Centered on Health 2-13-25 - Pelvic health ... why it's so important with Erin Jenkins, physical therapists

Centered on Health 2-13-25 - Pelvic health ... why it's so important with Erin Jenkins, physical therapists

Episode Transcript

Speaker 1 (00:02):
It's now time for Centered on Health with Baptists Health
on use Radio.

Speaker 2 (00:06):
Wait forty telbody, yjas Now here's doctor Jeff Tubler.

Speaker 1 (00:12):
Good evening, everybody, and welcome to tonight's episode of Centered
on Health with Baptists Health here on News Radio eight
forty whas. I'm your host, doctor Jeff Tublin, and we're
joined from the studio by our producer mister Jim Finn,
who is waiting to take your calls to talk to
our guest this evening. Our phone number five oh two,
five seven one eight four eighty four if you want

(00:34):
to call in and be a part of the show
five oh two five seven one eight four eight four.
Twenty five percent of women experience pelvic floor disorders in
their lifetime, and by the time women reach their eighties,
it's up to forty to fifty five percent. And we're
talking tonight about the impact of pelvic floor and pelvic

(00:56):
floor dysfunction and why it is so important and to
help us talk through that, we have Aaron Jenkins. I
want to introduce you to Aarin. She's a physical therapist
with the Baptist Hospital Medical Group with practices in Salzburg,
Indiana and Floyd's Knobs. She's a graduate of Bellarmine University
in twenty twelve and for the last two and a
half years has been in the acute care setting. She

(01:19):
developed an interest in pelvic health in twenty seventeen and
began taking courses. Her momentum is fascinating and we're going
to hear about it. She's been in orthopedics, she helps
postpartum and now men and women with pelvic health in
the outpatient setting. She's married to her high school sweetheart
and they have three wonderful children. Welcome to Centered on Health.

Speaker 3 (01:42):
Hi, thank you very much for having me.

Speaker 1 (01:44):
You know, Aarin, I'm so excited that you're here tonight
because even as I was preparing for this, I just
learned so much about how important this topic is. And
we haven't had a physical therapist on to help talk
us through. But I want to start by a message
that I got from a colleague of mine today where
she said, it can be a very dark and helpless

(02:06):
world when you are in the thick of it. I
am grateful more people are talking about it because I
had to figure it out all on my own, and
I just I wanted to start with that and get
Your initial reaction is that? Is that how you how
you feel about this?

Speaker 2 (02:21):
Yeah?

Speaker 3 (02:22):
Definitely. I actually got interested in pelvic health world myself
after delivering my first child, because I had my own
issues and even though I kind of had heard of
pelvic health through schooling, I myself still didn't know a
lot at that time and had to kind of ask around,
asking friends and even patients I've seen and see. That

(02:43):
is one thing I think a lot of them, you know,
some of these conditions are tricky to navigate through, and
they might have been through different specialists and different already
tried other things, and they get to the point where
they're kind of desperate for help. So sometimes they do
feel lost a lot of sometimes very depressed, and it
definitely affects their life a lot.

Speaker 1 (03:02):
Yeah. I think that's just a great introduction to kind
of the various things we're going to try and tackle tonight.
So what kind of training did you have to go
through to do what you're doing now?

Speaker 3 (03:16):
Yeah? So of course after a PT school that's usually
when or even during some therapists will choose to do
a pelc health like specialty clinical to get a little
bit more in school, and then after you graduate. There's
different areas of how you can go through training, but
basically continuing education. So I actually went through the Herman

(03:36):
and Wallace Institute and they offer all kinds of different
coursework and that's where I started to start, from pelic
floor one all the way up to really complex conditions,
so you can kind of go any area you want
in your specialty.

Speaker 1 (03:53):
Perfect Now, before half of our audience turns off or
turns the channel, this is a condition that effect both
men and women, and we're going to get into that
a little bit more, but could you just give us
an overview of how it affects men as well.

