Demystifying Pelvic Floor Care: A Case Series for All Physical Therapists
Nick Rainey, Helene Bengtsson, Kelli Wilson, Patricia R. NelsonIntroduction:
This case series reports the pelvic health management for 3 patients with typical orthopedic diagnoses.
Case Descriptions:
Each case presented with pain related to the referral diagnoses of low back, pelvic, hip or sacrococcygeal pain. All had prior physical therapy (PT) care without successful resolution. Additional assessment via systems review, followed by external assessment of the pelvic floor, and assessment of respiratory breathing pattern led to identification of additional impairments that could be addressed by PT interventions.
Outcomes:
All cases had subjective and objective findings suggestive of pelvic floor muscle (PFM) impairment, as well as altered breathing patterns. Identified PFM impairments included pain, incoordination, limited contractions, and nonrelaxing contractions. Breathing pattern dysfunctions revealed loss of lateral rib and abdominal excursion with excessive thorax elevation. An integrated PT management regimen that addressed both orthopedic and PFM functional needs led to full or substantial improvement for all cases.
Discussion:
Inclusion of pelvic health-related subjective questions and assessment of breathing pattern and PFM using external strategies with the patient fully clothed is fully within the skill set of all physical therapists. Inclusion of these techniques led to positive outcomes for 3 different patients.
Informed Consent:
Consent was provided by all patients.