Ah, the question we get asked every single week: Do men have a pelvic floor? Typically this is coming from a new patient who is asking for their partner, a curiosity after learning about all that the pelvic floor does for individuals with a vagina, or because they see the penis pelvic model in the clinic and decide to ask. Regardless of why they are asking, the answer is: YES, men (or those born with a penis) do have a pelvic floor! If you think about the five functions of the pelvic floor it makes sense! The pelvic floor is key for:

If you have ever heard the word prolapse or have been diagnosed with a prolapse you are probably asking yourself: Why does prolapse happen? Let's set the scene. You are on the toilet, go to wipe and notice a new and weird feeling when you wipe. You grab a mirror Okay let’s be real, you likely grab your phone camera, and you see something that looks like it is falling out of your vagina. Yikes! Or maybe you go for a long hike and about half way through you start to notice something rubbing against your underwear and think ‘ What in the world is that?!’ In these scenarios it sounds like you may be experiencing a prolapse. The good news is that You are not alone. There is help for prolapse!

So, you noticed your baby has a head turn preference or someone mentioned torticollis… Now what? Maybe you do a quick Google search for “how to treat torticollis in babies” and aren’t sure where to start! First, let’s talk about what torticollis is. Torticollis is a condition where an infant’s head tilts to one side while their chin points in the opposite direction. This happens when the neck muscles—specifically the sternocleidomastoid muscle—become tight or shortened. Torticollis can be caused by several factors, including positioning in the womb, difficult delivery, or simply favoring one side while sleeping or sitting. In some cases, it may also occur due to congenital muscle tightness, known as congenital muscular torticollis. If left untreated, torticollis can affect your baby’s motor development , making it difficult for them to achieve key milestones such as rolling, sitting, or crawling. Because babies are growing so much each day, positive outcomes from therapeutic intervention are usually noticed as soon as a few days after beginning your baby’s personalized care plan! Here are 10 ways to support torticollis resolution . Keep in mind that, for optimal results, a clinician with specialized experience should be consulted to build a personalized plan to help your little one.

We are back to answer another one of those "wait, neurogenic what?" questions! Whether you have been Googling your symptoms or were diagnosed by a medical provider, you may be wondering “what is neurogenic bladder?” In this blog post we explain what neurogenic bladder syndrome is, how additional factors can impact our bladder, the common diagnoses associated with neurogenic bladder, and how pelvic floor physical therapy can help you manage your neurogenic bladder. What does neurogenic bladder mean? Neurogenic bladder occurs when you bladder control is impaired due to a brain, spinal cord, or nerve problem/injury that impacts the nerves that control the bladder. Neurogenic bladder is also commonly referred to as Neurogenic Lower Urinary Tract Dysfunction (NLUTD). Let’s talk anatomy. The bladder functions through a series of neural pathways and reflexes under a combination of voluntary and involuntary control. The bladder system communicates with the brain via our peripheral nerves and spinal cord, as well as with our pelvic floor muscles to coordinate bladder filling, storage, and emptying.

