Pelvic Floor Therapy

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Pelvic Floor Therapy 

Amanda Griener, MPT

Longevity Physical Therapy St. Augustine

 Pelvic floor dysfunction is seldom discussed in private, much less public forum.  This is unfortunate as it is both prevalent and managabe.  The pelvic floor consists of 2 layers of skeletal muscles, sphincters, a mesh of connective tissue, and a plexus of nerves and blood supply.  It rests in the base of the bony pelvic girdle and helps give support to the abdominal viscera and the pelvic girdle and is intimately related to low back and hip function. Dysfunctions of the pelvic floor include but are not limited to incontinence of bowel or bladder, pelvic pain at rest or with penetration, pelvic organ prolapsed, and chronic constipation.  We will discuss urinary incontinence and pelvic pain focusing on research proven physical therapy interventions for each.

Physical Therapy treats pelvic floor dysfunction form a musculoskeletal and neuromuscular approach beginning with a thorough musculoskeletal exam.  If incontinence is the primary complaint, the client will fill out a three day voiding diary to help quantify symptoms, identify bladder or bowel irritants, recognize inappropriate habitual management techniques, and determine the amount of time the bladder can hold urine.  If the client gives informed consent an external and internal pelvic floor exam will follow.  This allows the clinician to assess resting tone, neural control, and strength of the pelvic floor muscles, as well as pelvic organ prolapse.  In pelvic pain clients it allows assessment of scar tissue mobility and trigger points.

Stress incontinence is the leakage of small amounts of urine with exertion of force like sneezing or lifting.  Urge incontinence is the inability to control a powerful urge resulting in a large loss of urine.  Often those with stress incontinence will dehydrate themselves for fear of leakage and begin bad habits including “just in case voiding” and these lead to urge incontinence.  Therefore, these often occur in concert.  Over 22.5 million women in the U.S. experience urinary incontinence and an estimated 16 billion dollars is spent yearly in management.  Why then is it not discussed more openly? Women use feminine hygiene products from an early age and many have accepted the misconception that urinary incontinence is a natural part of the aging process.  It is never normal to leak urine!  Women at risk are those who participate in high impact sports, who have had a child via vaginal delivery or who labored for over an hour before c-section, who have experienced an abdominal or pelvic surgery, and who are postmenopausal due to changes in pelvic blood supply. Physical Therapy treatment is aimed at strengthening the pelvic floor and educating the patient to promote healthy bladder habits.

Pelvic pain can occur for many reasons and is often linked to a hyperactive, high tone pelvic floor.  This abnormal resting tone may be due to trauma, scar tissue, neural dysfunction, or muscle imbalance.  Trigger points often develop in the larger, deeper of the 2 layers of pelvic floor muscles.   Scar tissue formed by trauma or surgery can be hypersensitive causing burning with touch or stretch.  It can also interfere with normal mobility of adjacent tissue to include nerve mobility.  Physical Therapy focuses on down training overactive muscles, quieting trigger points, and restoring normalmobility to scar tissue.

Upon completion of the evaluation, I personalize a plan of care focused on the client’s complaints, impairments, and lifestyle.  This is the strength of the Physical Therapy approach, and the key to successful outcomes for my clients. Physical Therapists have several modalities available to promote maximum medical improvement: electrical stimulation and biofeedback for strengthening, bladder re-education, and pain management; vaginal dilators for tissue re-education; and vaginal weights for strengthening.  Clients can rent and purchase home units if needed to allow for ease of compliance and continuation with the program after being discharged from care.Stress incontinence is often resolved in only four to six treatment visits.   Don’t continue to suffer pelvic floor dysfunction in silence.  The American Physical Therapy Association can help you find a qualified therapist.

If you suspect you or someone you know is suffering from pelvic floor dysfunction, please contact us immediately! Call us at (904) 217-0520 or email us at or go to our website At Longevity Physical Therapy St. Augustine we can help you get back to your better self!

Burning and Tingling in the Foot

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Burning and tingling in the foot are common symptoms of a significant condition called neuropathy.

Burning and Tingling in the Foot: Neuropathy

Thomas A. LeBeau

St. Augustine Foot and Ankle

Burning and tingling in the foot are common symptoms of a significant condition called neuropathy or peripheral neuropathy. Peripheral neuropathy refers to the conditions that result when nerves that carry messages to and from the brain and spinal cord from and to the rest of the body are damaged or diseased.

There are several different kinds of peripheral neuropathies that stem from a variety of causes. As a group, peripheral neuropathies are common, especially among people over the age of 55. All together, the conditions affect 3% to 4% of people in this group. Neuropathies are typically classified according to the problems they cause or what is at the root of the damage, like ‘neuropathy of the foot’.

There are two types of neuropathy; mononeuropathy and polyneuropathy. In podiatry we see the most common form of peripheral neuropathy, polyneuropathy, most often. One of the most common forms of polyneuropathy is diabetic neuropathy, a condition that can occur in people with diabetes. It is more severe in people with poorly controlled blood sugar levels. Though less common, diabetes can also cause a mononeuropathy. Diabetic neuropathy, commonly found in the foot, will cause burning and tingling in the foot and toes. This burning and tingling in the foot can be very uncomfortable and painful. Because people with chronic polyneuropathy often lose their ability to sense temperature and pain, they can burn themselves and develop open sores as the result of injury or prolonged pressure. If left unchecked diabetic neuropathy of the foot can be and cause a major health issue.

With our experience at St. Augustine Foot and Ankle we will do everything we can to help with the burning and tingling in the foot or toes you may be feeling and get you back to your regular activity. If you are experiencing burning and tingling in the foot please come see us as soon as possible. If you suspect you have diabetic neuropathy of the foot or are feeling pain in your foot or lower leg of any kind please give us a call to set an appointment at (904) 824-0869 or feel free to email us at