Explore common diagnoses that we see and treat with pelvic floor physical therapy for women through all stages of life in Charleston.
Women's Pelvic Health
Women’s Pelvic Health Conditions We Specialize In:
Bladder Dysfunctions:
Bladder dysfunction is not only leaks! See what we can help you with when it comes to bladder health and function:
- Incontinence: leaks of urine you cannot control, may be drips or significant
- Urge incontinence: these leaks are specific to sudden urges that result in leaks before you can get to the toilet
- Stress incontinence: these leaks occur with movement, exercise, exertion, cough/laugh/sneeze.
- Overactive Bladder (OAB): very disruptive urges to urinate, more than 6 times per day, usually without leaks
- Nocturia: waking with the urge to urinate, more than 1 time per night
- Interstitial Cystitis (Bladder Pain Syndrome): a chronic condition, though usually presents with a persistent pain in the lower abdomen that may or may not be relieved with urinating
- Frequent "UTIs": feels like a UTI but cultures are negative, may experience urgency or burning with urination
Bowel Dysfunctions:
Bowel dysfunction is not only constipation! But constipation can cause many symptoms, such as:
- Painful bowel movements, with or without chronic hemorrhoids and/or fissures
- Significant straining to empty, defined as greater than 10 minutes
- Urges to defecate but unable to go
- Infrequent or unpredictable bowel movements
We also help with the following when it comes to bowel health and function:
- Chronic diarrhea
- Abdominal pain
- Rectal pain
- Fecal incontinence: leaks of stool that may appear to be stains, or may leak large amounts
- Gas incontinence: leaks of gas beyond control
- Chronic conditions such as IBS, Crohn's, UC that would like help managing pain
Pelvic Organ Prolapse:
You may have a diagnosis of prolapse, or feel like you have one and would like an assessment. Prolapse symptoms are commonly:
- Feeling heaviness in the vagina
- Feeling or seeing a bulge of tissue around or out of the vagina
- Incomplete emptying of the bladder or stream changes
- Incomplete emptying of bowels
Symptoms may fluctuate and commonly are worse after bowel movements, after lifting, or at the end of the day.
Our assessments for prolapase the following look at:
- Degree of tissue movement with functional activities like bearing down, coughing, standing, squatting and lifting
- Tissue quality and health
- Levator ani (pelvic floor) tone and ability to support
- Risk of developing/worsening prolapse based upon pelvic floor support
- Muscle/nerve tension that may be contributing to symptoms
- Nervous system regulation
In cases where women would like to avoid or delay surgery but the pelvic floor is struggling to provide adequate support alone, we can fit for a pessary.
A pessary is either a ring or a cube shaped device to help support the vaginal walls with a goal of allowing the pelvic floor to provide support. When tissue has migrated below the level of muscle support, the muscles cannot lift or contract well. This can be frustrating if you are trying to strengthen, but the prolapse is in the way! A pessary can be extremely helpful for many women when it is fitted correctly. It should never be uncomfortable to wear and the goal should be to eventually not need it.
You are not alone if you are experiencing any of the following. We have a gentle approach when we address internal exams/treatments, especially for:
- Dysparuenia (painful sex): this can be pain with insertion, deeper pain, pain in only certain positions or pain after intercourse. It may also be a combo of all above.
- Vulvodynia: pain at the vulva, which includes the labia, vaginal opening and the clitoris.
- Provoked vulvodynia: pain only occurs when the vulva is touched (can be manual touch or with clothing, etc.)
- Unprovoked vulvodynia: pain at the vulva without touch, can be constant or persistent
- Clitorodynia: pain, burning or discomfort at the clitoris
- Vaginismus: pain/muscle guarding that prevents any insertion into the vagina; this can affect intimacy, but also the ability to wear tampons, receive pap smears, GYN exams and/or vaginal ultrasounds.
