Charlotte's Pelvic Floor PT & Orthopedic Specialists
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Our Service

Women's Health

Things we treat

Vaginismus & Dyspareunia

Vaginismus is when the pelvic floor muscles chronically clench and hold. These muscles limit the space at the entrance of the vagina making any type of penetration difficult, painful and sometimes impossible. Most individuals are unaware that they are contracting their pelvic floor muscles. The pain is secondary to the increase in lactic acid that is produced from the chronic contraction, soreness in the muscles, and the increased friction. With education, relaxation and other modalities, the muscles can easily learn to let go and become pain free.

Dyspareunia is the medical term for painful intercourse. Intercourse should never cause pain. However approximately 30% of women experience painful intercourse during their lifetime. Though often attributed to dryness associated with menopause or post-partum, it is often due to muscles that are too tight, scar tissue from delivery, or certain skin conditions. Clenching of the pelvic floor muscles, tight hip muscles on the inside of the pelvis, and certain skin conditions, as well as other causes can easily be addressed by PT and lead to pain free intercourse.

Pelvic and Abdominal Pain

Causes of Pelvic and Abdominal Pain can be very complex. There are tight abdominal wall muscles, endometriosis, scar tissue from prior surgery, nerves in the abdomen, as well as other causes. Treatment depends on the specific origin of pain.  Once discovered, treatment can include relaxation, stretches, and visceral/myofascial/soft tissue mobilization.

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Urinary Incontinence

Urinary Incontinence (UI) is when urine leaks accidentally. Even a drip is not normal!

There are several types and causes of UI. For some, it is important to become stronger, and for others, relaxation needs to be accomplished first.

Stress Urinary Incontinence (SUI). Do you leak when you sneeze, cough, laugh, jump or run? This is known as Stress Urinary Incontinence.  It can be attributed to PFM (pelvic floor muscle) weakness and lack of muscle coordination.  Many women experience this with exercising, childbirth, or age.  Men frequently have SUI after prostatectomy. Increasing the strength and coordination of the pelvic floor muscles can help.

Urge Urinary Incontinence (UUI) If you feel yourself rushing to the toilet, and don’t quite make it, this is Urge Urinary Incontinence. The bladder starts contracting and releases the urine too soon.  To treat UUI it is important to “calm” the bladder with relaxation. It is also important to limit certain irritants like caffeine and soft drinks.

Mixed Urinary Incontinence is a combination of both.

Fecal Incontinence

Fecal Incontinence (FI) is when a person leaks stool or is unable to control bowel movements. This can be due to poor muscle control or strength, rectal awareness or sensitivity, improper diet, as well as other causes. Women who have a fourth-degree tear (from vagina to rectum) with delivery are particularly at risk and should have a pelvic floor assessment to help with strengthening and healing.

Pelvic Organ Prolapse

Uterine Prolapse is when the uterus descends into the vaginal canal. 

Cystocele is when the bladder descends into the vaginal canal. 

Rectocele is when the rectum descends into the vaginal canal.

Prolapses can occur with pregnancy and delivery, chronic constipation, chronic coughing, some types of exercise, or other causes.  Most women have some changes from a vaginal birth. As the hormones return to normal (after nursing is completed), the organs will naturally ease closer to their original positions. It is important to have support and strength of the pelvic floor muscles and have healthy bowel and bladder routines. Surgery can be recommended when these cases are very severe. But even when surgery is needed it is vital that the pelvic floor muscles support the organs long term, and that proper exercise, breathing and bowel habits prevent re-occurrence.

Coccyx or Tail Bone Pain

Pain in the tailbone or coccyx can be caused by a former trauma or fracture to the coccyx. It can also be due to the muscles that attach to the coccyx. Many of the pelvic floor muscles attach to the coccyx and if a person chronically clenches the pelvic floor muscles, it can lead to severe tailbone pain.

Pubic Bone Pain/Osteitis Pubis

This is pain on or at the pubic bone located in the lower abdomen or at the joint called the symphysis pubis. It can happen with pregnancy and delivery, trauma, overworked abdominal muscles (which attach at the pubic bone!) or other causes. This is treated with relaxation, stretches, strengthening, sacro-iliac belts, etc., depending on what is needed.