PT For Hysterectomy? Yeah, We Do That.

The Procedure

Hysterectomy, or the surgical removal of the uterus, is the
second most common surgery performed on women in the United States,
after cesarean deliveries. The ACOG (American College of Obstetrics and
Gynecology) describes a hysterectomy as a treatment of last resort,
however, the US has the highest rate of these surgeries performed in the
industrialized world with approximately 600,000 hysterectomies performed
each year. It is a common surgery, and physical therapy can play a helpful
role both in preparing for surgery and in optimizing your recovery.

Why remove it?

​Current protocols for women’s health support
hysterectomy as a potential treatment for the following: cancer, fibroids,
abnormal/heavy bleeding, pelvic support issues such as pelvic organ
prolapse, and endometriosis. While clinically we know there may be many
viable alternatives to having this procedure, unfortunately many women opt
for this significant intervention due to a lack of information and knowledge of
alternatives within both the public and medical communities. We understand
the difficulties women face when considering a hysterectomy. There is
nothing “simple” about deciding to pursue surgery, and it is often a long and
arduous journey, both emotionally and physically.

How can PT help: Knowledge is Power!

As with any surgery, the more information you have, and the better your
health going into the procedure, the better your outcome is likely to be.
Before surgery​, your PT will help you optimize your pelvic health, learn
breath techniques, improve your muscle strength and tone, discuss nutrition
and bowel health, as well as help you understand the support you’ll need
around the home, and learn post-surgery strategies to help with recovery.
Remember, even when done laparoscopically with small incisions, a
hysterectomy is still a major abdominal/pelvic surgery! After surgery:​ We
aim to help you be you again! That may mean guidance in returning to
exercise, making sure you return to normal bladder, bowel and sexual
health, and providing any needed therapy for your scars or other tissues,
along with answering any other questions that arise along the way. We take
the time to help you discuss your best strategies to meet your needs in
recovery and in the future, including how rapidly fluctuating hormone levels
can impact your long-term bone and heart health.

‘Tis the Season for 5Ks!

It seems every weekend from mid-May through fall ushers in a new road race for runners, whether it be a 5K, 10K, half marathon, or triathlon.  As physical therapists, we see an influx of new patients with running injuries not only of the foot, ankle, knee and spine but also with new complaints of incontinence, pelvic pain and prolapse.  It is always our goal to get the client back to running, especially since for many it’s their preferred way to stay fit and also acts as a social, stress reducing activity that they are passionate about.  What we find out during the initial Physical Therapy evaluation is that the source of their running injury can be a distant site from where they feel the pain.  We often find that a misaligned pelvis or tight hip is causing foot pain or calf strains.  Since the pelvic and hip muscles are anatomically and functionally related to the core and pelvic floor, we often see runners with symptoms of incontinence who also have other complaints such as back, hip or foot pain.  Therefore the core and pelvic floor is where we begin our focus.

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Pelvic Floor Awareness and Relaxation

Relaxation of the Pelvic Floor Positions

We believe that the awareness of breath and body are fundamental but often difficult concepts to integrate into an exercise program.   It is not just about calorie burn and high intensity.  This type of exercise can contribute to spinal and pelvic floor dysfunction.  The complete action of the pelvic floor is both to relax and contract.  If you are only contracting your pelvic floor, you are missing the whole picture.  Many of our sessions revolve around improving the mobility and flexibility of the pelvis in order to allow for the optimal pelvic floor health.  Here we have put together various yoga poses and stretches that can facilitate a deeper understanding of the relaxation in the pelvic floor.

Constipation: It Shouldn’t Be This Hard

As pelvic floor physical therapists we educate people about how to go to the bathroom, EVERY DAY.  As PT’s, one of our primary roles is to educate patients about the evacuation process.  Our therapy sessions are then focused on teaching patients to become aware of their pelvic floor and to RELAX these muscles.  Most of our patients are baffled that humans have screwed up such a natural process and relaxation is a key to a good poop!  Constipation is a symptom of a more complicated system.  Your muscles are one important variable but we spend quite a bit of our time, providing education about other variables involved in this process.

Here we highlight overall constipation, and a few of the important variables that are involved.

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Becoming Activist Medical Shoppers

Americans love to shop, and we’re quite good at it. We research, we read, we consult, we buy. We are educated shoppers too, because information, mostly online, is right at our fingertips. When we buy a car, we know what the dealership paid for it, what other buyers in the area paid for similar cars, reliability ratings, and what brand of stereo it includes before ever walking into the dealership, so of course we know exactly what we should pay for that car. Why then are we such poor shoppers for our own medical care? Perhaps we aren’t entirely to blame. Given the current structure of our healthcare system, shopping, researching and buying is much more difficult.

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2017 is the Year! Make a Plan, Not Resolutions

2017: This is the year, right.

Please take a harder look at those resolutions because according to science, they will not work. Don’t worry, we can still inspire positive change for ourselves in 2017 and beyond but you have to understand the science behind habits and behavior change. Let me explain further by giving you a little background on how my family has planned for the best 2017.

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