagina and anus). The pelvic floor muscles normally wrap quite firmly around these holes to help keep the passages shut. There is also an extra circular muscle around the anus (the anal sphincter) and around the urethra (the urethral sphincter).

Although the pelvic floor is hidden from view, it can be consciously controlled and therefore trained, much like our arm, leg or abdominal muscles.

What do pelvic floor muscles do?

Pelvic floor muscles provide support to the organs that lie on it. The sphincters give us conscious control over the bladder and bowel so that we can control the release of urine, feces (poo) and flatus (wind) and allow us to delay emptying until it is convenient. When the pelvic floor muscles are contracted, the internal organs are lifted and the sphincters tighten the openings of the vagina, anus and urethra. Relaxing the pelvic floor allows passage of urine and feces.

Pelvic floor muscles are also important for sexual function in both men and women. In men, it is important for erectile function and ejaculation. In women, voluntary contractions (squeezing) of the pelvic floor contribute to sexual sensation and arousal.

The pelvic floor muscles in women also provide support for the baby during pregnancy and assist in the birthing process.

The muscles of the pelvic floor work with the abdominal and back muscles to stabilize and support the spine.

What can make these muscles loose?
Pregnancy and childbirth for women
Straining on the toilet
Chronic coughing
Heavy lifting
High impact exercise

Please call us at His Therapy to get more information and schedule your first session! It is an important part of your body that you need to learn how to control and work! We look forward to being able to serve you this coming new year! 864-534-1780

Constipation is Important to Deal with in Order to Obtain Good Pelvic Floor Health

Suffering from constipation?

There are many causes including posture and pelvic floor dysfunction. Within a couple of treatments with our pelvic floor specialist, you can learn proper posture and how to relax your pelvic floor to have healthy bowel movements without straining. We also focuses on diet and brings awareness to certain foods that cause constipation and bladder irritation. Call us today for more information!

Why Would You Need to Have Pelvic Floor Therapy

Have you ever wondered if pelvic floor therapy is for you? Here are a couple questions you can ask yourself to determine whether you could benefit from seeing our specialist.

1) Do you leak urine when you cough or sneeze?
2) Do you strain with bowel movements and often find yourself constipated?
3) Do you wake up during the night to use the bathroom?
4) Do you have pain during sexual intercourse?

If you answered “yes” to any of these, pelvic floor therapy IS for you! With as little as 2-3 sessions, you will see improvements in your pelvic floor which will improve your confidence and help you live the happy and healthy life we all desire!

Call  today for  more information: 864-534-1780

Pelvic Floor Therapy an Answer to Prayer!

Imagine dreaming of taking the gospel to all the nations. Imagine life being busy and the dream being put on hold. Finally, you get the opportunity and call to go and minister in another nation. The excitement is palpable and you are sure this is God’s time for you, but then you experience lower back pain while sitting. Pain so intense and excruciating that your heart breaks as you realize you will not be able to even make it through the long flight. Your heartbroken as you say “NO”.
For one of our patients this was a reality until a couple weeks ago. After only two physical therapy sessions this patient reports feeling 75% better already! We are blessed to be able to turn this patient’s “NO” into “Yes”! Our prayers will be with you as you minister to the nations.
Matthew 28:18-20 King James Version (KJV)
18 And Jesus came and spoke unto them, saying, All power is given unto me in heaven and in earth.
19 Go ye therefore, and teach all nations, baptizing them in the name of the Father, and of the Son, and of the Holy Ghost:
20 Teaching them to observe all things whatsoever I have commanded you: and, lo, I am with you always, even unto the end of the world. Amen.

Physical Therapy Can Help Men Before and After Prostate Cancer Surgery by Sabina K. Weaver, MSPT

What it is:
Prostate cancer is a cancer or uncontrollable growing of cells in the prostate gland, while Prostatitis is inflammation of the prostate gland. The prostate gland is a walnut-sized gland present only in men, found in the pelvis below the bladder. One in seven men will be diagnosed with prostate cancer in his life. Prostate cancer is one of the most common types of cancer that develops in men and is the third leading cause of cancer deaths in American men. Since prostate specific antigen (PSA) screening for prostate cancer became widely used, men are being diagnosed younger and with more limited spread of disease. Last month, the USPSTF upgraded its recommendation for screening men ages 55-69. The task force previously recommended that men not be screened for prostate cancer using (PSA) tests.  Now the recommendation is that men ages 55-69 discuss their risk factors with their doctor and decide if PSA testing would be beneficial on an individual basis. African American men and men with a family history of prostate cancer are at higher risk for prostate cancer and may need closer monitoring. The USPSTF still does not recommend PSA screening for men over the age of 70 because they feel the possible harm outweighs the benefits. One in seven men will be diagnosed with prostate cancer in his lifetime. Will this number be affected by the recent change in the U.S. Preventive Services Task Force’s change in recommendations on screening for prostate cancer? What happens when a man has his prostate removed? Is it possible to predict, prevent, or repair urinary incontinence and erectile dysfunction?
Signs and symptoms after surgery:
Urinary Control  
One year after surgery, 89-100% of men who had robot assisted laparoscopic prostatectomy are using 0-1 pads for incontinence.   Of men who had open radical retropubic prostatectomy, 80-97% are using 0-1 pads for incontinence. Risk for incontinence increases when the man is over 70 years old or has detrusor overactivity (overactive bladder) before surgery and if the surgeon uses certain surgical techniques or does not have a lot of experience. The prostate surrounds the urethra and supports it to help control urination. After prostatectomy, the pelvic floor muscles have to work overtime to make up for the loss of support. If they are not up for the challenge, urine can leak. Coughing, laughing, sneezing, jumping, or getting up from a chair can be especially challenging for the muscles to control. If leaks only occur during these activities, it is called stress urinary incontinence. Pelvic floor PT before and after surgery can help train the pelvic floor muscles to reduce incontinence. ³ The body is asking the muscles to do something they have never had to do before, so average muscles need conditioning to bulk them up (think bodybuilder’s bulky muscles) and support the urethra.  Strength, endurance, and coordination training for the pelvic floor help prevent leaks. MRI images comparing pelvic muscles before and after recovering from incontinence showed that pelvic muscles were thicker and the bladder neck was moved higher and forward after they regained continence. ³

