Ortho - Pelvic PT Connection
COMPLEMENTARY ORTHO AND PELVIC PT
There is considerable overlap between pelvic floor physical therapists and orthopedic specialists. While the majority of orthopedic pain in the pelvic area can be treated externally, there is a large subset of patients where pelvic floor dysfunction contributes to their symptoms. Often these patients won't improve as quickly as would be expected, or something keeps ortho PT interventions from 'sticking.' Below are some resources for helping determine 1) if a patient has pelvic floor involvement and 2) when to refer and co-treat with a pelvic floor physical therapist.
Pelvic PT - Ortho Connection
This is a one-page informational sheet that we created for the local orthopedic PTs that we often partner with. It provides common orthopedic complaints where the pelvic floor can be a component, including hip, tailbone, low back, groin, and SI pain. Often orthopedic PTs notice that their work isn't 'sticking' - as if something else is holding the patient back. In many cases, that may be due to internal pelvic floor trigger points and hypertone.
This sheet also has a brief screening questionnaire that can help you determine if your patient is also experiencing pelvic floor dysfunction. Constipation can be a sign that the pelvic floor is unable to relax to allow for defecation. Incontinence can be due either to over-tight or weak pelvic floor muscles. Sitting compresses the nerves and muscles of the pelvic floor, and often is a trigger for pelvic pain. Pelvic pain or pain with sex are symptoms that may be accompanying their condition, but that they don't feel comfortable mentioning - or even understand that they can relate! Finally, a history of tailbone trauma is a risk factor for pelvic floor dysfunction, as every pelvic floor muscle attaches at the tailbone. These brief questions can help you understand if there is a pelvic floor component to an orthopedic patient's condition that may be holding them back from recovery.
PELVIC FLOOR DYSFUNCTION
Using a retrospective analysis of PelvicSanity patients with confirmed pelvic floor dysfunction, we analyzed the symptoms that most closely correlated with dysfunction and created a comprehensive, 10-question screening questionnaire. If patients answer 'Yes' to 3 or more questions, it accurately identified more than 90% of patients with pelvic floor dysfunction.
Symptoms which indicate pelvic floor dysfunction in patients include:
Pelvic Pain (greater than 3 out of 10) - 84% of patients
Urinary Symptoms (Incontinence, retention, hesitancy) - 81% of patients
Orthopedic Pelvic Pain (Low back, hip, or groin pain) - 71% of patients
Sitting Increases Symptoms - 68% of patients
Painful Intercourse - 48% of patients
Constipation or Bowel Dysfunction - 52% of patients
History of Tailbone Fall or Trauma - 45% of patients