Pelvic Floor Physical Therapy

Common pelvic floor issues in women include:

• Incontinence – urge, stress, urinary frequency
• Pelvic organ prolapse
• Interstitial cystitis (painful bladder syndrome)
• Pelvic pain
• Pelvic floor weakness and dysfunction
• Coccyx pain
• Dyspareunia (pain with sexual intercourse)
• Pain after abdominal surgery
• Chronic constipation
• Issues related to pregnancy
  • Preparing for childbirth
  • Childbearing conditions
  • Episiotomy scarring and pain
  • Pain after C-section
  • Diastasis recti (separation of the abdominal muscles)

Common pelvic floor issues in men include:

• Incontinence – urge, stress, urinary frequency
• Benign prostate hyperplasia (BPH), or enlarged prostate
• Post-prostatectomy issues
• Pelvic pain
• Coccyx pain
• Pain after abdominal surgery
• Pain after hernia surgery
• Chronic constipation

At Lotus Physical Therapy of Long Island, we will first conduct a comprehensive evaluation of your symptoms and history leading up to your current condition. This includes an analysis of your posture, strength, balance, pelvic alignment, flexibility, range of motion, and assessment of any scars.

Depending on your current symptoms, our physical therapist may need to perform an internal exam to evaluate the strength of your pelvic floor muscles, presence of any trigger points or spasms, scar integrity, and degree of any organ prolapse. We will always obtain your consent prior to performing an internal exam.

After the exam is finished, the findings from your exam will be discussed as well as what your personal plan of care will include. You are likely to have many questions even before your appointment, and it is a good idea to write them down and bring them with you on the day of your evaluation. We will take the time to answer all your questions and help you feel comfortable with your recommended treatment.

All visits with our physical therapist are confidential, private, one-on-one sessions lasting 60 minutes.

Your personalized care plan may include a combination of the following:

• Manual therapy techniques and stretches to reduce tension in pelvic floor muscles
• Modalities for pelvic pain and sexual dysfunction, such as radial extracorporeal shock wave therapy (rESWT)
• Biofeedback to help retrain the pelvic floor muscles
• Exercises to strengthen weakened muscles
• Relaxation techniques
• Home exercise program

Biofeedback is a major component in the treatment of pelvic floor dysfunction. A sensor is placed in the vagina in women and in the rectum in men to measure pelvic muscle contractions and provide feedback to the patient. This feedback helps increase a patient’s awareness of pelvic muscle function and teaches them how to strengthen and relax the pelvic muscles in order to improve bladder function and decrease pelvic pain.

Shock wave therapy is a new and effective treatment for pelvic pain, prostatitis, sexual dysfunction, and many musculoskeletal issues. It delivers low-intensity acoustic pulses to stimulate metabolic activity, which promotes healing and reduces pain. It is a simple, noninvasive therapy that can easily be delivered during an office visit. Currently, this therapy is available only in our Syosset office.

Pelvic floor physical therapy can also help during gender confirmation surgery rehab. Your personalized PT care plan can improve post-op healing, speed your recovery, lessen any pelvic pain, and optimize your urinary, bowel, and sexual functioning after reassignment surgery.

Specialized manual therapy techniques and motor control training can help after transgender surgery. Bowel retraining, bladder retraining, and manual soft tissue work is especially important after surgery in order to restore normal function. Instruction on a dilator protocol, self-stretches, and home management are all important in order to maintain the integrity of the surgery.

Undergoing gender confirmation surgery is a very complicated process, and in order to restore function, the guidance of a pelvic floor physical therapist can help you heal properly.