Questions about Pelic Floor Physical Therapy

[curlygirl]

what is pelvic floor PT like? do they do internal vaginal manipulations?
thanks

[MakinIT]

Curly cue: the concept behind PFD is that the IC is causing you to unconsciously tense up your muscles in your pelvic floor ...like constantly, such as an unbearable back spasm or neck spasm. I think most of us have had those. Problem is, with IC it becomes a vicious cycle. We've got pain in our bladder, tense our pelvic floor muscles to protect, then the pain in bladder gets worse....tense our pelvic floor musles (which, BTW are the muscles generally considered between vagina and rectum ..your perineal muscles..however, we also include vaginal muscles as well) :D So...anyway, you can see the problem cycle building. and believe me, it gets AWFUL. I am a oh so much fun recipient of these treatments. OK...so here's the dirt on the therapy. It sounds sucky but you know, this disease is sucky and we do what can do to survive.

I will go through my experience. Others may have different experiences. My first meeting the PT didn't do any internal exam. she just felt my tummy from the outside, noting where scar tissue was, tender points were, got my history, blah, blah, blah. Second meeting....she brought the gloves and goo. She was VERY kind VERY sensitive and stopped IMMEDIATELY when it hurt too much. She first checked the area around the urethral opening for trigger (spasms) points..She found many. Spent quite a bit of time gently pushing one finger on the sore point until the soreness went away. She moved down to my vaginal area but the "first time" only messed with the outside, again findinding lots of triggers. (no wonder I couldn't have sex) then the perineal muscles. The joy of this is I could now peeee without starting and stopping. OK so the next week she went into the vagina and was very sweet about it. Once again gentle and could find all the silly "knots" so it hurt like hell but she was sensitive and stopped. We worked for 8 weeks 2 times week, with like reverse kegals to do. (kegals strengthen, these relax...I farted so may times it was reeeeeediculos) But Anne didn't care.

After those 8 weeks I was turned over to a PT who knew TAI CHI, Yoga, and other relaxation exercises. SO...there I was, 2 times /week.

It's embarrassing, hurts, and not much in the way of fun. BUT, it is an awesome thing once you are done. I'm thinking, since I had a car accident last month, I'm going to have to see her again. However, I can't recommend it enough.

IF your doc recommends it, do it!!!! make sure it's a female (duh) trained in the field of PFD. ask questions before you start.

Tracey

[Melanie]

I explain to my non-IC friends that it's like a long OB/GYN exam. That's not entirely accurate, but it's a beginning.

I have been going to PT for years. My therapist does the internal myofascial release. But she also works on my back, belly, legs, etc. The internal work is usually part of the therapy.

The therapist will wear gloves & lubricant. She'll use her hand on the inside and outside of the vagina to work on the pelvic floor muscles. Often the patient will be asked to do kegels as part of the process.

It can be uncomfortable and sometimes painful. But I swear by it. My sex life would be non-existant without PT. Having a comfortable relationship with the therapist is a must!

Do you have any other specific questions?

[curlygirl]

How long do you have to do the therapy to feel a difference. Do you think if you felt comfortable with the internal stuff the first meeting, they'd do it? Or is that just not part of the process? Are there also things that you can do on your own that help, once you've started the PT?
What is a typical cost for this type of therapy? I have an HMO, but don't know if they provide this. And my therapist therapist (as in my shrink) said she had incontinence as a resutl of a back injury and knew someone really good that she recommended to me. I imagine that it can get pretty expensive, no?
Thanks.

[yorkyloverx3]

:thumbsup:
I agree 100% physical therapy is worth any little embarrasment you may have over an inside exam.
I also agree you need to make sure your ur sends you to someone who is trained in how to do IC treatments.
My pt will ask when I come in where do I hurt today and will start from there whether it be neck, shoulders, back or pelvic. We do inside or outside, she always ask and on a day I may have more pelvic pain she will only do the pressure points from the outside.
And we always finish with warm moist heat pads on "where ever my sore spots are on that day. That feels awesome. I could stay there for hours but only get 15 minutes!!