So, maybe you’ve heard the terms “torticollis” and “plagiocephaly” thrown around and wondered if they’re just fancy medical jargon or if they actually go together. ( Spoiler alert: they go together.) Let’s break it down! Torticollis: “Stiff Neck Syndrome” First things first, torticollis is like your neck’s way of saying it’s had a hard day at the office. Also known as “wry neck,” it’s when your little one’s neck muscles are so tight on one side that their head tilts to that side while their chin juts the other way. It’s a twisty predicament, but not a permanent one - thankfully. While some babies are born with torticollis (congenital torticollis) due to their position in the womb (especially common in breech babies), others develop torticollis (positional torticollis) during delivery (especially with forceps or vacuum assisted delivery), or prolonged positioning, such as only feeding on one side or not turning their head while sleeping on their back. Plagiocephaly: “Flat Head Syndrome” Now, on to plagiocephaly. This is the condition where baby’s head develops a flat spot, often resulting in a slightly misshapen or lopsided appearance. Think of it as a head that's had a bit too much time on one side—literally. Babies’ skulls are very moldable and quickly shift in shape when spending a lot of time in one position, and especially looking in one direction more than the other. This is why tummy time is so important! Plagiocephaly is most commonly seen in babies who spend a lot of time on their back with a preference of looking to one side almost exclusively, or spending time on their back without turning their head. It is also common in premature babies and those who spent time in the NICU. The Connection: Torticollis and Plagiocephaly—A Head-Turning Relationship Here’s where our twisty tale intertwines: torticollis can definitely lead to plagiocephaly. But why? Option 1: When a baby has torticollis, they favor turning their head in one direction, especially at rest. This head-turning habit can cause them to spend more time lying on the same side, putting pressure on that spot. Over time, this pressure can flatten one side of the head, leading to plagiocephaly. It’s a case of “I can’t turn my head, so my head physically becomes lopsided.” Option 2: These babies are often noted as having a preference in which direction to turn their head - so baby may spend most of their floor time (tummy or back) or in ‘containers’ (car seats, swings, bouncers, etc.) with their neck turned so they are always looking in the same direction. Occupational Therapy to the Rescue Enter the occupational therapist with a game plan to untangle the knots. We’re here to help correct that head tilt and encourage more balanced head positioning and related muscle symmetries throughout the body. Our toolbox is packed with play-based activities and positioning strategies to elicit the best results. Other tools may include infant massage or parent-led stretching. The goal is to get the baby's head to turn freely in all directions, reducing the chances of flattening and ensuring a more symmetrical head shape. Hips and arms will also likely be involved in the therapy dance. Treatment focuses on not only improving current presentations but also preventing further flat spots or muscle tension for complete resolution of symptoms. In summary, yes, torticollis CAN cause plagiocephaly. The twist? Not all babies with torticollis develop head flattening when early intervention is provided. Both conditions can be managed effectively when you have the right people on your team. With timely therapeutic intervention and parental involvement, you can set the stage for a happy, healthy, and head-rotating baby. So, let us work with you to twist and turn that neck to get your little one moving and grooving! Keep that head up—both literally and figuratively!

Did your physical therapist mention the option to add dry needling to your care and now you are wondering if you should do it? Anytime you consider starting a new treatment you always weigh the pros and cons right? So let’s go over the pros and cons of dry needling! First, what is dry needling? Dry needling is a technique that utilizes a thin needle to release trigger points and decrease tension in the muscle being treated. It can be used alone or in combination with electrical stimulation to treat muscles, tendons, and even scar tissue.