- Dysorgasmia: sharp, burning or deep cramping pain during or after orgasm
- Anorgasmia: inability to orgasm despite stimulation/arousal
- Persistent Genital Arousal Disorder (PGAD): pain, aching or pressure in the pelvis that is not resolved with orgasm; it is persistent and uncomfortable and not triggered by arousal/intimacy - triggers are usually spontaneous and non-sexual.
Sexual Dysfunctions:
Aches & Pains:
Orthopedic pain that commonly has a pelvic floor muscle/nerve involvement:
- Hip pain
- Lower back pain
- "SI" Joint Pain
- "Sciatica"
Especially if there is bladder dysfunction, bowel dysfunction, sexual dysfunction along with any of the above pains - it is likely a pelvic floor problem.
Tailbone Pain:
Tailbone pain needs it's own category, because it absolutely has pelvic floor muscle/nerve involvement. Also called the coccyx, it attaches directly to the pelvic floor. It also attaches to the coccygeus muscle, the glute max (butt) muscle, the external anal sphincter, five sacral ligaments, and two major pelvic ligaments called the sacrotuberous and sacrospinous ligaments.
We assess and treat the coccyx internally and externally, through specific movement patterns, and through all surrounding tissues and nerves.
We assess and treat the coccyx internally and externally, through specific movement patterns, and through all surrounding tissues and nerves.
Chronic Pain Conditions:
Our goal with addressing the following is not to treat the condition, but to treat the resulting painful and guarded muscles and nerves affecting movement and everyday function to improve management of chronic pain and living your life.
- Endometriosis: hallmarked by painful periods, bowel dysfunction, bladder dysfunction, dyspareunia, and pelvic pain - you do not have to have every symptom. We help with symptom and pain management, as well as collaboration with medical team
- Pudendal Neuralgia: can cause significant genital pain at the clitoris, vagina, perineum, and anus - pain is usually worse with sitting and is described as sharp and shooting
- Interstitial Cystitis: pain that occurs in the lower abdomen with or without radiating pain that gets worse as the bladder fills, leads to frequency and urgency and does not always resolve with emptying the bladder
- Persistent Genital Arousal Disorder: aching, throbbing, uncomfortable pain in the pelvis that is not associated with intimacy/sexual stimulation
- Pelvic Venous Disorder (Pelvic Congestion Syndrome): a dull ache/heaviness in the pelvis caused by genital varicose veins, can affect the bladder, sexual function and functional activities like standing prolonged
- Polyendocrine Metabolic Ovarian Syndrome: previously named PCOS; if pain is present, there may be underlying pelvic floor dysfunction associated with painful ovulation, painful periods or ovarian cysts.
- Lichens Sclerosis: inflammatory skin condition that can cause adhesions and pain affecting urination, bowel movements and sexual function.
A hysterectomy is the most common surgery among women in the US - with no prep or post-op rehab. A few things determine how we help:
Our goals with pre-rehab are education, resolving any current pelvic floor muscle tension or pain, resolving any constipation, and providing tools/garments for recovery.
Our goals with post-operative rehab are improving scar tissue, ensuring return to exercise without pain or concern, returning to intimacy without pain or concern, ensuring no bladder or bowel dysfunction development and providing support through a physically and mentally challenging time.
- Type of hysterectomy (partial or full)
- Surgical approach
- Reason for hysterectomy
- Age
- Menstrual history
The reason these matter is because our approach will be different for the woman receiving a hysterectomy for pain or for preventive reasons, such as cancer.
Our goals with pre-rehab are education, resolving any current pelvic floor muscle tension or pain, resolving any constipation, and providing tools/garments for recovery.
Our goals with post-operative rehab are improving scar tissue, ensuring return to exercise without pain or concern, returning to intimacy without pain or concern, ensuring no bladder or bowel dysfunction development and providing support through a physically and mentally challenging time.
Hysterectomy Prep & Post Op:
You don't have to know exactly what's wrong. We're here to listen, uncover the cause, and help you find the right path forward.
