Most people are familiar with how physical therapy can treat a sports injury or help patients recover from surgeries. Few realize that it can also be beneficial in treating pelvic pain and improving bowel or bladder function in both men and women. This specialized therapy approach, called pelvic floor physical therapy, can help with diagnoses ranging from incontinence and difficulty with urination and/or constipation, to painful sexual intercourse, pelvic and back pain and endometriosis, among other conditions.
Kacy Houle, a doctor of physical therapy at Hurley Medical Center, specializes in pelvic floor PT, treating adult patients from the age of puberty to well into their 80s and 90s at Hurley SportsCare – Flint (4500 S. Saginaw St.), located on the second floor of Insight Fitness. While the majority of her patients are women, Houle says that men experience chronic pelvic and abdominal pain too, often after having a prostatectomy, a procedure used to treat prostate cancer. According to Houle, with the proper PT regimen, patients can strengthen and retrain their pelvic floor muscles to address the conditions mentioned above, especially the most common (and dreaded) diagnosis among her patients: incontinence.
“A lot of patients think it’s normal, especially if they’ve had a hysterectomy or after pregnancy, but it is not supposed to happen,” Houle says, emphasizing that leaking urine does not come with getting older, or any stage of life.
The techniques that Houle uses encompass pelvic floor exercises (also known as Kegel exercises), biofeedback – a machine with sensors to help you learn better pelvic muscle coordination – and lifestyle changes. Often, patients are unintentionally perpetuating bad habits, such as not drinking water to avoid having to go to the bathroom or training their bladders to increase frequency by forcing the issue when they don’t have to go.
As word gets out about the positive outcomes both men and women have achieved with pelvic PT, the team at Hurley hopes more patients will start a conversation with their doctors.
“The biofeedback machine can give them a visual of what their pelvic floor is doing, how strong it is. A lot of patients get better with just habit changes, strengthening exercises and retraining their bladder,” Houle says.
Sometimes, the muscles don’t need to be strengthened. The problem stems from muscles being too tight, in which case relaxation techniques such as breathing can be used. On the first visit, the therapist usually discusses a patient’s history, including how long they’ve been having symptoms, when they most often occur and whether or not they’ve had vaginal births, C-sections and/or abdominal surgeries. Patients receive a diary to log patterns in their urinary and bowel habits, plus go over their nutrition and diet, since certain food and drinks, such as caffeine and some citruses, can irritate the bladder.
To begin treatment, patients need a prescription from their family doctor, nurse practitioner, gynecologist or urologist. Sessions last an hour, 2-3 times a week, and patients receive handouts so they can continue their exercises at home.
“We’re more of a coach,” Houle says. “We get our patients in a routine, something they can do at home and will carry over, even beyond therapy.”
While pelvic physical therapy might seem like an unusual approach, time and again it has provided patients with relief from pain and symptoms many find embarrassing without having to resort to surgery or pain medications. As word gets out about the positive outcomes both men and women have achieved with pelvic PT, the team at Hurley hopes more patients will start a conversation with their doctors. Those who have already done so and received a prescription for therapy can call 810.262.9350 to schedule an appointment. If you have questions or would like help facilitating a prescription, contact Kacy directly at 810.262.2285.