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How Physical Therapy Can Help Pelvic Pain, Incontinence, Musculoskeletal Disorders

callanIncontinence, pelvic pain, pregnancy-related and post-partum-related musculoskeletal disorders are a part of daily life for many people. However, there is help for these disorders. Skilled physical and occupational therapists specially trained in these areas can work with patients to develop individualized treatment programs designed to relieve the problems.



Incontinence, which affects both men and women, is the involuntary loss of urine or fecal matter. There are several kinds of incontinence, but the most common are stress incontinence, urge incontinence and mixed incontinence, which involves both stress and urge.

  • Stress incontinence often occurs while performing an activity, such as standing up from a seated position; walking; running; or jumping, and may be related to weak pelvic muscles. Although a common home remedy to strengthen pelvic muscles is performing Kegel exercises − repetitive contractions of the pelvic muscles – it is not always effective. A physical therapist can conduct a full musculoskeletal evaluation to help determine the cause of stress incontinence. The therapist will work with you to develop a treatment plan, which may include biofeedback as well as a strengthening program.
  • Urge incontinence occurs when you have an unexpected urge to urinate and cannot restrain it. This type of incontinence can often be traced to your diet, because many foods act as bladder irritants. A therapist can work with you to help identify irritants, as well as re-train your bladder to empty on a timed schedule, which can reduce urgency.


Pelvic Pain

Men and women suffer from different types of pelvic pain. In women, it can often follow childbirth due to scarring in the pelvic muscles and soft tissues. But both sexes can suffer from pudendal neuralgia, in which the pudendal nerve becomes entrapped and/or irritated. Bicyclists commonly suffer from pudendal neuralgia due to the pressure on this nerve for extended periods of time. Physical and occupational therapists skilled in treating pelvic pain and associated musculoskeletal disorders can provide treatment, which may include trigger point therapy; biofeedback for pelvic-floor relaxation; and re-training of the pelvic muscles.


Pregnancy, Post-Partum-Related Musculoskeletal Disorders

While pregnancy is an exciting time, it can sometimes be complicated with aches and pains such as neck and back pain; sciatica − leg pain that originates in the lower back and travels through the buttock and down the large sciatic nerve in the back of the leg − carpal tunnel syndrome; and headaches. Although these symptoms can limit a pregnant woman’s activity level and ability to work or socialize, proper treatment will enable a pregnant woman to maintain her levels of activity and health. Treatments may include manual therapy, therapeutic exercise, taping and pool therapy. Pool therapy is also beneficial for patients diagnosed with pre-eclampsia or gestational diabetes, because the water provides a safe place to exercise and lowers blood pressure.

Following pregnancy, some of these symptoms may continue as the woman’s hormone levels are affected by breastfeeding. Other problems may arise from the childbirth process, such as vaginal tearing, that lead to scar tissue and pelvic pain or incontinence. Another common post-partum related disorder is a separated abdominal wall. Therapists use manual therapy, tailored exercise programs and other treatments to help patients with this condition improve their strength and mobility, as well as decrease pain. FBN



EntireCare Rehab & Sports Medicine Experts, Specialties

The therapists and specialists of Northern Arizona Healthcare’s EntireCare Rehab & Sports Medicine department have the education and hands-on experience required to provide comprehensive, individualized treatment plans and therapies.

Each specific type of therapy − occupational, physical, hand and speech − is considered a specialty, and plays an important role in the rehabilitation process. The EntireCare team functions as a cohesive unit, where all members share information and knowledge. The ultimate goal is the patient’s improvement and return to the highest possible functioning level. Choosing EntireCare means patients also have access to a myriad of additional services, such as advanced facilities, technology and equipment.


To make an appointment at one of EntireCare’s Flagstaff locations, call 928-773-2125.

  • Flagstaff Medical Center: 1215 N. Beaver St. The outpatient therapy center includes a large exercise gym; private rooms for hand; wound; electrical stimulation and other treatments; an above-ground therapeutic pool; group exercise classes and more.
  • East Flagstaff: 7810 N. Hwy. 89, Ste. 280 (in the Elden Ridge Business Centre next to Subway). Full-time physical therapists provide comprehensive treatment options in a state-of-the-art facility. The clinic offers both private treatment rooms and a gym-like area for patients to work one-on-one with therapists.


Dixie Callan, P.T., D.P.T., is a physical therapist with Northern Arizona Healthcare’s EntireCare Rehab & Sports Medicine, and is located at Flagstaff Medical Center. She specializes in treating women’s health concerns, including pelvic pain; pelvic floor dysfunction; incontinence; prolapses and conditions that accompany pregnancy and the post-partum period. She performs trigger-point dry needling to release trigger points; vestibular treatment for benign paroxysmal positional vertigo; and orthopedics and manual therapy to treat post-surgical pain, trauma, sports injuries, headaches and spinal dysfunction. Dixie earned a bachelor’s in health science at the University of Arizona in Tucson, Ariz.; and a doctorate of physical therapy at Creighton University in Omaha, Neb. She has worked in the field of physical therapy since 2011.


EntireCare Rehab & Sports Medicine is a member of Northern Arizona Healthcare, which also provides healthcare services through Flagstaff Medical Center, Verde Valley Medical Center, Northern Arizona Healthcare Medical Group − Flagstaff, Verde Valley Medical Clinic, Cancer Centers of Northern Arizona Healthcare, Fit Kids of Arizona, Guardian Air, Guardian Medical Transport, Heart & Vascular Center of Northern Arizona, Northern Arizona Homecare, Northern Arizona Hospice and Valley View Care.


To learn more about the programs and services offered at Northern Arizona Healthcare, visit NAHealth.com. “Like” NAH at Facebook.com/NorthernArizonaHealthcare.

By Dixie Callan, P.T., D.P.T.

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