Whether you have been Googling your symptoms and stumbled upon it or you saw a medical provider who gave you the diagnosis, you may be wondering “What is neurogenic bowel?” In this blog post we explain what neurogenic bowel syndrome is, how additional factors can impact our bowels, the common diagnoses associated with neurogenic bowel, and how pelvic floor physical therapy can help you manage your neurogenic bowel. What does neurogenic bowel mean? Neurogenic bowel is an umbrella term used to describe any bowel condition that an individual may be experiencing due to a brain, spinal cord, and/or nerve problem/injury that impacts the nerves controlling and supporting colonic or gastrointestinal (GI) system function. Our bowels function through a series of neural pathways and reflexes under a combination of voluntary and involuntary control. The gastrointestinal tract is additionally regulated by its own nervous system called the Enteric Nervous System. Further, our GI system communicates with the brain via our peripheral nerves and spinal cord, as well as with our pelvic floor muscles to coordinate bowel filling, storage, and emptying. If there is an injury or dysfunction anywhere along these pathways, this can impact the body’s ability to move, store, or empty feces. Our patients that suffer with neurogenic bowel often report: Fecal urgency (a strong need to go) and/or frequency Fecal incontinence (leakage of stool) associated with urgency (trying to get to the bathroom on time) or stress on the system (cough, laugh, sneeze, or with activity like standing up or walking) Constipation including irregular bowel movements, incomplete bowel movements, harder-to-pass stool consistency, as well as feeling the need to strain to empty Bowel symptoms can be impacted by additional factors, such as: Functional mobility- Are you able to safely get to the bathroom on time to empty? Arm, trunk, and lower body mobility and dexterity- Any difficulties or discomfort with removing clothing/pants, transferring to the toilet, or maintaining a seated position on the toilet or commode? Schedule constraints- How much time do you have to complete your bowel routine? Dietary changes- What does fluid and nutrition, including fiber, intake currently look like? Fatigue- Are symptoms of fatigue impacting your ability to get to the bathroom on time and safely? Medication side effects- Are you taking prescription medications such as certain antidepressants and opioid-based pain medications that can impact symptoms of constipation? Symptoms of bowel dysfunction can also impact other parts of your day-to-day, including getting to work on time, exercising without leakage symptoms, and even sexual function and health. What diagnoses are associated with neurogenic bowel? Neurogenic bowel symptoms can occur due to a number of neurological conditions, including but not limited to: Traumatic and nontraumatic brain injury (TBI or stroke/CVA)- changes to the gut including constipation and fecal urgency are among the most common symptoms with a TBI or CVA. Those who experienced a traumatic injury may also have scar tissue from their injury and/or surgical procedures that can impact the recovery of the GI system Multiple Sclerosis (MS)- constipation and fecal leakage are frequently reported by those with MS with varying mobility, strength, and balance changes that can impact safety and comfort with a bowel routine Parkinson’s Disease (PD)- constipation is the most common symptom in both early and late stages of PD. Bowel routine can frequently be impacted by postural, mobility, and cognitive/mood changes. Spinal Cord Injury (SCI)- establishing and supporting a bowel program is important to those with any level of a spinal cord injury (traumatic or non-traumatic). Timing, toileting transfers and positioning, equipment use, and defecation mechanics all can play a role in a healthy bowel routine. Cerebral Palsy (CP) & Spina Bifida - constipation and fecal leakage is frequently reported by those affected by CP or Spina Bifida. Commonly, upper or lower extremity spasticity or muscle stiffness changes can impact toileting positioning safety. Caregiver education can be a helpful component to supporting bowel symptoms! In addition to the listed diagnoses above, we at Pelvic Pride work with individuals navigating other neurologic conditions, including post-concussion syndrome, tethered cord, transverse myelitis, and Guillain-Barré syndrome (GBS), to name a few. Please feel free to give us a call for a free phone screening to learn if pelvic therapy is the right fit for you! So how can pelvic therapy help with neurogenic bowel? Most folks may not realize pelvic health therapy can be helpful for the management of neurogenic bowel symptoms! Maybe you’re still experiencing chronic constipation after a traumatic brain injury, or noticing some unwanted leakage of bowel with a sneeze or during exercise or sexual activity. Your pelvic health therapist should focus on education regarding the root cause of your symptoms and treatment to best support your symptoms with a goal to maximize any intact sensation or motor function. This can include strategies for: Bowel routine support- such as suppository or enema use timing, toileting setup and positioning strategies, and fluid and intake recommendations Fall risk assessment- improving the ability to get to the bathroom on time and safely Caregiver education and training- teaching and working with your caregiver(s) how to best support you with your bowel routine Breathing exercises- learn how to improve defecation mechanics with your breath for improved pressure management Lumbo-pelvic mobility & strengthening- addressing the flexibility and stability of the muscles around your spine, hips, and pelvis for improved pelvic floor muscle tension, ability to get to the bathroom safely and on time, and comfort with toileting positioning Pelvic floor muscle coordination training- building awareness of our pelvic floor muscles ability to contract, relax, and lengthen our anal sphincters in order to improve bowel emptying ability and bottom-up support to the bowel system, such as during movement and exercise (however dependent on the extent of the neurological involvement) Soft tissue mobilization, or hands-on external or internal pelvic floor work- addressing any lumbo-pelvic muscular or fascial tension or scar tissue impacting GI motility and bowel emptying What are the results that someone can expect from pelvic PT? Great question! Although a pelvic-neuro pelvic health therapist cannot revert, alter, or prevent any pathological nervous system changes due to a progressive or non-progressive neurological condition, our goal is to find treatment techniques and strategies that best support your bowel symptoms, help you improve your quality of life, and gain or maintain control over your GI functions! Common results of pelvic PT include: Improved daily bowel habits and routine to address constipation Improved bowel leakage that may occur with daily tasks including functional mobility like transfers, walking, or trying to get to the bathroom on time Improved bowel frequency, urgency, and/or emptying ability Improved awareness and coordination of the lumbo-pelvic musculature, including pelvic floor, abdominals, spinal, and hip muscles, dependent on intact innervation of these muscles Improved scar tissue mobility and sensitivity if present following a traumatic event Improved overall knowledge of the anatomy and function of the nervous system (brain, spinal cord, and nerves) and connection with the GI system It is likely that your pelvic PT will want to communicate with other members of your medical team, including gastrointestinal or neurology, to ‘quarterback’ your care via interdisciplinary collaboration for holistic support and care. Further, your medical team may incorporate additional testing or imaging to learn more about your symptoms (such as anorectal manometry testing to assess the function of the anal sphincters and rectal musculature) and discuss medication management for symptom support, such as prescription or over-the-counter suppositories or enemas for bowel routine management, medications that address spasticity, discomfort, or pain associated with nerves, as well as anxiety and depression. Curious if you’d benefit from pelvic floor therapy for your neurogenic bowel symptoms? Complete the questionnaire below to learn more about your current bowel routine and symptoms. A higher score can indicate that you will likely benefit from bowel routine support and from seeing a neuro-based pelvic health therapist!

