At The Restoration Space we offer many services for women. Pelvic Floor Dysfunction, Pelvic Girdle Instability and Antepartum and Postpartum services.
PELVIC FLOOR DYSFUNCTION
Women’s health and men’s pelvic health issues often originate with the pelvic floor muscles. When these muscles are under active or weak, symptoms such as prolapse and incontinence can result. When they are overactive or have excessive tension, discomfort and even painful symptoms may be present. While it can be embarrassing to talk about these types of symptoms, we can promise you, you are not alone. We have specialized training to help address these conditions. In some cases, with a better understanding of how the pelvic floor muscles work, after your first visit you may see results. In fact, educating you is our passion. Awareness of where these muscles are and what they should be doing is half the battle in overcoming pelvic floor dysfunction. That’s when the “magic” happens.
What is equally important is how YOUR pelvic floor is working for YOUR lifestyle.
We need to know that they these muscles are working, but even more so, if they are working in the proper sequence (yup, that’s a thing!) and to counteract the forces you put on them. Are they able to contract at all? If so, are they able to relax at all? Do you hold stress in your pelvic floor (also a thing!)? Do you sit for most of your day? Or do you need to lift for your job or for demands of your home and yard? Are you more of a yogi or a cross-fitter? The answers to these questions matter and they help us design a program that is individualized to you.
This is so much more than a Kegel. In some cases, we actually want to avoid those altogether.
At The Restoration Space, you will undergo a comprehensive exam of the pelvic floor and pelvic girdle and abdomen, including your breathing patterns. We will use your story combined with our findings to create a customized action plan for you, so that you will see how and when we will progress your program to meet your end goals. We will even discuss when we may expect that to happen. You will be an active participant in your care and the more you are willing and invested, the better your outcomes. If appropriate, we may recommend a free consult with our partnering integrative practitioners, who will collaborate with your physical therapist to address factors you may not realize are adding to your issues, for the most holistic treatment plan in the area to get you the results you desire.
Conditions this service can assist with are but not limited to: prolapse, urinary incontinence, dyspareunia, vaginismus, vestibulitis, vulvodynia, coccyx pain, piriformis syndrome, sciatica, pelvic pain/dysfunction, hip pain that has not resolved with traditional PT and exercise, constipation, fecal incontinence, and lower abdominal pain.
PELVIC GIRDLE INSTABILITY
the ACTIVE FEMALE
The pelvic girdle is the foundation for most movements of your trunk, hips and legs. The muscles and ligaments of this area need to be working properly and in a balanced way to support the low back and legs during activity- from getting out of bed or standing up from a chair to taking a Barre class, running or playing a sport.
The female pelvic girdle is different from men for specific and beautiful reasons. Understanding these differences are key in understanding why our bodies respond to changes in ways that may result in imbalance and eventually pain and inflammation. Many things can affect the balance of the pelvic girdle for females: puberty changes, hormones (another bonus of our menstrual cycle!), pregnancy and post-partum (even years well after childbearing).
Understanding the effects of puberty on the pelvis is so important for the teenage girl who has played the same sport year-round from her pre-teen days or has been a dancer or gymnast since she was in elementary school and is now adjusting to her teenage body. Hormones make the pelvis more unstable throughout different points in a cycle, which can change the very foundation on which your body has been used to moving, and therefore affect performance as well as make your body more vulnerable to injury in the hips, knees, ankles and spine.
The pelvis changes during pregnancy in numerous ways. Ways that are MEANT to happen and ways that happen for us to accommodate for and prepare for delivery of the baby. But in doing so, these changes are, by definition, causing pelvic hypermobility and instability, resulting in a crazy amount of compensations throughout the mid core and legs. Whether you are on your first baby, or even more so if you are on your 4th; whether you had a baby 3 months ago, 3 years ago or 23 years ago, your pelvis is likely still unstable and your muscles around it are likely still unbalanced, unless you have specifically taught them how to work correctly. Chances are, you haven’t. Because no one told you to….until now.
