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Published on June 10, 2020

Understanding Pelvic Floor Muscle Physical Therapy

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Fariha Bhatti

Patient: Fariha Bhatti

Diagnosis: Pelvic floor dysfunction

Treatment: Botox treatment, physical therapy

For patients suffering from back or joint pain, it’s common for treatment to include physical therapy (PT).

But rehabilitation for certain orthopedic problems might not involve what you’d first expect.

According to EvergreenHealth physical therapist Katie McGee, it’s often the case that back and hip problems emanate from muscles deep inside the pelvis.

That’s where her specialty comes in—she’s a pelvic floor muscle physical therapist.

“When patients are living with back or hip pain, the cause can often be attributed to pelvic floor dysfunction, and vice versa,” McGee explained.

Her role is to evaluate pelvic organ and orthopedic symptoms, followed by an internal vaginal exam to assess the pelvic muscles.

From there, pelvic floor rehabilitation includes hands-on treatment of muscles and other soft tissue, while also addressing related body mechanics such as breathing and proper alignment.

“In conjunction with physical therapy, our goal is to help educate patients on exercises they can do at home and throughout physical activity to help them achieve their best quality of life,” McGee said.

“The strong relationship between urogynecology and orthopedics is largely unrecognized. Yet understanding it is necessary to prevent, recognize and treat chronic and painful conditions like Fariha’s. Having open conversations between patients, primary care providers and specialists allows for treatment to begin earlier, and result in more effective outcomes and better quality of life for patients.”

Meet Fariha

After a severe car accident, Fariha Bhatti pursued countless forms of medical treatment to address chronic pain in her hips and lower back, but nothing seemed to help ease her debilitating discomfort.

Then she met Dr. Mia Swartz, a female medicine pelvic and reconstructive surgery (FMPRS) urogynecologist at EvergreenHealth.

A physical therapist suspected Fariha's pain was caused by pelvic floor dysfunction, and she referred Bhatti to Dr. Swartz to explore treatment.

“I needed a provider who listens and focuses on treating the whole self—and that’s exactly what I found in Dr. Swartz,” Fariha recalled. “Not only is she extremely knowledgeable, but she is also compassionate. She cares about me as a person and she’s willing to have an open dialogue to help find the best treatments.”

Together, the two discussed various treatment plans, including Botox injections to the pelvic floor muscles, combined with internal (vaginal) pelvic muscle therapy.

For the first time, Fariha is optimistic about her prognosis, and she’s passionate about sharing her experience to help others understand the importance of communication in achieving wellness.

Dr. Swartz shares the hope that Fariha's case will promote better awareness among providers and patients of the common relationship between urogynecology symptoms like pelvic or sexual pain, and bowel or bladder symptoms, and other seemingly unrelated orthopedic conditions, like spinal issues or joint problems.

Dr. Swartz is currently leading a study on the use of Botox injections for treating pelvic pain.

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