If you’ve been looking into pelvic floor therapy you may have noticed a trend: most of them are out-of-network. And the ones who aren’t have SUPER long waitlists. So do you wait on the really long waitlist or do you put up the money and pay for the out-of-network clinic to get started sooner? Well, the answer is a little more involved than a yes or no. Let’s dive into the four areas that make out-of-network clinics the best choice for many! First, to set the tone for this whole blog post, I started my career in a private practice that accepted insurance. When I moved to Maryland I worked for a large company who accepted insurance. There are great therapists who work at companies who accept insurance. Typically the issue isn’t the therapist, it is the restrictions placed on them by the insurance companies or the big bosses to be able to make enough money for the company to run. So this is not at all meant as a way to bash on those therapists - they are doing their best! And that isn’t to say that patients who need to go in-network to use their insurance cannot get good care. What it does mean is that patients going in-network need to be aware and advocate for their needs as best as they can or make an informed decision around what to expect with an in-network vs out-of-network clinic. *Steps off soap box* So like I said in the beginning this can be broken down into four parts: Expertise Care Service Cost

Figuring out when you can exercise after birth is tricky! Do you wait until the 6-week check in? But what if you feel ready to start trying some things earlier? Or what if you don’t? Will it cause delays in healing? Will it help you feel better soon? We will answer all of these questions and provide you with some safe exercises to do from 0-12 weeks after birth, so keep reading! Should you wait until your 6-week check in to start exercising? The short answer: NO! Think about it, you are already squatting, lifting, carrying, rolling in bed, walking around the house - you ARE exercising! It may not be a full blown group fitness class but it is movement and it counts! The thing to keep in mind during the first four to six weeks after your little one is born is to listen to your body and monitor for bleeding. If you notice an increase in pain, soreness, or bleeding, your body is telling you to slow down. While we will need to incorporate stretching and strengthening exercises into your daily routine soon, at this point the two main things I want you to focus on are: Breathing Posture Breathing Managing your intra-abdominal pressure (inside of the diaphragm, abdominals, and pelvic floor as pictured below) is key to provide support to your low back, abdominals, and pelvic floor! When we breathe in the abdominals expand and pelvic floor drops, then as we breathe out the abdominals draw in and the pelvic floor lifts up. It is important to utilize these mechanics to protect your body in the newly postpartum phase.

