When most people think of physical therapy, they are likely to think of patients who have suffered an injury, undergone surgery or had a stroke; they are less likely to think of patients who need to retrain and strengthen muscles that have been improperly used or weakened over time.
That’s particularly true when those muscles quietly support internal organs and help control sensitive body functions.
But through Tennova Healthcare – Harton’s new women’s services program at the North Jackson Street Rehab Center, such rehabilitation is exactly what physical therapists Noi Fraker and Joy Bylsma are now helping female patients to do with muscles of the pelvic floor.
“We are bringing into the area a program that is not readily available here,” said Fraker. “The closest one is in Murfreesboro.”
Though both men and women have a pelvic floor muscles holding pelvic organs in place, pelvic disorders are more common in women. The most common cause of a pelvic floor disorder is childbearing, though heavy lifting, excess weight and previous surgeries can also increase the risk.
The National Institutes for Health report that one in four women in the U.S. experience some form of pelvic floor dysfunction. The term refers to a wide range of issues that occur when the muscles of the pelvic floor are weak, tight or damaged.
Weak pelvic floor muscles can lead to stress incontinence, a condition in which urine leaks during any activity that creates sudden pressure within the abdomen, like coughing, sneezing, lifting heavy objects or running and jumping. More rarely, weakened muscles can also cause the bladder, uterus or other pelvic organs to drop (prolapse) from their normal positions.
Tight pelvic floor muscles, often the result of stress and general muscle tension or prolonged sitting, can contribute to bladder urgency and frequency or lead to constipation or pain when the clenched muscles release.
Pelvic floor disorders can also contribute to sexual dysfunctions.
These conditions are not life threatening, but if left untreated they can negatively impact one’s lifestyle and may lead to additional disorders or severe depression.
Pelvic floor rehabilitation is a non-surgical approach to reversing those symptoms by retraining the muscles of the pelvic floor and surrounding tissues.
The first step, Bylsma said, is to create an awareness of the underlying problem. Often, patients don’t realize that their problems are the result of muscle failures.
And though pelvic disorders are more common with age, they are not a normal result of aging.
“(Women) think ‘I do leak, but I thought that was just normal for me when I sneeze or I’m just getting old’,” Bylsma said. “We tell them that, no, that’s not normal. We can rehabilitate that.”
Many women dealing with incontinence will try Kegel exercises for pelvic floor strengthening, but Bylsma said many problems are the result of a failed system, not just a single failed muscle.
Since Kegel introduced his pelvic floor exercise in 1948, research has expanded to show that there are two mutually supportive sets of muscles – those of the pelvic floor and of the transverse abdominus (the core abdominal muscle) – that must be equally fit to properly work together.
“When we talk about pelvic health, it’s not just the pelvic floor itself; we look at everything that surrounds it,” said Bylsma. “The muscles all work together. You have to train them to work together.”
Through a private, comprehensive evaluation, therapists test the tone, symmetry and strength of the muscles, ligaments and connective tissues that support the pelvic organs to find the cause of the dysfunction.
Once the cause is found, specific therapeutic exercises are employed to restore muscle strength and function and to retrain body movements and improve the coordination of the pelvic floor and supporting muscles.
“Just like anything else, if I don’t know what’s causing (the problem), I can’t give you the right exercise to do,” said Fraker. “We’ve gone a long way from just doing Kegels now.”
The program operates on a referral basis. Patients with pelvic issues should discuss treatment with their doctor.
For more information about the Harton program, call Tennova Healthcare Harton Physical Therapy at 393-7964 and ask for Joy Bylsma or Noi Fraker.
The Rehab Center is located at 1805 N. Jackson St.