Services

Here are the problems I treat and how they’re treated:

Bladder | Bowel | Pelvic pain | Sex | Men | Prolapse | Pregnancy | Postpartum | Transgender | Cancer

Transgender

What transgender issues do you treat?

It’s usually spoken of like this:

“My shoulders and upper back are so tight ever since I had top surgery. The scars from surgery are tight and sensitive. I spray when I pee. My ability to urinate has changed. It hurts to have sex. I have pain in my pelvis.”

When transgender or gender non-conforming people utilize packing, tucking, or binding techniques or undergo gender-affirming surgical procedures, it can have negative effects on the trunk, lower extremities, pelvic floor and surrounding structures—resulting in pain and dysfunction.

Pelvic floor physical therapy can assist in minimizing or eliminating the pelvic, back, and chest pain and urinary, bowel and/or sexual dysfunction that can arise from these techniques and surgical procedures.

There are a number of common complications of gender affirmation practices and surgeries. Bottom surgeries drastically change anatomy, thus impacting how pelvic floor muscles function. Other postoperative considerations include dilation (for neo-vaginoplasties), wound care and scar tissue management, and learning optimal toileting behavior. Other procedures like mastectomy or breast augmentation create changes in chest, back, and shoulder muscles, as well as lymphatic circulation.

• Pain from surgical scars, vaginal penetration, pelvic pain, chest and back pain, shoulder pain

• Inability to achieve vaginal penetration

• Urinary urgency, frequency, hesitancy, incontinence, and spraying

• Loss of neovagina depth due to neovaginal stenosis

• Pelvic floor muscle dysfunction

• Suboptimal posture

What can physical therapy do about it?

Pelvic floor Physical therapy can assist in minimizing or eliminating the pelvic, back, and chest pain and urinary, bowel and/or sexual dysfunction that can arise from these techniques and surgical procedures.

Treatment options include:

• Internal and/or external pelvic floor evaluation to assess muscle function, tone and sensory awareness

• Whole body scan with special attention to your abdomen, spine, pelvis and hips, as well as any scar tissue from surgeries

• Specific pelvic floor treatment which will include strengthening when you are able to selectively isolate the pelvic floor muscles. The traditional Kegel exercise has a place, but there is much more to the pelvic floor. I’ll design a program based on your own function and functional needs.

• Biofeedback can help you see what your muscles are doing as you work to improve their function. 

• Bladder and bowel training which starts with completing a bowel and bladder diary, and education about what is normal.

• Therapeutic exercises designed specifically to help you stretch and strengthen as needed so that you have optimal support for good alignment and movement

• Manual therapy to address scar tissue and soft tissue restrictions, and to improve the alignment and mobility of your joints