Speaker 3 (04:10):
Yeah, for sure. Well, the role of the public toour
is of course controlling. Part of it is controlling bound bladder,
maintaining continence, and even sexual functions. So even with men,
those things are very important. So if men are struggling
with any pain in the in the penile region or testicles,

(04:31):
sexual function issues, also constipation, urinary incontinence, or even dealing
with prostate issues. I know some will go have prostatitis
problems and also if they had even cancer, unfortunately down
in the area, radiation and things can affect how they
recover and it can cause incontinents and other issues.

Speaker 1 (04:55):
So tell us in the general sense, what helvic therapy is.
So we talked about pelvic health, so kind of tell us,
tell us, what does pelvic health mean to you and
what is pelvic physical therapy.

Speaker 3 (05:10):
Yeah, that's actually a question I kind of asked my
patients a lot of times when they first get to me,
is do you know kind of what pelvic health therapy is,
because sometimes they really don't understand because when you think
of physical therapy, you don't normally think of down there,
you know, right, So I kind of yeah, So I
usually just go ahead and talk to them about are

(05:31):
what we kind of treat and how we look at
the muscles down there. When they come to me, I
always go over, of course, a little bit about the pelvis,
what the pelvic floor muscles are, where they're kind of located,
their function of course, and how it's going to be
related to their condition. So normally, when a patient comes,

(05:51):
of course, we get a thorough history, subjective reports, and
then we just start at evaluation. We always look at
the patient as a whole first in therapy, of course,
how they're moving, even just like normal functional activities and
standing I think is important to look at because up
and downe the chain it can affect their center. So

(06:13):
looking at that and then even from there going through
external assessment, looking at how their spine, how their spine
mobility is, how is their posture. Hip mobility is extremely important.
One of the deeper muscles we can reach internally is
obterator interness and sometimes if patients have already been through

(06:34):
like orthopedic treatment and are still getting hip pain and
like deep pain inside, sometimes that's something we can help address.
If they've kind of already done other things, so external
assessment as well, and then as long as they can
sense and it's appropriate, we also can do an internal
exam with of course clean hands, gloves, lubricant, assessing the

(06:57):
vaginal tissue as well as the rectal area. So we
look externally first at tissue quality, looking at any asymmetries,
checking for also any neurological conditions or if there's numbness, tingling,
that kind of thing as well, So it's pretty kind
We try to hit all areas, but also patient comforts
number one as well and reading, making were't sure we're

(07:20):
reaching their goals.

Speaker 1 (07:21):
So if somebody's listening and wondering if they have a
like a pelvic floor issue that could respond to physical therapy.
What are the kinds of most common symptoms people come
to see you.

Speaker 3 (07:33):
With, Typically well pain, so if they have any pelvic
pain down low deep inside. Sometimes they'll even feel heaviness pressure,
if they have any urinary incontinence or vowel incontinence or
also constipation is something that we can help and address

(07:57):
sometimes lower abdominal discomfort as well as you've ruled out
other major conditions of the abdomen, we look at that
in relation to even the public floor muscles. So really
kind of anything down there you can think of, I
tell patients and female.

Speaker 1 (08:16):
And before we take a quick break, how do patients
find you? How do they get to you to a
physical therapist for their pelthic issues?

Speaker 3 (08:24):
Yeah, they can talk to their physician or even there's
any physician that they're seeing, or their nurse practitioner. Of
course they can get an order from them to be
referred or depending on the insurance as long as it's
most commercial insurances. We do have direct access in all
of the country now, so that means patients can self

(08:46):
refer as well to physical therapy and then they can
get in contact with our clinic to schedule the hospital.

Speaker 1 (08:57):
Well, we're gonna we're gonna pick your brain about some
of the issues and how you can help people when
we come back. We are talking tonight with Aaron Jenkins,
who is a physical therapist. We're talking about public health
both for men and women. This is centered on health.
I'm your host, doctor Jeff Tublin. Our phone number five
oh two, five seven one, eight four eighty four. If

(09:17):
you want to call in and ask a question, we'll
be right back. Welcome back to Senate on Health. With

(09:39):
that just health here on news radio eight forty WJS.
I'm your host, doctor Jeff Tublin. Tonight we're talking about
pelvic health and pelvic physical therapy with Aaron Jenkins. Our
phone number is five oh two, five seven one, eight
four eight four.

Speaker 3 (09:55):
Our producer, mister Jim.

