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Diane Lee, PT, Clinical specialist, BSR, FCAMPT, CGIMS, RYT200

For many years, I felt that ‘women’s health conditions’ such as incontinence, pelvic pain (related to the vagina and vulvar regions) and pelvic organ prolapse required different therapy than women with postpartum pelvic girdle pain (Sacroiliac joint dysfunction, pubic symphysis, piriformis, etc.).

However, patients tell a different story.  Over time, it becomes apparent to all clinicians (both pelvic floor therapists and orthopaedic manual therapists) that conditions are linked or related.

My message now in all my women’s health courses is to help all physios understand when to treat the pelvic floor and when to look elsewhere.

The common link between so-called ‘orthopaedic conditions’ and incontinence, pelvic pain and prolapse (women’s health conditions) is the pelvic floor.  Four years ago, I became very curious to gain more understanding about how to assess the pelvic floor muscles and their relationship to other areas like the thorax, abdominal wall, cranium and foot. 

In my clinical experience, I had witnessed overactive pelvic floor muscles relax dramatically when:

  • The foot and ankle were treated (decreasing the ascending internal rotation force on the femur)
  • The thorax was treated (decreasing intra-abdominal pressure)
  • The cranium was treated (reducing tension on the coccyx through the spinal dura)
  • The neck was treated (perhaps reducing the neural drive to the phrenic nerve and thus the diaphragm, and secondarily the pelvic floor)

In these cases, the pelvic floor was reacting to problems that were elsewhere. There were also patients whose overactive pelvic floor muscles were causing the problem, and not reacting to others. Clearly, we needed tests that could differentiate when the pelvic floor was the victim and when it was the criminal

My message now in all my women’s health courses is to help all physios understand when to treat the pelvic floor and when to look elsewhere. 

 

Diane Lee, PT, Clinical specialist, BSR, FCAMPT, CGIMS, RYT200
@DianeLeePT

Comments

Fascinating! Thank you for this post. How do you feel about the theory of successful treatment of the pelvic floor through treatment of the feet as being due to smudging of the homunculus (genitals are next to the feet)? Do you find treating the feet works well with those with chronic pelvic pain who cannot tolerate internal treatment?

Thank you!

Thanks ,What activities help increas tone in the pelvic floor? 

 

Diane, I entirely agree with your treatment protocol described.  As a physiotherapist now trained osteopathically I recognize your protocol as yes entirely osteopathic. 

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