COMMON ≠ NORMAL

All too often I hear things like, “oh ya, I pee my pants when I run but I’ve had kids so it’s totally normal and that’s life.” Or, “I can’t jump on the trampoline with my kids because I pee my pants and I just live with it.” I hear this one less often than the “pee my pants” one but, in my opinion, hearing it once is one too many times, “sex is uncomfortable and less enjoyable after having kids.”

My newest schtick is educating on the saying “common does not mean normal.” Yes, leaking urine after having children is common. Muscles, fascia, ligaments all get stretched out during pregnancy and childbirth. This can cause changes in strength and alter the ability of the muscles of the pelvic floor, core and glutes to function correctly and in unison. These changes will affect your ability to create pressure enough to close off the urethra (where our pee comes out) and possibly your rectum and can lead to unwanted leakage. However, just because these changes and stretching happens during pregnancy and with childbirth, does not mean long standing effects from these are normal and should be lived with.

Along with urinary incontinence, I also hear women stating that their experience sexually is uncomfortable and marginally (sometimes extremely) painful ever since having children but they live with it because “that’s just what happens after experiencing childbirth.” Again, things do get stretched, pulled, irritated, torn, changed, during pregnancy and childbirth and some women experience these more than others. However, living with less-than-satisfactory sexual interactions that are considered to be due to the physical act of childbirth should not be considered normal and do not have to be “lived with”. Pelvic floor physical therapy can conservatively and effectively help to decrease incontinence and dyspareunia linked to childbirth. Whether you are 6 weeks postpartum or 6+ years, pelvic floor PT can help make a difference and improve your quality of life.

Here are a few reasons why you may be having incontinence or dyspareunia:

• You had tearing during childbirth that was stitched. Everything is back together and that is great. However, you may have scar tissue from the tearing. Scar tissue can grow like a spiderweb below the scar and adhere onto other structures. This adhesion pattern will affect the muscles ability to contract and relax appropriately thus decreasing strength. Adhesions can also cause pain. Similar to when you pull a bandaid off of your skin, scar tissue that has adhered down can pull on structures and cause pain.

• You think you are performing kegels correctly but you’ve never been formally taught or checked. I have treated many women who say they are doing their kegels religiously but still leak. When I do an internal examination I find that they are squeezing their glutes and abdominal muscles but have very little activation in the muscles of the pelvic floor; the ones that ultimately keep us from peeing our pants!

• Tightness! Muscles cannot be strong if they are too tight. Imagine that you can only straighten your elbow 50% of the way. Your bicep muscle (the one that bends your elbow) can only be 50% strong. For it to have 100% strength, it must be able to stretch out fully. This concept is the same for the pelvic floor muscles and is actually heightened due to the size of the muscles “down there”. The pelvic floor muscles are small and do not have much excursion (amount of distance a muscle can stretch and then contract) to begin with. Therefore, if they are at all tight, the strength is going to be severely affected.

How can we help these things?

1. Learn how to correctly contract and relax your pelvic floor muscles (also known as doing kegels). The best way to do this? Go see a pelvic floor PT who does internal work!

2. Assess for tightness around the hips, groin and pelvic floor muscles. Again, a pelvic floor PT who does internal work will best be able to assess this for you.

3. Work to decrease scar tissue adhesions through manual internal release.

Remember, common does not have to mean it is your new normal! You can do something about your pelvic floor symptoms and improve your quality of life!

Contact Verity Physical Therapy & Wellness today to schedule your assessment!

REHAB LIKE AN ATHLETE AFTER HAVING A BABY

So you just had a baby? CONGRATULATIONS! Now, rehab your body like an athlete who just had ACL reconstruction. Well, not EXACTLY like that but the point is, rehab after having a baby is just as important to your quality of life and function as is rehabbing after a major orthopedic surgery. Why? Pregnancy and childbirth are beautiful and natural things that women have been doing since the beginning of human history but it is also 9 months of muscles stretching out, increased lordotic pressure on your low back, and ligaments becoming more lax, to name a few. For as long as women have been having babies, they have also been having pain and dysfunction that result from the childbearing process. Again, childbearing is beautiful and natural, but what if we approached it like we approach orthopedic surgeries? A good orthopedic surgeon will instruct you to attend a few physical therapy sessions prior to your surgery in order to learn the exercises and strengthen before you go through the surgical trauma. After the surgery, the orthopedist will IMPLORE you to follow a specific rehabilitation protocol with the guidance of a physical therapist for multiple weeks, if not months, to ensure you return to your pre-injury self. Now don’t get me wrong, I’m not saying childbearing is an “injury” or women’s bodies are fragile and on the verge of shattering during pregnancy. I believe the complete opposite! Women’s bodies are AMAZING and do incredible things….like CREATE HUMANS! We are anything but fragile. However, it is just plain science; growing a human in your body and then either pushing it out vaginally or having it surgically removed via a C-section, is harsh on the body and no matter how strong that body is, rehabilitation afterwards would do that body good! Just like even the strongest athlete will still need to follow a rehab protocol after having ACL surgery, a woman would greatly benefit from following a simple rehab program after having a baby. 