Speaker 1 (09:56):
Fn is on standby to take your calls and put
you through to ask questions. So Aaron, welcome back. I
want to talk about something when it comes to public health,
which is sort of maybe the stigmata around bringing this
up or talking about it. I get the sense that
you know, when patients are older, maybe they just assume

(10:19):
this is part of aging, or when they're younger, they're
almost embarrassed to bring it up. What would you say
about people listening about being talking about this and getting
it out there.

Speaker 3 (10:32):
Yeah, for sure. Yeah, I think that that's definitely a
common misconception, like as you get older. I mean, of course,
some of this does increase with age. You know, we
have hormonal changes, tissue changes, different things we'll change a
little bit, of course. But one thing that I would
try to talk to patients about it even though you're
suffering with these things and they are hard to talk about,

(10:54):
you don't Definitely it's good to reach out and get
help now. You don't want it to become a chronic
issue and continue for a long period of time. Some
of the things, especially like urinary in continence, like after
delivering children. That's something that we hear a lot that
people say is oh, you know, I had a baby
and I was told that's just normal. You just dribble sometimes,

(11:14):
which that is it is very common, of course, but
we know that there are ways that we can help
these patients. So I definitely do hear some of that
stuff sometimes, and I think, really I'm hoping that even
by talking about it, you know now, it just helps
get it out there. Even though some of this stuff
candy common at times and it does happen, it doesn't
always mean that it's normal and that you have to

(11:36):
live with it.

Speaker 1 (11:36):
There's help, that's great advice. And do you feel like
in our primary care offices or in the guion offices
that we're doing enough to assess people to ask these
questions or do we need to be doing a better
job of that?

Speaker 3 (11:54):
Yeah, I think it varies definitely. I think I think
sometimes especially in the special areas, you know, just even
as you being an especially, I definitely think that I
see people you're able to hone in on that quicker.
Sometimes I see more primary care doctors not really knowing
what to do with some of the information. So of
course I think at that point it's appropriate to refer

(12:15):
to specialists if you don't know, because some of this
stuff can mimic other things. So I think it is
good to make sure we're getting a thorough assessment, making
sure there's no section or any other major thing going
on with especially when you're looking abound bladder dysfunction. But
then also definitely once you realize that things are being
ruled out and we're not seeing a pattern of other

(12:35):
medical issue other maybe conservative measures like certain medications and
things aren't helping. Then maybe try physical therapy and educate.
I think it's really great on our end if the
patient is also educated in the office from the doctor
at like what public health therapy is, what they may
be doing when you get there, because sometimes they get
there and they're like a deer in headlights. They're like, oh,

(12:57):
you might do this, and so I think that would
also be that's really good for them to understand why
you're referring them.

Speaker 1 (13:04):
So that's a good good point. So talk us through
kind of what a typical visit is, like what is
a typical assessment, Like what can you learn from a
physical exam and kind of what is your normal approach
to kind of that initial screening and evaluation.

Speaker 3 (13:22):
M Yeah, So of course, like I mentioned before, just
making sure we go through good subjective reports. You can
get so much information just by talking to them going
through that, finding out of course where their pain is
when it occurs, just different patterns with that, having them
move in the clinic, just doing different functional activity, looking

(13:43):
at squatting or listing something, just doing different things, so
just see their movement patterns, and then of course strengths
testing is needed if we do find that there may
be a neurological component, reflex testing, even sensation testing as needed,

(14:04):
and also I look always of course if there's back
pain included with any of the dysfunction, assessing the spine
hips just lower extremity in general, and then I that's
at that point, then I'm getting them on the table,
getting them on the table, looking also at the tissue
mobility of the abdomen, low back, the glue area just

(14:26):
around the hip, and then if they're comfortable, I then
will have them change of course draped. Always be respectful first,
looking externally, always first, so we want to make sure
that the tissue quality is good, there's no discoloration, redness,
Assessing externally the tissue like in women, looking at the

(14:47):
mobility of the certain structures externally, and then if if
we so like, we also looking at how they cough
and how they bear down, how they contract, looking at
that peraneum area and how it's reacting. And then from there,
if an internal assessment is necessary the patient's okay, we

(15:08):
can then go internally feeling for any tightness checking strength
of even doing a lot of people know what a
cagel exercise is right looking at yeah, yeah, looking at
the power, like how strong is it, the endurance, how
many repetitions, and also we look at something called quick
flicks where they like contract quickly and relax also to

(15:31):
get some of those faster twitch fibers if needed, like
if you do sneeze or cough, you need that to
kick on quick. So that's kind of like some basics
there kind of what we look.

