4 minute read
PHYSICAL THERAPY
from OTK Issue 04
by One To Know
What you should know (about that body part)
By Elizabeth Sehon
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Illustrations by Amber Davis
She was 23 when she first experienced pelvic pain. She had no idea what was happening to her body after numerous attempts to find the source of the pain, and her health care providers were silent on a solution. “Everyone kept telling me that everything was fine, and no one would listen,” Louise Vraney says.
Louise now holds these answers with a doctorate in physical therapy and is a certified lymphedema therapist at SporTherapy in southwest Fort Worth. She is a pelvic-floor health care professional.
Later, an obstetrician-gynecologist removed vaginal tissue for a biopsy and confirmed nothing was life-threatening and diagnosed Louise with a condition unknown to many — a weakened pelvic floor. Now 33, she says her diagnosis and the physical therapy to correct her weakened pelvic floor was “life changing.” After a few years of practicing physical therapy, she began a specialty in the treatment of pelvic-floor disorders. Louise now performs thorough pelvic floor exams with a list of patient questions about urinary health, bowel health, vaginal health, and obstetric/gynecologic history that are specific to each patient. She also provides an internal exam for further evaluation, which tests the strength, length and sensitivity of the pelvic floor. This may sound simple, but it relays a great deal of information about a patient’s body and issues she might be experiencing.
The Pelvic Floor Explained
The pelvic floor is a layer of muscles, ligaments and connective tissue that bridges the bottom of the pelvis and holds all the pelvic organs — including the vagina, cervix, uterus, bladder, urethra, rectum and prostate, Louise says. Although anyone may experience pelvic floor dysfunction, many of her patients seek her therapy after giving birth.
As a baby grows during pregnancy, it causes an increased mass sitting on the pelvic floor and expands the muscles around the pelvic girdle, and then coupled with relaxin, a hormone produced by the ovary and the placenta, the muscles are expanded and weighed down even more.
“During a difficult labor, pelvic muscles have to expand to a certain length for the baby to exit, which could have a huge effect [on the pelvic floor] afterwards,” she says.
With a dysfunctional pelvic floor, pelvic organ prolapse may occur, which causes urinary and bowel incontinence because the pelvic floor muscles and tissues become weak, allowing pelvic organs to drop or press into other organs — like the bladder or bowels.
-LOUISE VRANEY
PT, DPT, CLT
Pelvic-Floor Disorders
How Pelvic Floor Therapy Has Changed Lives
Many women who have never experienced pregnancy or the birthing process may also experience pelvic floor issues.
One of Louise’s patients Sami Bruemmer confided that she came to her with a great deal of sadness, pain and little hope because of her pelvic floor dysfunction. Sami had scar tissue from a past surgery, and this made intercourse incredibly painful and often, impossible. “I was newly married and full of shame that I couldn’t have the sex life I wanted,” she says.
Sami was so downhearted by her situation that she was convinced she’d never be able to carry and deliver a baby. After working with Louise every week for a year, she was able to gain hope, encouragement and heal physically. A year after her physical therapy, she gave birth to a baby girl, much to her delight.
“Just as Louise was there cheering me on throughout my treatment, she showed up for me to celebrate my daughter’s birth,” she says. “I cannot emphasize enough how much women’s health physical therapy treatment affected my life and how impactful it was to have a therapist that consistently challenged and encouraged me.”
Exercises that Strengthen the Pelvic Floor
Types of exercise may vary considering the patient’s symptoms and pain. Vraney says one important exercise is teaching women how to properly do Kegal exercises as they are vital to maintain vaginal strength and prevent pelvic floor problems, yet nearly 80% of women do them incorrectly.
Her main goal with physical therapy is to train pelvic floor muscles to function for everyday activities like laughing, squatting, picking up a baby and jumping.
Preventive Care Is Key to a Healthy Pelvic Floor
Because several issues may arise, Louise encourages people of all ages to be proactive and get a pelvic floor exam. “Women-health physical therapists are here to help you be the best version of yourself,” Louise says. “We help with mostly anything regarding the pelvic floor, which has a huge impact on improving your quality of life.”
FOR MORE INFORMATION
SporTherapy is located at 6501 Harris Parkway, Fort Worth, TX 76132. For appointments, visit sportherapy.com or call 817.370.9891.