Here are a few points on why I think pelvic floor physical therapy is so important for the pregnant and postpartum momma:  

• The pelvic floor is made up of muscles, tendons, ligaments, blood vessels, nerves, and bones just like any other joint/area of our body…so why not treat it like we do the knee or shoulder when it gets injured or stressed?

• Prehab physical therapy helps the brain learn what it will need to do after surgery/childbirth when the connection is “fuzzy” : When the body goes through a traumatic event, like ACL reconstruction or vaginal child birth, the muscles around the trauma site will seize up, freeze, and stop working properly. One of the first exercises you would do in ACL rehab is a Quad set. This exercise is an incredibly simple contraction of the thigh muscle but, post-ACL reconstruction, it can be unfathomably difficult to perform. It is very helpful to already have a knowledge of this exercise prior to surgery so that when you start rehab, your brain will “remember” that exercise and you will have an easier time recruiting the muscle again. This same thought process can be applied to kegels (pelvic floor muscle contractions). If you are proficient at kegels prior to childbearing because you saw a pelvic floor physical therapist, your ability to re-recruit these muscles after giving birth will be much easier and your strength will return more quickly. Prehab has been shown to improve outcomes after ACL reconstruction. If it works on the knee joint and surrounding muscles, why can’t prehab help improve outcomes after childbirth? IT CAN and IT DOES! 

• In France, pelvic floor physical therapy is prescribed to every momma after giving birth, no matter what, and that is how it should be here too! Not every woman will need extensive therapy, but every woman should be checked by a physical therapist to make sure strength of the pelvic floor muscles is returning to normal and screen for prolapse and other dysfunctions that could lead to issues down the road. 

• We are doing a total disservice to women by telling them to “do nothing” for the first 6-weeks postpartum. Many women are told to “do nothing” for the first 6-weeks postpartum and then told they can go back to “life as usual” after the 6-week checkup. First of all, I don’t know any women who are able to “do nothing” for the first 6-weeks postpartum as they are caring for their newborn. ESPECIALLY those mommas who have other children. At the very least, momma is squatting to sit on the toilet and into and out of chairs, carrying a car-seat  with their infant (for a likely total minimum of 20 lbs) around to the multitude of doctor appointments that the baby gets after being born, and bending over countless to lift baby up from where they were sleeping. This is NOT NOTHING and, most of the time, is unavoidable. So why not say, instead of “do nothing for 6 weeks”,  “Hey momma, your body just went through a lot. You did great! But also, it would be really beneficial if you focused on some rehab exercises with a pelvic floor PT for these next 6-weeks so that when you are carrying that 20+lbs car seat with your baby in it, you don’t develop prolapse, incontinence, or other issues that can come up after giving birth!”  

• We are doing a total disservice to women by telling them to return to “life as usual” at the 6-week mark, after 6-weeks of “nothing”. On the flip side, returning to “life as usual” after following your doctor’s orders of “doing nothing” for 6 weeks can lead to injury and dysfunction. You don’t sign up for a marathon and then run it the next day (hopefully). You sign up for a marathon and then train for it for 3 months. Many women self-limit their exercise and activity as they progress in pregnancy due to discomfort and fatigue. If you stopped doing most exercise at 8 months of pregnancy, and then took the following 6 weeks off postpartum, that’s over 3 months of unusually sedentary life. Jumping right back into what you did before you were pregnant is a recipe for injury! 

Pelvic floor physical therapy after having a baby is not rocket science; the wheel has not been reinvented. The only difference is that the rehab is generally in a more sensitive area of the body. The concepts around muscle healing and strength gaining are the same. Rehab your body like an athlete! It is the only body you have! It does amazing things but sometimes, it needs a little extra help along the way.

