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Pelvic & Women's Health Rehabilitation

Pelvic Health or Women’s Health rehabilitation appointments begin with a specialty-trained therapist who is able to address issues related to the deep core (diaphragm, transverse abdominus, multifidi, pelvic floor) and provides whole body integration to reach each individual’s goal. There are a wide variety of issues that could include musculoskeletal, fascial, genital, gastro-intestinal, nerve/neurological or dermatological aspects as well. These issues may lead to challenges with movement, problems with voiding, sexual dysfunction &/or pain. Ultimately, it is a brain-body connection that is imperative to address from an integrated approach and tailored to each patient.

For this arena of rehabilitation we work with children and female bodies of all ages, from high-level athletes, child-bearing ages, as well as peri- & post-menopausal females. We are trained in both vaginal and rectal muscle testing; however, it is important to note that no one ever "has" to have an internal examination as a part of their care. There are things that we may be able to be more accurate about assessing with that testing but it is never imperative and we can often address so many aspects without that at the initial evaluation. Additionally, Amy Zipp has been trained on imaging ultrasound and has in-clinic ultrasound for external assessment which can give a highly robust and more accurate measurement for various contributing factors when it comes to issues related to the structures of the pelvic floor and/or abdominal wall.

Our goal is to help you to figure out your best pathway forward that improve your quality of life in a sustainable way. 



Some common pelvic-health related issues:

  • Musculoskeletal pain related to pregnancy and post-partum

  • General pelvic pain disorders, may be related to low back pain with related pelvic floor symptoms

  • Urinary incontinence

  • Fecal incontinence

  • Constipation

  • Chronic recurrent cystitis

  • Coccydynia

  • Diastasis Rectus Abdominus

  • Dyspareunia/painful sexual intercourse

  • Osteoporosis-building safe strength training programming

  • Pelvic floor muscle dysfunction

  • Irritable Bowel Dysfunction (IBS)

  • Irritable Bowel Disorders (Crohn’s, Ulcerative Colitis)

  • Interstitial Cystitis (IC)

  • Orthopedic injuries

  • Sacroiliac joint pain

  • Mastectomy rehabilitation

  • Hysterectomy rehabilitation

  • Cesarean and vaginal delivery rehabilitation

  • Pre/Post Intervention for individuals who do need surgery such as (neuro-stimulators, uro-gynecology issues, etc)

The initial appointment with you (&/or with you and your child) will include a thorough evaluation. This includes background and current medical history, completion of a bowel & bladder diary for at least 48 hours as well as more in-depth questions about your eating, drinking, and voiding habits. An orthopedic and possibly neurological examination will further the understanding of your body’s current status. Additionally, when indicated, use of either the Selective Functional Movement Assessment (SFMA) or possibly the Functional Movement Screen (FMS) will help us understand how you move your body & the best pathways to help you to reach your goals.

In addition to a more traditional orthopedic evaluation, the muscles of your pelvis (the pelvic floor) will be evaluated to determine any issues with their function (over-activity, under-activity, hernias, prolapses) and dyscoordination that might be contributing to your symptoms. This will include an external assessment and might include an internal assessment if that is agreed upon and if it would give us additional information about the endurance, strength & other factors related to your pelvic floor muscles. Wireless imaging ultrasound is an additional tool mentioned above that will not only enhance the accuracy of the clinician's assessment, but will allow you to be able to actually “see” your movements on the screen. We are able to work together to further improve your coordination and assess changes over time. The ultrasound can be used both across the abdomen &/or across the perineum (not intra-vaginally or intra-rectally). This allows us to look at how you are moving/contracting your muscles in real-time. Having this also cuts down on your medical “red tape” & spending time and money on some types of additional appointments.

You will leave your initial visit with beginning understanding of your areas of need, and we’ll work to start on not just exercises and coordination of the pelvic floor with the rest of the systems of your body, but also on cognitive techniques to address the role of the brain in directing your body and reaching your goals. Because the initial evaluation can take quite some time, in order to leave with some treatment techniques, we prefer to take a longer initial appointment, than is allowed through insurance based practices. We do accept traditional Medicare and those visits will be limited to 1 hour in most instances. 

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