Speaker 1 (15:41):
At fantastic and you know, as a gastrologist, we send
a lot of people for this type of physical therapy
and a lot of our patients get bio feedback.

Speaker 3 (15:52):
What does that mean? Yeah, i'le feedback. That is a
device that you can or also sometimes there are of
electrodes that you can put on the absomen or around
the rectal vaginal area and then don't give patient feedback
on their like their muscle action and the resting potential

(16:13):
of their muscles. So there's a certain level of muscle
activity that is natural in the muscles of the pelvic
floor and you sometimes it can help them either contract
safe they're weak, can we get a better contraction? Then
they can kind of see sometimes visually to give them
visual feedback on what on if they're contracting more or

(16:35):
are we not getting a good contraction, or even also relaxation,
are you able to relax well? Because I think in
this world we hear a lot of the do kegels,
dou kegels, the do pelp floor contractions, which also relaxation
is so important. So people with pain, constipation, things like that,
we also want a good relax so sometimes they can't

(16:56):
do that very well. So a bile feedback can help
give them information and see it so that they can
help control it on their own.

Speaker 1 (17:06):
Fantastic. One of the things obviously we hear about is
you know postpartum and after delivery that there can be
some changes over time. So talk to us a little bit.
I know you spent time doing postpartum care, but let's
start with the with prepartum care. Is there anything that

(17:26):
you advise people to do when they're pregnant or when
they're thinking about getting pregnant to sort of strengthen ahead
of time or is this all things that take place postpartum?

Speaker 3 (17:37):
Yes, definitely, of course, definitely, as our tissues change or
you're just with the hormonal changes that come alongst pregnancy
as well as your postural changes with the pregnant belly,
with your your back and things like that. So we
definitely recommend a good, nice, well rounded strengthening program of course,
core strengthening, public force strengthening, even like the hip area,

(18:01):
glute slow back, all of that together just to help
with pain management. As they you know, approach nearing the
end of their pregnancy, making sure they can still move well.
Working out is still not discouraged. You know, if moms
are already working out before, there are safe ways to
still do running and working out and listing. I think

(18:21):
it's just making sure it's safe and you're responding well,
so that's definitely encouraged. And then as well as there
are some things they can do before they deliver to
help prepare for birth. So sometimes we'll teach them like
pereneal massage to help reduce their risk for tearing during delivery.

(18:41):
Of course, going over deep breathing and helping improve their
ability to relax as well, so that when they are
going through labor that we're not getting, of course a
tightening when they're trying to push, we're getting more of
that relaxation and just just all going back to reducing
their risk for tearing and delivering a little easier.

Speaker 1 (19:07):
And when patients deliver and then they're going home, you know,
their focus obviously a lot of times are going to
be on their newborn and taking care of the newborn,
and that's their new priorities. What should we be doing
or what are we doing when women go home to

(19:27):
encourage them to kind of not develop these problems postpartum.

Speaker 3 (19:32):
Yeah, Well, one thing I like to go over almost
immediately with these patients is pressure management. And all that
means really is we're trying to reduce too much pressure
build up in the abdomen or like even clinching of
the abdomen throughout the day, ensuring that when they do activities,
we're getting nice deep difraumatic breaths as well as a

(19:55):
good exhale with their activity. Sometimes this sounds silly, but
I have this little chicken and the clinic that when
you squeeze it actually below a little egg kind of
will pop down. And that's just to show them that
if we keep it's a good visual, but if it's
the kind of shows them that too. You know, if

(20:16):
you keep holding tension in the belly or if already
you know, typically after delivery, things are a little elongated,
a little bit less efficient, so the muscles you're a
little weaker. If we're having a hard time engaging those
muscles properly, we can keep getting forced down low over time.
And if we also I think with that postpartum looking