Interested in postpartum rehab? Find more information on the programs that I developed to specifically bridge the gap for the postpartum woman here: Verity Postpartum Rehab Programs

Physical Therapy Exercises are BORING

I’m a physical therapist and I LOVE what I do. I love teaching people about their bodies. I love educating and instructing in proper exercise performance. I love educating on injuries, how to prevent them and how to recover from them. I love it all! I am also the first to admit that, despite how great it all is, when it comes down to the nuts and bolts of rehabbing from an injury or surgery, PT IS BORING! The actual application of all the knowledge bombs I drop, the actual performing of the prescribed exercises, the time commitment, is boring/tedious/monotonous…whatever adjective that you want to use! At the end of the day, doing your physical therapy exercises tends to be the last thing you want to do. I understand. I have been there and am CURRENTLY there. For the most part, I know what to do whenever an ache or pain pops up, but I still struggle to do my exercises day in and day out. Why? Because I would much rather be doing almost anything else than doing my boring PT exercises. 

Time to do my exercises. I get down on the ground to start my, what feels like millionth, clamshell exercises and suddenly I notice that the baseboards urgently need to be wiped down! I walk to my closet to grab my foam roller and, oh my, I MUST sort through my clothes and make a donation to Goodwill ASAP. I stand at a window to do my hip abductions and wow, my entryway is in desperate need of sweeping….you get the picture. It is amazing how chores that I typically despise doing suddenly become a labor of love when it is time to do my exercises. 

My entire profession is based on exercise and movement modification for pain reduction, injury recovery, and injury prevention. Unfortunately, most of the time, those exercises and movement modifications are monotonous and we “fall off the wagon”. My advice: DON’T! Do whatever you need to do in order to stick to your physical therapist prescribed exercises. They DO work, but it will require you to be committed to them. Find a way to make them a habit and stick to it. Side note: Atomic Habits is a fabulous book about, you guessed it, habits. If you are curious about how we make new habits or break bad ones, give it a read! One suggestion from Atomic Habits, for when you are trying to build a new habit, is to attach the new habit to a pre-existing habit. For example, if one of your exercises is heel raises, try doing your heel raises while brushing your teeth (if brushing your teeth is already a tried and true habit…which hopefully it is haha). 

I can’t stress enough how important doing your physical therapy exercises actually is! In addition to my three and a half years of graduate school education, anecdotally I know that doing your home exercise program WORKS. I have a labrum tear in my right hip which was confirmed via MRI eight years ago. Luckily, thus far my pain and dysfunction from the tear have not gotten severe enough for me to pursue surgery. However, I have had bouts of pain from the tear which sidelined me from running for weeks and sometimes months at a time. The times that my pain resurfaced were, without a doubt, the times that I was less focused on my rehab exercises. More recently in my life I have gone over a year without a flare up! That year included earning a Black Shirt in the Dipsea, finishing 4th female at the Waldo 100k, finishing 1st female at the 2022 Labor Day Tam Climb race, finishing 3rd female at the Solomon Women’s Trail 1/2 Marathon, three Ride&Ties, on 50-mile endurance horseback ride, weekly track workouts, and countless Wednesday morning SFRC group runs to the top of Mt. Tam…to name a few of my activities I’ve been involved in :) 

This past year has been filled with miles and miles of exciting exercise that in the past, would have caused me to have increased hip pain and forced me to dial it back. What makes this year different? A lot of things of course! I would not be being true to my ethics if I were to say that doing my PT exercises were the sole reason why I have not had issues with my hip. However, I know, without a doubt, that I have been much more dedicated to my rehab exercises than I have ever been. For over a year now I have consistently done my home exercise program at a minimum of three times per week and I know that that consistency, in the face of boredom and monotony, has made a difference in my ability to run further and faster than ever! 

Do your rehab exercises folks! They do work. They take time and consistency. You will NOT see overnight results. You WILL have days where you think it is a waste of your time. You WILL get bored. But, it will be worth it and at the very least, you will get stronger! 💪🏼

Desensitizing the Pelvic Floor: One poop, pee and orgasm at a time!

I’m a pelvic floor physical therapist which means I casually talk about the things that most likely make you uncomfortable: pooping, peeing, sex, orgasm, pain in your vagina and penis…..yes, I just said vagina and penis and sex all in one sentence. These words have become normal, everyday things that I talk about. I no longer wince and I can openly have a conversation among friends describing what I do for a living. Although, sometimes I do wait until after dinner is finished to really get into the nitty gritty! 