Even the smallest changes in the pelvic girdle structures can lead to small muscles doing the work for big muscles, and/or compensatory movements. This results in symptoms like hamstring tendinitis, sciatica, piriformis symptoms, groin pain or hip pain. Often, women get treated for these with typical orthopedic treatments that may work for a time, but for some, symptoms inevitably return. Why? Because the pain in the hip is not coming from the hip itself. That is a just a symptom of the actual problem. In fact, the WHOLE pelvic girdle needs to be assessed, inside and out. In doing so, we are able to address and balance out the muscles to optimize your pelvic girdle stability and get to the true culprit of your pain.
At The Restoration Space, we evaluate and assess your whole pelvic girdle for any culprits creating instability and resulting muscle imbalances and determine whether an internal pelvic floor evaluation is appropriate. Once your comprehensive pelvic girdle exam, we will implement a multi-system approach for patients utilizing orthopedic, respiratory and pelvic floor perspectives. Most importantly, we educate you on how your body is meant to move, correct any movement compensations and then transition these corrections into your activity. We provide guidance during the activities you want to return to, and may even do this in conjunction and direct collaboration with our partnering yoga and pilates instructors, exercise physiologist and running experts.
Conditions this service can assist with are but not limited to: Hip pain, sciatica, piriformis syndrome, chronic hamstring tightness and tendinopathy, ischial tuberosity bursitis, especially those who have not responded to traditional physical therapy and orthopedic treatments.
ANTEPARTUM & POSTPARTUM
A woman’s body experiences many changes during pregnancy. In this culture, we have tons of services during the prenatal experience: birthing classes, prenatal yoga, a plethora of websites and mommy blogs and even (if you are lucky!) prenatal massage. There is lots of pampering to take advantage of! But a lot of the education for expecting moms is about how the baby develops and how the body is accomodating the needs of this little being inside of you. What we don’t learn is how our muscles and joints are changing throughout our spine and pelvis and how these musculoskeletal changes can be challenging and even painful. Your needs during pregnancy are unique and often change as your pregnancy progresses. And they certainly may not restore back to pre-pregnancy once you have the baby.
As mentioned above (see pelvic girdle), pregnancy wreaks havoc on the pelvic joints. It is similar to spraining your ankle. Have you ever rolled over your ankle, like off a curb? Once that happens, your ankle is more prone to this happening again, because your ligaments and tendons (the things that hold everything together and control movement) have been stretched out. If it happens again, you are at an even higher risk for yet another repeat. Pregnancy is like spraining your pelvis, a few times over, in the course of 9 months! Learning how to stabilize and support the pelvis with the muscles surrounding the pelvis is the key to preventing the instability from turning into a snowball effect. Knowing and understanding your body and these changes is the key to that stability. Knowledge in this case is not just powerful, it is empowering.
Similarly, the knowledge of how your pelvic floor is taking on a ton of responsibility throughout your pregnancy, during your labor and in your post-partum recovery will improve the entire physical experience of all of these stages. We can make sure it is working for you and not against you. We can help you prepare these muscles for delivery, and make sure your body is comfortable in birthing positions to put these muscles at an advantage instead of a disadvantage. We can guide you, even before you have the baby, on the things you can do almost immediately post-partum to promote safe healing, allow your body to restore and greatly reduce chances and/or severity of many post-partum conditions, like incontinence, sciatica, pain with intercourse or pelvic pain.
If we had our way, we would evaluate every pregnant woman after she has her 8-10 week prenatal visit. Because changes begin happening in your body that early! It may seem crazy (for you first timers, you will probably not even be showing for another 2 months!) but the earlier we can teach you how to adapt with and retrain some of these changes in your body, the more likely you are not to NEED us for the aches and pains that many women experience in 2nd and 3rd trimesters. We can guide your muscles, joint and movements throughout your pregnancy, just as the doctor ensures that the baby and your belly are growing the way they should. It would be an honor for us to be a part of your prenatal experience, help you prepare for labor and delivery and guide your body to heal and restore after you delivery that beautiful baby. As an added bonus, we may recommend (and always offer) a free consult with one of our independent practitioners who want to collaborate with us to care for YOU as your body cares for your baby.