(20:36):
at midline too, sometimes there's something called a dialysis rec diabdominus,
which the abdomen can the tissue can sind and separate.
That also will create some pressure issues. So having them
just be mindful of relaxation, inhaling on more of the
easy part of inactivity, exhaling and engaging on the work

(20:59):
that can really help. That's them up for success so
that when they do start moving more, picking up, carrying baby,
holding car seats, things like that, they're aware of what's
happening in their mid section, so we're not getting more
pressure down low. So that's the first thing I kind
of go over with them for sure, and then from
there making sure they're emptying properly. We talk about sometimes

(21:21):
that we use of the squatty potty ensuring that they're
able to yeah, so not straining again, especially if they
tour or even with their C section. We don't want
to be straining and pushing force down over and over
on these healing tissues, so ensuring again even there we're
breathing while we're getting relaxation down low, so that when
you empty, you don't are not straining. I think those

(21:43):
are like the most important things to begin with, and
then from there when they're ready, some gentle strengthening of course,
and then just progression as they go, coming to outpatient
when needed, and also just having them identify early on
what are some issues that can occur after they deliver,
and identifying those early, talking to their doctor at their
follow up as they've already noticed these things and then

(22:05):
get referred as needed.

Speaker 1 (22:08):
You know, that's fantastic, and I'm actually I'm really glad
you mentioned the C section too, because you know, I think,
you know, we tend to think of this as like, oh,
I delivered a large baby and that's why I have
some of these issues. But even when delivering by C section,
it sounds like pelvic you know, physical therapy can be useful.
So thank you for bringing that up. We're going to
take a short break. I want to remind everybody that

(22:29):
you are listening to Centered on Health with Baptist Health
here on news radio eight forty w h as. We're
talking about pelvic health tonight with Aaron Jenkins and our
phone number five oh two five seven one, eight four
eighty four. If you'd like to call in and ask
a question, we'll be right back. Well, welcome back to

(23:02):
Center It on Health with Gottus Health here on news
radio eight forty WHAS. I'm your host, doctor Jeff Teblin,
and we're talking tonight if you're just joining us with
Aaron Jenkins, who is a physical therapist with the Baptist
Hospital Medical Group, about pelvic health and the importance of
physical therapy with pelvic health. So one of the things
Aaron I like to do is sort of let our

(23:24):
listeners know sort of what we're doing out there in
the community to address whatever the issue is that we're
kind of talking about on the show. So I know
these are kind of specialized areas of treatment and kind
of give us a little idea of the landscape of
where these things are taking place. What is your setup
and what is kind of unique about Baptists.

Speaker 3 (23:47):
Yeah, well, there where we are right now currently, we're
actually in Baptist Health Floyd Hospital just said it, or
if you ever wanted to go to any other clinics outline,
it's just a normal physical therapy clinic. You just have
to check any location that you go to that if
you you have a certain location you want to go

(24:08):
to make sure that they do just have a pelvic
health therapist there. But where we are are in the hospital,
we have a gym area of course, and when they
come in, that's we have a really we work on
of course, not just on the table things, but in
the clinic too, so just depending on what they're there for.

(24:30):
It's not always just laying on a table doing manual
therapy the whole time. Sometimes it also is addressing standing
functional activities as well, because the main goal is to
get them back to function as they want to be.

Speaker 1 (24:43):
You know, that's an interesting point, and I think you
mentioned it earlier, but you kind of mentioned that the
pelvic strength kind of affects other parts of the body too.
Can you expand on that a little bit?

Speaker 3 (24:58):
Yeah, well, just public floor strength in general. So I
always talk over with this with patients, kind of like
that brain body connection. So our brain is our bladder,
our bowels, that's they're gonna it's going to communicate with
the brain of course, which also our pelvic floor, which
we can control either with contraction or relaxation, will help

(25:22):
eat with of course our continents. So the pelvic floor,
if we're weak in that area, it definitely can affect
if our ability to reduce our leaking with especially on
their loads like let's say we had cough or snees,
and then also if we're not relaxing properly, we can

(25:43):
reduce our ability to empty well, so that internally also
to just working with like single leg balance, single leg activities,
walking up and downstairs. Even though these muscles like don't
cross any certain like they don't cross the hip joint
or anything like that, they still are there to help
support our internal organs help when we stand on one leg,

(26:05):
we definitely can get activity of those muscles as well,
So they're very important with our just normal daily activities
to disband up and down steps, squatting all of those things.