It is (one of) my mission(s) to de-stigmatize and encourage more open, matter-of-fact conversations about the pelvic floor and ultimately what the main point of having a well-functioning pelvic floor is; to painlessly excrete waste (urine and feces), support our pelvic organs, and provide enhanced sexual experiences. There are a couple other functions of the pelvic floor but those three are the most exciting ;) 

So, since we all poop and pee daily (well, hopefully daily...if not, maybe you should call me) and we all want our organs to stay in place and a majority of us crave some form of sexual pleasure (it is 100% okay if you don’t), why can’t we talk about it? I’m not saying we need to discuss every time we have a bowel movement and what it looked like. BUT, if these topics weren’t so taboo in our society, then when something wasn’t feeling quite right, we might be more apt to bring it up with a friend, family member or healthcare practitioner and get the help we need sooner rather than later. 

Pelvic floor physical therapy is much more than teaching how to perform kegels. As a physical therapist who specializes in pelvic floor, I teach how to integrate your entire core (pelvic floor, diaphragm, deep back muscles, and the deep abdominal muscles) into your every day routine. I educate on how breathing can make a significant impact on chronic pain, indigestion, and how breath can help you learn how to activate muscles. I talk about proper positioning for having a bowel movement and how many seconds you should pee for to know that you are in control of your bladder and not the other way around. I focus on bringing the “black box” of the body out into the light, educating on it, and help to make talking about it less stigmatized. The more we feel comfortable talking about these things, more people will know about conservative measures for their pain and dysfunction; less unnecessary surgeries will be performed and less people will suffer thinking they are alone in their pain.

Want to talk about all things related to pelvic floor, learn about your entire core and how to use in to improve function and strength, or know you need to see a pelvic floor PT and just haven’t made it happen? Contact me today and let’s get the conversation started!

Can You Prevent Perineal Tear During Labor? What the research says!

Have you ever wondered if there was a way to reduce your risk of experiencing a perineal tear during vaginal delivery? Well, there are things you can do proactively to try to prevent tearing but the jury is still out on whether it actually helps. Just like how the jury is still out on whether the type of stretching (active vs. static) and stretching pre- or post-activity will actually help prevent injury in sports, the research is limited and somewhat inconclusive as to what you can do to help prevent perineal tears during vaginal delivery.  So let’s talk about it!

First off, let me explain some basics:

Spontaneous tears during vaginal delivery happen in 44-79% of women (Soong and Barnes 2005; Dahlen, Homer et. al. 2007) and the tears can range from a 1st degree tear (tearing only of the perineal skin) to a 4th degree tear (perineal skin, muscles, anal sphincter and surrounding tissues). 4th degree tears happen in in 0.25%-2.5% of spontaneous vaginal births (Byrd, Hobbiss et. al.2005; Groutz, Hasson et. al. 2011).

What does the research say?

In 2006 Beckmann and Garret combined the results from four high quality research studies done on perineal massage and its effectiveness. They found that women who were assigned to do perineal massage had a 10% decrease in their relative risk for perineal tears (relative risk - the number that tells you how much doing something you do, such as maintaining a healthy weight, can change your risk compared to your risk if you’re very overweight).  So, if your absolute risk for experiencing a spontaneous perineal tear during vaginal delivery is 35% and you do a perineal massage as prescribed to decrease your relative risk by 10% then you will have decreased your absolute risk for experiencing a spontaneous perineal tear from 35% to 31.5% (0.35x0.1=0.0315). These findings are for first-time moms only.

Other findings:

• Second-time moms who had delivered their first child vaginally did not have a decrease in perineal trauma (any tearing that requires stitches) whether they followed a perineal massage protocol during pregnancy or not.

• Second-time moms who followed a perineal massage protocol did report a 32% decrease in the risk of ongoing perineal pain at three months postpartum.

• Perineal massage during pregnancy decreased the overall risk of perineal trauma (any tearing that requires stitches so this includes non-spontaneous tears such as an episiotomy) but the research is too weak to see if there are any differences in outcomes of types of tears (1st-4th degrees)

To massage or not massage?

As long as you are not massaging and stretching into pain then I say go for it! As a pelvic floor specialized physical therapist with a background in sports and orthopedics, I tell patients who ask about stretching before running or other athletic events that the research is inconclusive so as long as it feels good to you and you are not stretching/massaging into pain then they should do it. I take the same approach with my pregnant mommas. If you feel comfortable doing it and you are not causing pain then go ahead. Will you not experience a perineal tear during vaginal delivery if you do perineal massage? The research says that it does not make much of a difference. However, it can’t hurt (as long as you are listening to your body and not pushing into pain) so why not right?