Conditions this service can assist with are but not limited to : low back pain, instability of the sacroiliac joints and your pelvis, sciatica, rib pain, carpal tunnel syndrome, postural changes, round ligament pain, vulvar varicosities, coccyx pain, pubic symphysis pain, and pelvic floor muscle dysfunction.
Our bodies go through crazy changes in just a short 9 months. And then, even more quickly, the body is supposed to adapt to life without that life inside of us. But, as you have likely noticed if you have had a baby, things don’t just go back to the way they were. The more we understand those changes, the easier it is to consciously correct them and gently guide the body back to how it once was. Maybe even better.
Clinical research supports that rehabilitation after a normal or challenging delivery or pregnancy can prevent incontinence, prolapse, and/or sexual dysfunction. After any type of pregnancy and delivery, balance the muscle of the abdomen and the pelvis (strengthen things that were stretched, lengthen things that were shortened) and regain stability surrounding the pelvic girdle so that you may SAFELY and EFFICIENTLY return to activity and exercise. In days of youTube and Instagram, there is too much information from uncredentialed bloggers that may be causing us more harm than good. In times of social media, celebrated celebrities on magazine covers and (un)reality TV, the expectation to return to a fit figure and a flat tummy is magnified and causes us to try to strengthen our bodies before they are ready, and also may be causing more harm than good.
I am a strong believer that, as a culture, we are failing our mothers today in the post-partum period, especially compared to other countries. In fact, in France for one, post-partum physical therapy is as much a part of the post-partum care system as visits to the pediatrician or the lactation consultant. The French government actually pays for 10 post-partum PT visits to promote education and correct healing of your abdominals, pelvis and pelvic floor after delivery. Mind-blowing. But it shouldn’t be. It should be our norm.
In this country, we do well for the mother-to-be. But almost as soon as we hear that first cry, the focus of the care shifts to the baby. And as much as this new little life needs all the love and care it can get, the mother is quickly forgotten. So in a time where everyone is willing to take care of that gorgeous little baby, let US take care of you. We will help your body heal, recover and restore. We will be the place you can come take a breath (and we’ll even teach you how to do that more effectively), feed your baby (even guiding your postural muscles to work for you instead of against you), heal any incisions, see if those pelvic floor muscles are even still there (yes, we promise they are), check for any remaining weaknesses or muscle imbalances (yes, we promise they are likely still there too). We will help you with all of this and more. We will examine your body, and TEACH you all about what in the world it just went through, how to get it working the best it ever has, and, most of all, show you how amazing it is. Shower or don’t. Wear your comfy yoga pants or wear makeup for the first time all week to feel a bit human. It doesn’t matter. This time is for YOU. This is YOUR space, mama.
At The Restoration Space, we offer a HANDS ON, ONE ON ONE comprehensive post-partum program that includes re-strengthening of the pelvic floor and abdominals, correcting Diastasis Recti (or abdominal separation, present in more than 2/3 of pregnant mamas, increasing with subsequent pregnancies) and reversing your new mom posture of slumped shoulders, creating upper back pain. We will help you stabilize your pelvis to prepare for a return to activity and exercise, even if yours simply entails wearing, holding, lifting and carrying your baby. And once your body is ready, we will progress you to an individualized wellness/fitness program. If needed, we teach you to mobilize your C-Section scar, perineal tear or episiotomy scar as well. And, if appropriate, we may recommend a free consult with our partnering integrative practitioners will collaborate with your physical therapist for the most customized, aligned, post-partum restorative program in the area.
Conditions this service can assist with are but not limited to: Treatment of C-section scar, perineal tear or episiotomy, pubic symphysis pain, coccyx pain, painful intercourse, urinary or fecal incontinence post delivery, frequency and/or urgency of urination, SI joint pain, abdominal separation (diastasis recti), safe return to exercise.