The prostate, along with the testicles and seminal vesicles, create secretions for ejaculation. After prostatectomy, the prostate and seminal vesicles are not there to create fluid, so these men have dry orgasms.  
Pelvic Floor PT:
Additionally, about 50% of the men who have prostate cancer have some kind of pelvic muscle dysfunction or weakness. Men’s pelvic floor muscles are shaped like a hammock that attach to the front, side, and back of the pelvic bone and sacrum. These muscles that support the bladder, prostate, and rectum can become weak or subject to spasm due to surgery, trauma, or disease. Pelvic floor rehabilitation offers an alternative treatment for prostatitis/chronic pelvic pain syndrome. Physical Therapists can work with men who are experiencing pain in their pelvic region, penis, or testicles. Pelvic floor rehabilitation for prostatitis or post-prostatectomy can be useful for men that are also experiencing urinary urgency and frequency, urinary incontinence and erectile dysfunction.
What we do/interventions:
Physical Therapy and pelvic floor rehabilitation for post-prostatectomy and prostatitis can have a big impact and target different areas depending on the problem. To better evaluate a patient and figure out a specific plan, most therapists will perform a manual pelvic floor exam and a biofeedback testing using surface EMG pads which helps men learn how to properly contract and lift their pelvic floor. Included is a good exam of hip and lower back and core flexibility and strength assessment. These assessments can tell a therapist about the patient’s pelvic floor muscle dysfunction and recommend specific treatment to fit that patient’s needs. Treatments may vary from patients to patient, but some may include biofeedback, myofascial release, trigger point release therapy, postural exercises, manual therapy, relaxation exercises, stress management techniques, and cognitive behavioral therapy for bladder and bowel training.  Different treatments target different areas such as muscle tension, muscle strengthening, pain, inflammation, and blood flow.
Case report
Eli was a 69 yo male who came to pelvic floor PT three months after radical laparoscopic prostatectomy with urinary incontinence and erectile dysfunction. He presented with moderate pelvic floor strength and endurance, and was not sexually active. Surgery led to lack of urethral support and control, weakness in the abdominal wall, and nerve injury resulting in urinary incontinence and erectile dysfunction. His goals were to decrease the amount of urine leaking and possibly regain an erection. We taught him various exercises for his pelvic floor and proper core stabilization exercises to make them perfectly strong and bulky enough to support the urethra, which helped decrease his incontinence. We also did training on bladder and gut health and reviewed his bladder diary and taught him proper dietary concerns which helped his bladder retrain to gain more bladder control. We also helped him with correcting his posture and teaching proper body mechanics which helped him to do simple activities such as sit to stand without leakage and sneeze cough or lift without leakage.  He later joined a prostate support group.  
After beginning physical therapy and with about 4 visits he was only using one Depends per day, which was not very wet, instead of three completely soaked Depends. His strength and endurance were perfect. He ranked his improvement as eight out of ten. He had a satisfying sex life even though his erection did not come back. After about 6 sessions, he was able to do ADLS and enjoy other activities without the use of the pad and was very happy with his outcomes.
Prostate cancer affects the body and mind in different ways.  Physical therapy is useful after prostatectomy to improve urinary continence and erectile dysfunction. If you have been through treatment for prostate cancer and have urinary incontinence and/or erectile dysfunction, find a pelvic floor physical therapist who is comfortable and trained with working with this population. Not all pelvic floor PT’s are trained to work with men.

Clavell-Hernandez J and Wang R. The controversy surrounding penile rehabilitation after radical prostatectomy. Transl Androl Urol 2017;6(1):2-11.doi: 10.21037/tau.2016.08.14.
Mangir N and Turkeri L. Stem cell therapies in post-prostatectomy erectile dysfunction: a critical review.Can J Urol 2017;24(1):8609-8619.
Pacik D and Fedorko M. Literature review of factors affecting continence after radical prostatectomy. Saudi Med J 2-17;38(1):9-17. Doi: 10.15537/smj.2017.1.15293.
Santos NA et al. Assessment of physical therapy strategies for recovery of urinary continence after prostatectomy. Asain Pac J Cancer Prev 2017;18(1):81-86. doi:10.22034/APJCP.2017.18.1.81
Glickman C and Emirzian A. The Ultimate Guide to Prostate Pleasure. Berkeley:Cleis Press, 2013.
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Pelvic Floor Therapy for Pregnancy

Pregnancy is a beautiful things, but it can be hard on any woman’s body. It can cause: 
hormonal changes
physical changes
postural changes
musculature changes
This stress from a baby on your bladder and rectum can also lead to pelvic floor dysfunctions such as: 
stress or urge incontinence
back pain 
bowel problems 

In the busy days ahead, remember to take care of yourself and your pelvic floor. Come see His Therapy for any pelvic floor dysfunction or question you have today! We will get you a specialized plan that best fits you.