My biggest piece of advice I give to expecting mommas who want to be proactive with their musculoskeletal health is to pay a visit to a pelvic floor physical therapist in the 2nd trimester. You will learn how to correctly contract and relax your pelvic floor muscles, how to do a self perineal massage, and other stretches and exercises that will set you up for a speedier and healthier recovery postpartum. The research DOES show that pelvic floor physical therapy during pregnancy improves women’s outcomes postpartum!

Have questions? Don’t hesitate to contact me! I love helping women navigate the beautiful waters of pregnancy and postpartum life! There are resources out there (me!) for expecting and postpartum mommas so why not use them?!

carolyn@verityptw.com

615.604.5367

STOP PEEING AT NIGHT: How proper sleep habits will decrease the need for nocturnal urination

What do your pre-bed/sleep habits have to do with the pelvic floor? Well, not a TON but, I promise to make the connection. As a pelvic floor physical therapist, I teach that it is not a healthy sign if you have to get up to pee in the middle of the night. When a patient reports that they do get up once, twice, three times per night to go pee I will discuss things like bladder irritants, hydration intake before bed and teach habits to “retrain” the bladder. These things are all very important to continue working on but there’s another aspect to why we shouldn’t be getting up in the middle of the night to pee; it’s a sign that we are not reaching the very important REM (rapid eye movement) cycle! 

A lot of great things happen in our body during REM. It is a very important stage of sleep that influences learning, memory and mood. It is also one of the times when antidiuretic hormone (ADH) is released. ADH’s most important role is to conserve the fluid volume of your body by reducing the amount of water that is passed out through the urine. When fluid needs to be conserved and not expelled, ADH secretion increases and we urinate less. When we are properly hydrated, ADH secretion decreases and we urinate at the normal amount (every 2-3 hours and the flow should be strong for 8-12 seconds). 

ADH plays an important role in hydration but it also plays a huge role in our ability to sleep through the night! A well-hydrated adult should need to urinate every 2-3 hours. So, how are we supposed to be able to sleep 8+ hours straight without urinating? ADH! When we fall into REM sleep, ADH release is increased which decreases the amount of urine that is produced, we do not have to pee as much and, voila! We are able to sleep without peeing! 

The takeaway:

If you rarely fall into your REM sleep cycle, your ADH secretion will not increase, you will continue producing urine at the “daytime” rate and you will inevitably have to pee during the night. 

What to do about it:

Practice good sleep habits so you can fall into your REM cycle, increase your ADH production and NOT have to get up in the middle of the night to pee! If you chug a 32 ounces of water an hour before bed then inevitably you may have to get up to pee. Also, alcohol prevents ADH release which will cause an increase in urine production and dehydration. So, if you had a glass of wine before bed, this most likely will cause you to have to pee during the night. 

Healthy Sleep Habit suggestions: 

1. Set a consistent sleep schedule - go to bed at roughly the same time each night. 

2. Have regular bedtime rituals - take a bath, listen to music, meditate. These should be relaxing activities and so that you cue your body that it is time to go to sleep. 

3. Get regular exercise but make sure it is at least 2 hours before bedtime. 

4. Limit caffeine and avoid nicotine - these are stimulants and will interfere with your sleep. Try to stop caffeine intake after 12. Withdrawal from nicotine will initially interfere with sleep. However, once you are past the withdrawal phase, you should be able to sleep better (studies show).

5. Don’t eat a meal right before bed. Try to eat dinner at least 2 hours before bedtime. A light snack before bed has been shown to promote sleep however. 

6. Avoid alcohol - although alcohol is a sedative and initially promotes sleep, it will interfere with the quality of sleep; you will wake more often and might have increased nightmares.

7. Keep naps short to increase your “sleep debt” during the day to help you fall asleep easier. 

8. Use your bedroom for sleep (and sexual interactions) only! Try not to eat, watch TV or use other electronics in bed. You want to associate your bedroom with sleep and not other things that might trigger stress. 

9. Stop screen time 2 hours before bed - using screens (TV, cell phones, tablets, laptops) can damage our biological clock. The light emitted “confuses” our brain and makes us think its daytime.

10. Make sure your bedroom is cool, quiet and comfortable!

INJURY SPOTLIGHT: The Role the Obturator Internus Plays in Hamstring and Hip pain

Do you have hip pain? Do you have hamstring pain? Have you been told that you have hamstring syndrome? When asked to describe where your pain is, do you feel like you need to point “up there” to really pinpoint the location of pain? If you answered yes to any of these questions, your obturator internus muscle could be contributing to the pain and dysfunction that you are experiencing.

