Physical Therapy for Women’s Health – The Nebraska Medical Center


We steam at women that are basically in the
same situation that you are and they have gotten better. So we get women on both sides who might be
in their 20’s and their child-bearing age and they’re either experiencing pain or
they’re experiencing leakage and it can be very mortifying, very embarrassing. Unfortunately,
in our society, we don’t really talk about this region unless something’s not going
correct or we’re having some sort of issue. And our doctors are becoming more and more
enlightened as to asking various questions to help people feel more comfortable to come
on it. But it’s very common that our gals that are on the lower end can be quite embarrassed
just coming in. I would to tell them that Kelly and I have jobs because it is such a
common thing that we have both young women and older women. We’ve had women in their
80s and 90s come in and really improve their function. And have been quite pleased and
didn’t realize. We often hear, “Why didn’t I know about this 20 years ago, or 30 years
ago, when I had my kids?” So it can be quite delightful to take that woman and help her
reach her own personal goal. It’s important to know the diagnoses that
we commonly treat, which would be urinary incontinence or fecal incontinence, pelvic
pain (and that can be from various different origins), pregnancy-related pain (which can
be anything from abdominal, low back, sacroiliac joint, as well as constipation). And I think
that patients that come in to see us often times think that these things are normal part
of aging or normal part of pregnancy, and Liz (whom you’ll meet in a second) and myself
like to tell patients that, “No, there are things that can be done to make it better.” What’s important to you? We want to make
it so that your body and your function match your goals. We’re not going to push you
anywhere you don’t want to go, but we also want to work very very hard so that you’re
happy with how your own body works. So essentially what we’ll do when you come
into physical therapy, is we’ll collect a very detailed subjective history and figure
out how often you’re going to the bathroom, how much you’re leaking, what it is you’re
consuming for your fluid, those types of things. Then we will usually do an internal muscle
assessment. And that’s different when you go to your physician for your normal pelvic
exam. We are basically concerned with how your muscles are responding with a strengthening
contraction and trying to figure out where they’re at on a strength scale and an endurance
scale. We give each person an individualized exercise
program. It’s easy to read in a magazine or on a website; you’re supposed to squeeze
this many times for this long, for this entire time and most of the time that doesn’t match
up to each individual patients. So they go home and they’re really frustrated; “I
tried that and it didn’t work.” But it was because it wasn’t individualized to
their own body. Women do really really great with therapy.
I think that that, even as they’re coming in, we can provide them with that encouragement
to say, “We’ve seen that women that are basically in the same situation that you are
and they have gotten better.” For them, that’s just basically kind of like seeing
the sun rise; “Oh my goodness, I don’t have to leak urine, I don’t have to have
back pain with pregnancy, I can have intercourse with my husband and not be in horrific pain.”
I think that hope is good for them.

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