We were pleased to host Dr. Lauren Johnson—Doctor of Physical Therapy and current Director of the Pelvic Physical Therapy and Wellness Clinic in the Salt Lake City, Utah for our March Education Meeting. In this presentation, Dr. Johnson taught about pelvic health, how pelvic symptoms relate to ME/CFS and fibromyalgia symptoms, and how professionals can attempt to treat pelvic problems.

What is Pelvic Health Physical Therapy?

Pelvic health physical therapy treats pain and problems in the reproductive system, urinary system, and digestive system. When healthy, all these systems work optimally together. When in dysfunction, pelvic floor physical therapists may potentially offer help.

Pelvic floor physical therapists, like other physical therapists, treat muscles, ligaments, tendons, and organs. They cover a wide range of symptoms, ranging from irritable bowel syndrome and constipation, prenatal and postnatal care, to pain with intercourse and erectile dysfunction.

Pelvic Health in ME/CFS and Fibromyalgia
People with ME/CFS and fibromyalgia experience higher rates than control groups of pelvic problems such as early menopause, a hysterectomy, chronic prostatitis, and erectile dysfunction. In addition, pelvic pain can exacerbate other symptoms.

When we are in pain, we tense up. Chronic tension leads to pain, loss of strength and mobility, and fatigue. While this is true for all parts of the body, it is particularly intense for the pelvis since the body is very protective of the organs leading to rapid tension and slow relaxation. Therefore, addressing pelvic health needs may help reduce pain and fatigue and increase mobility.

What to Expect
When you go to a Pelvic floor physical therapist, your therapist will evaluate, examine, and educate you; then, offer treatment, establish a plan of care, create a home program, and ultimately discharge you.

During the evaluation, your therapist will ask about your symptoms, what you have tried in order to alleviate pain, medications you are on, and any significant surgeries, as well as lifestyle and behavior conditions. Ultimately, the therapist wants to gather a history and better understand from your firsthand account.

The examination is often the most stressful part of the process. It is key to remember that you are in control, and the therapist will work to help you feel safe and comfortable. Your therapist will look at your external and internal anatomy to check for scarred and irritated tissues, as well as painful or dysfunctional movement.

Afterwards, your therapist will educate you on what they find. They will then offer various treatments. Next, they will work with you to create a plan of care and home program. When you are ready, your therapist will discharge you to continue your home program on your own.

Treatment
Pelvic Floor Physical Therapists should follow a three-step program: 1) restore range of motion, 2) coordinate muscle movement, and 3) strengthen muscles.

Therapists have several strategies to help you restore range of motion. Mindfulness and biofeedback may help you become aware of how to relax and work with your body, while gentle stretches and energy efficient movements may help you with day-to-day tasks. Breathing patterns are also significant; most people in pain breathe shallowly from the chest, but breathing deeply from the diaphragm relaxes the body and increases available energy. Even strategies as simple as not sucking in your belly helps your body and organs move more easily.

Next, therapists help coordinate muscle movements. This can involve manual therapy, where the therapist teaches your muscles how to move more efficiently. Finally, therapists help strengthen muscles. The sequence of this treatment is integral to achieving improved mobility and strength in a safe and effective way.

We are grateful for Dr. Johnson’s insightful presentation, and thank her for her time and this valuable resource. If you live in Utah and are interested in pelvic health please contact Dr. Johnson’s clinic, Pelvic Physical Therapy & Wellness, in both Draper and Murray.

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