Ruling out Hip Impingement as a Cause of Chronic Pelvic Pain
Femoroacetabular Impingement (FAI), also known as Hip Impingement, occurs when there is abnormal contact between the femoral head and acetabulum during motion. FAI and the muscle imbalances around the joint can alter hip and pelvic biomechanics during gait. Performing range of motion testing of the hip and special orthopedic tests such as the FADIR may help diagnose the issue. With the patient supine with one leg extended, flex, adduct, and internally rotate the hip. The test is positive if this reproduces the patient’s anterior groin or anterolateral hip pain. In patients with FAI there is...
Read MoreWinter/Spring 2018 Newsletter
Featured articles include Osteitis Pubis, Retraining the Pelvic Floor in a Pilates Instructor, and Hip Impingement Can Cause Pelvic Floor Muscle Pain. To view the newsletter, please click here.
Read MoreHelping Reflux with Physical Therapy and Dietary Changes
There are 2 types of reflux that patients suffer from. Laryngopharyngeal reflux (or LPR) is when stomach acid comes up into the throat. A common treatment for this is a proton pump inhibitor oral medication. Gastroesophageal reflux or GERD involves a backup of stomach acid into the lower esophagus. We treat GERD and LPR via visceral manipulation, spinal joint mobilization, corrective breathing pattern techniques, and other advanced manual therapies. Here we are performing a manual release technique of the lesser curvature of the stomach. This patient has decreased mobility and motility of...
Read MoreRetraining the Pelvic Floor Muscles in a Post-Partum Patient who is Training as a Pilates Instructor
Here we are using Rehabilitative Real-Time Ultrasound to help our patient downtrain the dominant use of her transversus abdominus muscle (a lower abdominal muscle). Many people who perform Pilates learn to overuse their lower abdominals instead of utilizing their pelvic floor muscles. The overuse of abdominal muscles during a pelvic floor contraction can create a downward force on the bladder. This is counterproductive because the pelvic floor contraction is to gain support of the bladder in an elevation pattern. The pelvic floor needs to contract in an “elevator fashion” upwards or...
Read MorePelvic Physical Therapy for the Transgender Patient
Our practice has been helping the transgender patient overcome pelvic pain and other symptoms they have due to transitioning surgeries. Dr. Morrison was the first physical therapist in the US to lecture nationally on the topic of physical therapy for the male to female transgender patient. She presented the surgeries they undergo, the overall costs, healing process, medications, post-operative pelvic pain issues, and how best to provide comprehensive care at the American Physical Therapy Association Meeting in 2012. Her audience included pelvic floor physical therapists predominantly. She...
Read MoreSacrotuberous Ligament Release to Help Prepare for Labor and Delivery
The sacrotuberous ligament is a structure that is under-recognized as important to assess and treat during pregnancy. The ligament runs from the sacrum to the ischial tuberosity and has connections into the tailbone and hamstrings muscles via connective tissue. It crosses posterior to the sacrospinous ligament creating an “x” or “t” depending on orientation.When taut the sacrotuberous ligament can cause the pelvis to become posteriorly rotated, cause tension in the same side pelvic floor muscles, inhibit needed coccyx or tailbone mobility for birth, be a source low...
Read More
