Decreasing Diastasis Recti in Subsequent Pregnancies
Diastasis recti in a postpartum patient, shown in the top photo below, is 3 finger width. The test being performed is a standard manual measurement whereby the patient curls their head up off the surface (as in a classic mini crunch) and the therapist measures the distance between the rectus abdominus muscles. The botttom image is showing the recti edges delineated via manual palpation, so one can confirm the findings. We also measure the inter-recti distance via rehabilitative ultrasound. The linea alba, the thick connective tissue structure that connects the left and right abdominal recti...
Read MoreBladder Rentention
In this photo we are measuring post residual void using rehabilitative ultrasound in our office! Post residual void is the amount of urine left in your bladder after you have urinated. Believe it or not there usually is a small amount of urine left in the bladder after emptying it, which is considered normal. In other words, it does not completely empty when you urinate. The volume of post residual void which is normal in patients over 65 is less than 50 mL; less than 100 mL is considered acceptable, but is considered abnormal in younger patients. Patients sometimes feel bladder pressure,...
Read MoreLow-Level Laser Therapy
Low-level laser therapy (LLLT) is a form of cold laser which uses only light energy to stimulate healing at the cellular level. Here you see expert pelvic physical therapist, Luba Starostiak, treating a patient who has an acute flare of mid back pain after receiving chiropractic manipulation in another clinic. Cold laser can quickly calm a painful area. The patient does not feel any heat from its use hence the term “cold laser”. Clinical applications include use in wound healing, tissue regeneration, and pain reduction. LLLT promotes vasodilation which improves blood supply and...
Read MoreSacrotuberous Ligaments (and Pregnancy)
Tension in the sacrotuberous ligaments hinders pelvic mobility, causes misalignment of the pelvis, sacrum, or coccyx & may result in tension in the pelvic floor muscles, hamstrings,or cause compression to the pudendal nerve. This results in less efficient vaginal delivery/childbirth, low back pain, or pelvic pain. In this image an external palpation of the sacrotuberous ligaments in all-fours position is achieved. This image is taken while attending a seminar on breech position in pregnancy. Other positions to assess the ligaments might be prone (our pregnancy treatment tables have...
Read MoreHip Pathology Affects Pelvic Pain
Hip pathology can be a cause of chronic pelvic pain – many patients with pelvic pain and pelvic floor muscle dysfunction have an underlying or related hip disorder. Here is an image of us performing a hip mobilization using a mobilization belt. This technique helps to relax the hip muscles, reduce pain, improve range of motion, reduce joint compression, and stretch the hip. Studies show that a number of patients with chronic pelvic pain have hip impingement syndrome (FAI – femoral acetabular impingement). There are 3 types of FAI. CAM deformity (or camshaft), Pincer, or combined...
Read MoreRelieving Coccyx Pain Through Manual Therapy
One structure that is a common cause of tailbone pain is the anococcygeal ligament. This ligament attaches the anal sphincter to the coccyx. Your physical therapist should be palpating for pain, tension, thickening, and integrity. Many times this ligament is damaged or sprained from a fall or other trauma and can be a causative or perpetuating factor in coccydynia, chronic pelvic pain, sexual pain or pelvic floor overactivity in men and women. Here we are performing a palpation assessment of the ligament and if needed manual therapies such as cross friction massage and myofascial release...
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