I have state blue cross blue shield which is one of the worst insurances to have and I pay my copay and the 20% which is around $20 - $30 dollars each visit. I varies in what they do on that day.

:thumbsup: I say go for it!!! It is worth a try
Denise

[Melanie]

How long will it take to feel a difference? Depends on your body & your therapist. I usually notice a difference immediately. Sometimes she may "stir things up" and I can actually feel worse for approx 24 hrs afterwards. But then I reap the benefits for days afterwards.
Internal stuff the 1st time? That depends on your therapist. They might want to evaluate the pelvic floor the 1st time, but not necessarily start too aggressively. If you aren't comfortable w/ the internal the very 1st time, just ask the therapist to start slow. And yes, internal is only part of the therapy (but I think a very crucial part).
Things on your own that help? Absolutely! Stretches, exercises, kegels, etc. Depending on your therapist, she may give you "homework" exercises.

Cost depends on your coverage. For me, I'm fortunate w/ great PPO coverage. I pay approx $10 per visit for 45minute sessions. You'll probably need a prescription written from your Urologist.

If your therapist (shrink) has a referral, that's a great way to start! Good luck & keep us posted.

[MakinIT]

My total therapy bill, if I didn't have insurance, going 2 x per week for geez, months, was like $17,000. Your HMO should pay. Call them and see. Total, I wound up paying up 200.

I too, found myself a wee bit uncomfortable after the treatment, but I loved the electrical stimulation and heat she put on my tummy for a 1/2 hour...that eased some of that pain. I definately think it is definately working.

[yorkyloverx3]

:( I hate to exercise and my therapist was on vacation last week, soooooooooo I did not do the exercises like I should have.:yikes: so this week I am paying the price. The pelvic pain has been hurting bad for the last 3 days. Thank goodness I go see her tomorrow. But then I am taking a month off....... I have to have someone to be accountable to each day or I will not do them.

I can't stress enough about those homework exercises. You don't think at the time......"well how is this helping" but IT DOES.

Pilates is better for me. Does anyone know the name of a good BEGINNERS basic dvd. I guess I need to have something at home to watch, because keeping a list of WHAT I am suppose to be doing is NOT working.


:grouphug: Denise

[MakinIT]

I like how my therapist has me "do" those "exercises". First, she has me tighten all the muscles around navel and then down into perineal area (she can tell by putting her hand on my musles onmy belly)
Then, she has me do what most therapists don't. She does "Reverse Kegals" We go from the tightened muscles to "over relaxation" You start relaxing the muscles slowly from the belly button,down to perineal area, and then the vaginal area. (um..if you do it right, you should uh, fart....ok...pass gas)
Do that like 5 times and if you haven't gassed yourself out of your room, you can work on strengthening your abs (through recommended exercises from your doc or Pt)

ANYWAY have fun!!!!!!!

Tracey:)

[Aspencad]

The more I read the posts the more I learn you guys are something else. I read the interview Jill had with Rhonda Kotarinos back in 01. Very good info. on PFD. Just finished reading the testimonies on "Pelvic Floor Therapies". As I was reading exactly what they (the PT) do during the sessions I saw the post about the perineal muschles and a big light went off in my head. I have always had some discomfort in that area but never had put it together with the PFD. It has always been like a burning sensation. I really appreciate you guys candor. I can only imagine how much that will hurt when massaged or used as a trigger point by the PT. I realize having gone to the cyro myself several times how they have to massage those trigger points to release the tightness in the muscle. Hurts initially but eventually feels better.

[MakinIT]

I had a car accident a few weeks ago. I'm seeing a chiro for the neck and shoulder probs But ,my pelvic muscles are sooooooo sore I'm going to talk to to my uro about going back to seeing Anne.

Anyway...gotta go.

