The Missing Link in Optimizing Function in Female Athletes: Connecting Pelvic Floor and Orthopedic Dysfunction

Wednesday, February 17, 2021
4:30 PM – 5:00 PM

Research suggests 22% of musculoskeletal injuries may present with concomitant pelvic floor dysfunction. Specifically, a higher percentage of patients with lumbopelvic pain may present with pelvic floor dysfunction.  Female athletes of all ages commonly present to physical therapy with lumbopelvic and hip pain or dysfunction. It is therefore important that sports and orthopedic physical therapists understand the relationship of the pelvic floor to the rest of the musculoskeletal system in order to effectively treat these athletes. This session will explore the anatomic connection of the pelvic floor to the spine, pelvis, and hips and discuss how lumbopelvic dysfunction may be related to pelvic floor dysfunction. Presenters will discuss common pelvic floor diagnoses such as urinary incontinence, diastasis recti abdominis, and pelvic pain. This session will focus on promoting optimal pelvic health for female athletes while presenting evidence for the presence of pelvic floor dysfunction in the athletic population. The biomechanics of sport related movements will also be explored in order to better understand their demands on the pelvic floor. Case studies will be utilized to illustrate the connection between orthopedic and pelvic floor conditions from adolescence into adulthood while presenting treatment options for the orthopedic and sports physical therapist.

 

Expanding the Clinician’s Toolbox: A Multisystems Approach to Interventions for Pelvic Pain and Gastrointestinal Dysfunction

Wednesday, February 24, 2021
4:00 PM – 5:30 PM

Evidence to support the benefits of medical, psychological, and physical therapy interventions in treating pelvic pain is well documented in the literature. Specifically, the aim of pelvic floor physical therapy, or PFPT, treatment is two-fold: to reduce sexual and genital pain and to restore or improve sexual function. Due to the complexity of persistent pelvic pain, treatment approaches in PFPT include the biopsychosocial model. Specifically, the application of a somatic based psychotherapeutic intervention can enhance functional outcomes. Many patients suffer from a combination of urogenital, gastrointestinal, and sexual dysfunction associated with pelvic pain and a multisystem approach is needed to treat functional impairments. Based on emerging pain science research, central sensitization of pain may play a role in the production of bothersome conditions such as urinary frequency, vulvar pain, and anal fissures. In addition, unintentional supragastric belching, defined as an episode when the diaphragm is repeatedly used to pull air into the esophagus, is a learned behavior further contributing to pelvic dysfunction. Using a multisystems approach for  patient education and behavioral modification is important to reduce unwanted behaviors.