Even in the day of standing desks, walking pads, and ergonomic chairs, we still get the question: Why does my tailbone hurt? Which is followed quickly by, “What cushion should I use?” Or “Can you help me?” The answers are: We will tell you in a little bit, and YES! So keep reading! So, why does your tailbone hurt? You can most likely thank your pelvic floor and your sitting posture for this. First, let’s point out the tailbone. (circled in red)

How many times do you think someone Googles “pelvic floor specialist near me?” The answer: A LOT! Think about it! How many times have you gone to Google to look up something “near me?” We all do it, and we all do it all the time. So you look up a pelvic floor specialist near you and then what? Google pops up a list of options. The first one is typically a Sponsored suggestion. Do you click it? Did they pay to be there? Does that mean they are good? But is it an ad? Should I just scroll by? (welcome to my ADHD brain thoughts when I use Google)

Do you ever find yourself wondering “why do I pee when I sneeze or cough?” Picture this: it’s a beautiful spring day, you are walking around the park, the flowers are blooming, the birds are singing, pollen is everywhere, you sneeze and out comes some pee. What a way to ruin your lovely stroll! Or maybe it's flu season, you caught the bug and you are laying in bed miserable. Not only are you coughing and sneezing, but now you are leaking too?! Ugh!! Don’t worry - if either of these scenarios sound like you, rest assured you are not the only one having this issue. And we are here to explain why you pee when you sneeze or cough. When someone leaks pee during a cough or a sneeze, we call that stress urinary incontinence. This happens due to a sudden increase in intra-abdominal pressure (the pressure that exists in the space created by the diaphragm, abdominal muscles, and pelvic floor). Physical activities that increase this pressure include coughing sneezing laughing straining exercising While many people believe this is only an issue that pregnant folx experience, leaking pee with a cough or sneeze can impact anyone . However, it is a common symptom during pregnancy and postpartum due to the anatomical, hormonal, and postural changes that occur. Despite being common, it does NOT have to be your ‘normal’ as pelvic floor therapy can be a great place to start treating this pesky symptom! Let’s dive deeper. Looking at the image below, we see the anatomy of the respiratory canister. The diaphragm (or breathing muscle) is at the top, the transverse abdominis core muscle wraps like a corset from the front to the back, and the pelvic floor muscles form a supportive sling at the bottom. When we take a breath in (left), the diaphragm lowers, the abdominal wall expands outward and the pelvic floor moves downward. When we breathe out (right), the diaphragm relaxes to lift up, the abdominal wall and pelvic floor muscles shorten to return to their resting positions.

Diastasis recti is a common occurrence in pregnancy. Keep reading to learn the top seven factors that impact the likelihood of developing an abdominal separation.

When you are diagnosed with a neurological condition, physical and occupational therapy become an important part of your rehabilitative journey. While you’ve likely worked on your strength, mobility, and fine motor skills to aid in improving how you walk, your posture, and other activities of daily living, chances are no one has discussed another important aspect of your care - your pelvic health. As a Doctor of Physical Therapy and neuro-pelvic health specialist, I am here to provide you with the ultimate guide to pelvic floor physical therapy for those with neurological conditions. In this blog, we’re going to break down everything you need to know about pelvic floor PT and how it can help you in your recovery whether your goals are to maximize your quality of life or regain function during your rehab process. Below you will find the answers to the following questions: What is the pelvic floor? Why does the pelvic floor need therapy if I have a neurological condition or diagnosis? What neurological-based pelvic health diagnoses can be treated in pelvic PT? What does neurogenic bladder and bowel mean? How can sexual health and function be impacted by a neurological diagnosis? What other implications does a neurological diagnosis have on my pelvic floor health? What neurologic diagnoses are treated in pelvic floor therapy? What goes into becoming a neuro-pelvic health specialist? How do I find a pelvic floor therapist who specializes in neurological conditions? What should I expect at the pelvic floor evaluation? What about at the follow-up visits? What are the results that someone can expect from pelvic PT? Can I use my insurance? I noticed a lot of pelvic therapists are out of network, why is that? How do I know if I need pelvic PT?