pelvic floor rehabilitation

Pelvic floor dysfunction affects men and women of all ages, and becomes even more common as we age. According to the National Institutes of Health, nearly 24 percent of women in the U.S. are affected with one or more pelvic floor disorders, including incontinence, constipation and pelvic pain.

What is the Pelvic Floor?
The pelvic floor is composed of a group of muscles in the pelvis and abdomen that form the floor of the core. With the abdominal muscles being the front of the core and the back muscles being the back of the core, the pelvic floor muscles contribute to maintaining continence and hold the major organs in your pelvis in place. The strength of these muscles is critical because it determines how well the anus, urethra and vagina open and close.

What is Pelvic Floor Dysfunction?
Pelvic floor dysfunction occurs when the pelvic floor muscles are not contracting—often resulting in urine or bowel leakage, or relaxing optimally—causing constipation or painful sexual intercourse.

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What symptoms are typical of Pelvic Floor Dysfunction?
With stress incontinence, urine leaks when you are doing activities such as running, coughing, sneezing, laughing or jumping.

With urge incontinence, it is difficult to hold the urine and you may accidentally leak before making it to the bathroom.

What is Pelvic Floor Rehabilitation?
Like other skeletal muscles, pelvic floor muscles benefit from stretching and strength training exercises to improve their performance. Just as you would do targeted exercises to increase your leg, arm or abdominal muscle strength, it’s important to similarly promote flexibility and strengthen pelvic floor muscles to keep them healthy and strong.

Who can provide treatment?
A physician trained in pelvic floor anatomy and the treatment of pelvic floor dysfunction can help with strengthening exercises. Other healthcare providers such as physical therapists and acupuncturists familiar with pelvic floor dysfunction can also help with the process.

What treatments are available?
A doctor can evaluate your pelvic floor problem and help determine treatment options.

  • Depending on your condition, you may benefit from exercises that specifically strengthen pelvic floor muscles and/or exercises that improve the relaxation of your pelvic floor muscles. You may also benefit from exercises to strengthen your core muscles.
  • Biofeedback can be used as part of the pelvic floor rehabilitation program to assist in training you to perform exercises correctly.
  • Electrical stimulation can help promote neuromuscular education. In addition to muscles, there are also nerves in the pelvic floor. Like all nerves, when not functioning properly, they can cause pain and muscle dysfunction.
  • Acupuncture can also treat dysfunction.
  • Medications and injections can be used for certain muscle and nerve problems.

While the likelihood of incontinence does increase with age, it is not considered a normal part of aging. Help for this condition is out there.

Atira Kaplan, MD, a board-certified physiatrist with additional fellowship training in women’s health rehabilitation and Rubina Heptulla, MD, MBA a board-certified endocrinologist and an acupuncturist, practice at Millennium Medical and Rehabilitation located at 1075 Central Park Ave. in Scarsdale and 535 E. Boston Post Rd. in Mamaroneck.; 914-472-2700.

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