[rumbat]

Hello,

I am a newbie to the site, and I fear I may have PFD. I have constant spasms. It’s the strangest thing to me! I feel the spasms so violently, yet when I ask others to place a hand on my bladder area, they can not feel anything. How are the treatments progressing for you? Please let me know because this may be an alternative for me.

I am so sorry for your difficulty, and hope you are making progress!

[yorkyloverx3]

I will respond to your question, after doing months of physical therapy. No one but you can feel the spasm because it is coming from the inside. Someone trained in physical floor therapy will be able to detect it right away.

I had a spasm so bad on one of the days I went in for therapy, she knew exaclty where it was and tried to massage it out.

Are you on any kind of muscle relaxer? Valium helps me tremdously, IF I get it in my system BEFORE it gets to bad. You have to know your own body, because YOU are the only one who feels the pain.

Before I started physical therapy, I was doubled over with the worst 'menstrual' feeling cramps. It was hard for anyone else to know I was in pain except the look on my face and I could not walk. Walking or being on my feet for a long length of time will still put me in a spasm.

I was very hesitant about going to physical therapy in the beginning, but now I love it.

Hope this has helped!

Denise

[JAMIEL]

Thanks for the info on PT. My Uro wants me to start PT and I was a little apprehensive. Thanks to all of your postings I now feel more confortable with going and confident that it will help. I met this PT at a support group meeting for IC and from talking to her she seems to know what she is doing. I start on the 27th so I will let you know!!!

Jamie:kiss:

[PikkuMyy]

I am also about to start PT for PFD and I'll let you all know how it goes.

[MakinIT]

Pik...

Good luck to you and I hope it goes well for you...remember... breathe, breathe......(Also, they don't do it the first time)

Tracey

[Cheryl529]

Is myfascial release the same thing has PFD therapy? If not, what is it? Thanks for your help b/c I think I may need something like this. -Cheryl :)

[MakinIT]

It's a kinda sorta thing. myofascial release, I believe, releases the tissue that connects your muscle to your skin. Myofascia is like 2 sided sticky tape...kinda. :yikes: When they do PFT, they are focusing on trigger points that can be a compilation of myofacial tissue, muscular knots, blah, blah. IF you've ever had trigger point release with a chiropractor, you will know what trigger point release is . Difference, of course, is instead of your shoulder or neck, they are working on your perineal area or vagina :dizzy: So...the best thing to do, is RELAX..(trigger point therapy wont work without trying to relax...It takes a very, very strong person to relax during this :bow:

Best of luck to you. It really will help you feel better once you are done..and the women trained to do this are very, very, sympathetic and proffessional ladies....(Uh..they don't train male PT's to do this.)

Again..good luck........T

[Cheryl529]

Tracey, thanks for the information, it sure helps! :)

[MakinIT]

So Cheryl....When are you going to try? or are you still wieghing the benifits? let us know....It is a good thing. I'm not real shy about my body any more, I tell ya....2 kids, illnesseses, surgeries, Now IC with a weekly bladder wash of steriods and something to soothe my nerves....(In my bladder)

Best of luck, whatever you decide.

Tracey

[Cheryl529]

Tracey and fellow members, I'm not sure when I'll be having PFT done. I feel I may be a good canidate for this :woohoo: and plan on speaking to my uro when I see him around the 16th. Did any of you have any type of test to determine you needed PFT or did they pretty much go by the symptoms you described :yikes: and then determined you should have it? -Cheryl.

[JAMIEL]

My uro actually gave me a pelvic exam and pressed on my pelvic floor muscles ..ooooch...he coud tell from my pain and actually feeling the muscles that I have PFD. Also I had a urine stream test (not sure of the technical name) and I had a bad urine stream...Today will be my fourth PT session...Although is does not seem to of helped yet I am very hopeful!!

Jamie

[MakinIT]

Mine just heard the symptoms, read the charts and said "you, girlfriend, need PFT..." she specializes in IC though. So, no nasty tests or even an exam...I'd imagine most folks would have to have an exam but there were enough notes in my charts saying internal exams were painful that that convinced her she didn't to do it.

Tracey