The obturator internus (OI) is a hip muscle that originates deep within the pelvis, wraps out and inserts on the posterior aspect of the femur head (the top of the thigh bone when it combines to form the hip joint). The main movement function of the OI is to rotate the leg externally. In addition to external rotation, the OI plays a major role in stabilizing the hip joint and is an important pelvic floor muscle.

The picture on the right is depicting the OI in green and is being viewed from behind.

Muscle Dysfunction and Trigger Points

Just like any other muscle in the body, the OI can become dysfunctional and trigger points (TrP) can arise for various reasons. In general, TrPs are an involuntarily contracted group of muscle fibers within a whole muscle. Because the TrP is involuntarily contracted and we cannot consciously relax the muscle fibers, blood flow is restricted to that area of the muscle as well as surrounding nerves and other tissues. This decreased blood flow can then result in hypersensitivity directly at the site of the TrP as well as aching pain in and around the area.

TrPs can be latent or active. A latent TrP is one that does not cause pain unless provoked, like with direct pressure during a massage or foam rolling. An active TrP is one that is painful without provocation. A latent TrP has the ability to become active and therefore start causing unprovoked pain. Both latent and active TrPs have the ability to refer pain to other areas of the body based on the referral patterns of the muscle that the TrP is in. OI trigger points can refer throughout the hip and leg on the side that it is originating from and often refers pain into the posterior hip (glute region) and hamstring. This common referral pattern is a large reason why many patients do not have resolution of pain after treatment of a hamstring or glute syndrone diagnosis; their pain is manifesting in the posterior hip and/or hamstring but the origin of the pain and dysfunction is from the OI muscle.

Is it the OI?

Having had personal experience with OI Dysfunction and treating patients with the issue, I have found that there are a few initial cues that help to tease out whether a patient is suffering from OI dysfunction versus hamstring, piriformis and/or gluteus medius syndromes. The first major sign is that the patient has difficulty pinpointing one location of pain. This is because of the many different referral patterns that the OI muscle has. Patients might say one day that they have pain on the outside of their hip or the pain is in the buttock region. Then, on another day they might describe a burning-type of pain at the insertion of the hamstring muscle at the “sit bone”; or maybe all three at once. Upon further investigation of these muscles with deep palpation, the patients might report that there is soreness in the area but that is not their “familiar pain”.

The next appropriate question focuses on locating where the exact familiar pain is as best as possible. This can be achieved by ruling out other muscles first. When asking a patient to pinpoint the exact location of the majority of their pain I ask it three ways. First, I ask by pointing to a spot directly over the piriformis muscle. Second, I point to the origin of the hamstring muscle at the “sit bone” (red arrow). And thirdly, I ask is it “up there” (green arrow)? If with deep palpation just medially to the “sit bone” and above the bottom of the butt cheek, familiar pain is reproduced you could be suffering from OI Dysfunction.  

OI Dysfunction Symptoms

The pudendal nerve runs in close proximity to the OI muscle. If there are latent or active TrPs in the OI, the pudendal nerve can get irritated and cause nerve symptoms such burning, pins and needles, shooting pain into the pelvic floor area or weakness of the pelvic floor muscles. The pudendal nerve is highly involved with pelvic floor functions such as helping to maintain urinary and fecal continence through innervating many of the pelvic floor muscles as well as providing sensation to the genitalia. Entrapment of the pudendal nerve is very rare and mostly seen in professional cyclists, however, irritation of the pudendal nerve can cause pelvic floor dysfunctions and the OI muscle could be playing a part in that irritation. Alleviating the irritation through manual work to the OI muscle, stretches and tailored exercises can significantly reduce symptoms and help prevent more permanent injuries that may occur with prolonged nerve irritation.

Many patients seek physical therapy to alleviate their hip and leg pain that they experience with running and biking but do not have full resolution. Evaluation and treatment of the pelvic floor, specifically the OI muscle, can significantly improve symptoms and help patients return to their sport pain and dysfunction free!

Carolyn Yates, PT, DPT is an athlete herself and is skilled in treating all musculoskeletal pains and disorders. She has taken extensive continuing education courses on how the function and mobility of the pelvic floor can effect your athletic abilities.

Verity Physical Therapy & Wellness can help you through any musculoskeletal pains or dysfunctions you may be experiencing. Contact Verity today to schedule an appointment.