Pelvic floor therapy

Roxie Roberts, left, doctor of physical therapy, pictured with Tonya Mills, owner of Abilene Physical Therapy & Sports Rehab, treats pelvic floor health.

Most people only hear about pelvic floor health in television and magazine advertisements for bladder-control products.

“People really don’t talk about it,” said Tonya Mills, physical therapist and owner of Abilene Physical Therapy and Sports Rehab. “There’s such a need for pelvic health or pelvic rehab.”

Losing bladder control can limit people, Mills said. With education and exercises, “people can get their lives back.”

Mills has been offering pelvic floor health therapy since she opened the clinic, but now the clinic is offering more advanced care.

This summer, Roxi Roberts went to Chicago for in-depth training in pelvic floor health and is looking at taking several more courses. Roberts is a doctor of physical therapy working with Mills.

“People think ‘this is the new me and I have to live with this.’ That’s kind of sad,” Roberts said.

More than 25 million adult Americans have some sort of bladder control issues, and more than half of those are older than 65, according to the Center for Disease Control. Three-fourths of those are women, and one in four women older than 18 will have episodes of leaking urine involuntarily sometime in their lives.

Roberts sees more than just older women as patients, though. She sees a lot of new mothers and even some men as clients.

Post-partum care is not as thorough here as in other industrialized nations, she said.

“So there’s been a big push,” she said. “It’s kind of driving this.”

Better ways to care for women who have just given birth, she said, may prevent problems years down the road. Injuries in childbirth can cause pelvic pain that lead to pain with lifting and carrying the baby and with sexual problems.

“There’s a lot of pain, and how do you treat that?” she asked.

She starts with an exam, external and perhaps internal, which she learned this summer.

She also uses biofeedback.

“That aspect is fairly new to our region,” Roberts said.

Mills said the clinic just bought a new biofeedback machine. As far as she knows, Roberts is the only physical therapist in the area using biofeedback and treating pelvic issues internally.

“The pelvic floor is muscle, just like muscles in any other part of the body, so we treat them that way,” Roberts said.

She uses a whole body approach.

“If you look at the pelvis, there are tons of muscles,” Roberts said. “There’s so many connections with the core, with the hips and the pelvis and the back.”

Treating pelvic floor issues can help with things like low back pain, she said.

“It’s been neat to see how it impacts other parts of the body by treating a dysfunction that maybe we had no idea it was going on, the root of it,” she said.

The pelvic floor may not be weak; it may be too tense. Once she knows what’s going on with the muscles, Roberts can treat them.

“We can stretch them, just like you have a knot in your back,” Roberts said. “We can work on those if there’s spasm in those muscles.”

Childbirth and age are not the only conditions causing pelvic floor problems.

“It’s not just a female issue. Males have a pelvic floor, too,” she said.

Research is finding a connection between incontinence and cancer. Women may have problems after a hysterectomy or mastectomy, she said, and men may have problems after prostate surgery.

Incontinence can also be caused by side effects from medication.

“People are really embarrassed when they come, or anxious,” Roberts said. “I’ve seen a lot and I’ve heard a lot. It’s not awkward for me.”

She doesn’t want you to be embarrassed, either.

“For those struggling for years, it’s not too late,” she said.

Contact Jean Bowers at

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