Episode 70 - What Is Abdominal Pelvic Health Therapy? Find Out From And Expert Meet Donna Pagano PT

Welcome. I’m Diane Carbo with Caregiver Relief, and today’s topic is going to be on what is abdominal pelvic health therapy. Today, we’re going to find out from an expert. I’d like to welcome Donna Pagano, a physical therapist who specializes in a very underserved branch of PT, abdominal pelvic health.

Donna, I’m so glad to have you here with me today. When I learned of your specialty and realized people don’t know what your services are. I just thought it was really important to educate people out there. So let’s get started. Again, welcome. I’m excited to be here. Thank you and I’m glad you’re having me because it is, like you said, such an underserved area and people just have no idea what it’s about.

I’m always saying when they come in with a script, they look like Mickey Mouse at 630 on a watch because his arms are crossed over as profits at that time. But, so it’s one of those things that I love to get out into the community and this is such a wonderful opportunity to do so. In fact, I’m treating a physician right now who had no idea it even existed.

It’s a part of physical therapy that you don’t really learn in physical therapy school or physical therapy assistant school. It’s all continuing education and the way we’re instructed is really up close and personal. Your pants are off the whole time. So we learn on each other both vaginally and rectally we do treat men and women. Children we usually don’t treat internally unless there’s an absolute need. But anyway, so there’s not a whole lot of people up for going into that kind of thing. And that being said, it is absolutely growing. So it’s getting to be more and more in the community but for all intents and purposes, there’s still not enough of us.

So that’s what it is and what we treat are any kind of things that happened in this area, whether it be incontinence of urine or feces, or the inability to keep either or in get it out. So urinary retention, urinary incontinence, both fecal incontinence and constipation. A lot of digestive work. We also address pelvic floor disorders and pelvic floor dysfunction.

Pelvic floor physical therapy and pelvic floor therapy are essential in treating these conditions.

That’s where the abdominal part comes in. So if people happen to have any kind of issues with scar tissue from abdominal surgeries that may include colon resections may include appendectomies, gallbladders, hernia repairs, C sections anything you can think of and even if it’s not scars, fascial adhesions, which is connective tissue. Pelvic floor rehabilitation is also crucial in these cases.

We’ll talk about fascia in a minute, but those adhesions can form simply because of inflammatory responses in an abdomen. So whether it’s inflammation from chronic constipation, chronic diarrhea, maybe about a food poisoning that you had, that gets to be really important in how we treat. So it’s easy to think just about, a bowel or bladder or it coming out. But when you think about bowel and bladder control, it’s more comprehensive.

Bladder control is another critical aspect we address.

But when you think about the fascia. In an abdomen, when you’re a little embryo being made, the intra abdominal fascia in your abdomen turns into the second of the three layers of our pelvic floor muscles. That’s why you can stick your finger in your belly button and feel something weird downstairs. So fascia is under the control of an involuntary nervous system.

So if I tell you for instance, Diane, straighten your elbow out for me, you can do that. But if I say digest that sandwich you ate, you’re not in control of that, right? So fascia is under that involuntary control system. And so the way you work with it is very different than just stretching muscle.

So over time, fascia can tighten up to 2000 pounds of pressure per square inch. What makes it tight? Some people can be born with tight fascia, but for the most part, it’s surgeries, it’s pain, it’s chronic inflammatory stuff. Even emotional stress or sometimes chemical changes with medication can tighten fascia. This can also lead to issues with pelvic muscles and the pelvic region.

Pelvic floor weakness is another condition we frequently address.

Frequently Asked Questions (FAQ) on Pelvic Floor Therapy

What is Pelvic Floor Therapy?

Pelvic floor therapy is a specialized form of physical therapy for pelvic floor muscles that focuses on improving pelvic floor function, strengthening pelvic muscles, and addressing pelvic floor dysfunction. It is used to treat conditions such as urinary incontinence, pelvic pain, fecal incontinence, and pelvic organ prolapse.

What are the primary functions of the pelvic floor muscles?

The pelvic floor muscles play a vital role in supporting the pelvic organs (bladder, uterus, rectum) and maintaining bowel and bladder control. They also contribute to sexual function, stabilizing the pelvic region, and assisting with normal bowel movements.

What are common causes of pelvic floor dysfunction?

Pelvic floor disorders can develop due to several factors, including:

• Childbirth (leading to pelvic floor weakness or pelvic organ prolapse)
• Chronic constipation and excessive straining
• Surgery in the pelvic region
• Aging and hormonal changes
• Heavy lifting or high-impact activities
• Nerve damage or pelvic pressure
• Injury to the pubic bone or surrounding muscles

What symptoms indicate a need for pelvic floor therapy?

You may benefit from pelvic floor physical therapy if you experience:

• Urinary incontinence or loss of bladder control
• Difficulty controlling bowel movements
• Pelvic pain or pressure
• Erectile dysfunction or sexual problems
• Chronic constipation or straining
• Pelvic discomfort after childbirth or surgery
• Pain in the vagina, pelvis, or pubic bone

What can I expect during a pelvic floor physical therapy session?

A pelvic floor physical therapist will typically:

1. Take a detailed medical history to understand symptoms and lifestyle factors.
2. Perform a physical exam to assess pelvic muscles, tension, and weakness.
3. Recommend specialized therapy, including kegel exercises, manual techniques, or electrical stimulation for pelvic floor rehabilitation.
4. Develop a customized treatment plan to help reduce pain, restore function, and improve support.

What treatment options are available for pelvic floor dysfunction?

Treatment may include:

• Kegel exercises to strengthen pelvic floor muscles
• Biofeedback and electrical stimulation to improve muscle control
• Relaxation techniques for pelvic tension and discomfort
• Lifestyle modifications to aid bladder control and bowel function
• Surgery (in severe cases, such as pelvic organ prolapse)
• Education on proper posture and movement strategies

How can pelvic floor therapy help sexual function?

Strengthening and relaxing the pelvic floor muscles can improve sexual function by increasing blood flow, reducing pain, and enhancing muscle coordination. For men, it may help with erectile dysfunction, while for women, it can address vaginal pain or discomfort during intercourse.

How long does it take to see results from pelvic floor therapy?

Results vary based on the severity of the condition and adherence to therapy. Many patients experience improvement in urine leakage, pain, and muscle strength within a few weeks to months.

When should I seek care from a pelvic floor physical therapist?

If you struggle with persistent pelvic pain, incontinence, bowel or bladder issues, or sexual dysfunction, it is best to consult a physical therapist specializing in pelvic health.