Speaker 1 (26:19):
And are there other members of the team, like are
there you know sometimes as we know this can go
along with you know, social anxiety or some depression issues
and things like that. Are there resources through what you're
doing or people you work with to kind of treat
those aspects of the therapy.

Speaker 3 (26:42):
We I mean, definitely we always talk when we when
talking with patients if there is more of a psychological
you know, involvement of anxiety, depression, or even some of
these things, if they're not managing those well, can also
increase just kind of like your upper trap sometimes people
get tense, same thing with down low. So definitely think

(27:04):
that is really good to address. So referring those patients
out to a specialist that can help with certain conditions,
even like with sexual function, there are definitely therapists that
specialize in that over others that are comfortable talking about that.
Or if these patients have had trauma in the past
and they're coming to us for lower conditions down there,

(27:29):
sometimes that can be hard for them. So definitely referring
them to somebody that can help them go through that
mental aspect of it and that psychological aspect to help
them feel more comfortable and also helps their condition in
general improve.

Speaker 1 (27:44):
That's great because you know so much of this, you know,
is kind of a lot of different aspects that are
being addressed. So let's move to the bladder, which I
know is a big issue for people with their pelvic floor.
So tell us a little bit about what urinary incontinence is,
what is the typical reason people develop it, and then

(28:06):
we can talk a little bit about what you do
with them.

Speaker 3 (28:09):
Yeah, So urinear incontinence, of course, is just an ability
to control your tea from coming out. So a lot
of times we'll look there's different causes. Sometimes sometimes, of course,
the sphincter muscles internally can be causing a problem. Sometimes

(28:31):
you can have your your rethrout we call it your
retral hypermobility. Sometimes that can be a little too mobile
and it not being held up up and back properly.
And then also conditions like even prolapse sometimes if they
have or like a bladder prolapse for example, if it
dropped down a little bit, sometimes it can still hold

(28:53):
a little urine. So when patients go to stand your
retral it kind of gets unkinked and then they will
still leak some fluid out or some urine. So with
those conditions, always assessing the patient is so important because
with incontinence, you definitely always first think of maybe we're

(29:14):
having some weakness going on, but also sometimes there can
be some increased tightness as well, reducing a good contraction
sometimes to control urination. So just assessing the patient properly
to make sure you're kind of identifying a cause and
then from there treating them with those findings. So if

(29:34):
they are for finding that they are needing more of
a strengthening, which is typically what we end up doing anyway,
that once you get them relaxed, strengthening is still good
to come back to making sure we're doing a ca
go properly and that we're also relaxing properly getting good
excursion of the tissue. And it does take time, just

(29:55):
like any strengthening program. I tell patients you may not
see it overnight, you know, improve but over time, just
building up their strength with like we talked before, different
core exercises, hip exercises, the glutes are so important as
well and help and helping them even in the clinic
loading that like even practicing carrying maybe a weight to

(30:18):
simulate holding groceries. Some patients will anytime they load themselves
the leak or jumping, having them jump on a trampoline
and practice engaging and holding properly so to build endurance
and strength in that area it's kind of how we
address that.

Speaker 1 (30:36):
And is that what you would refer to as sort
of bladder training or is that the kegel exercises or
is there more more involved.

Speaker 3 (30:46):
Yeah, so bladdery training also, So we do that a lot,
especially with you probably hear the word over the diagnoses
overactive bladder. So people with like urinary urgency or urinary
frequent the issues. I definitely with those patients, bladder training
can be very important. So basically really with that, we

(31:08):
typically have patients do a bladder diary because we want
to first identify if start with urge, especially are we
having any bladder irritants there that are giving you trouble?
Are you drinking enough water or are you drinking too
much water? And also identifying any other pelvic floor dysfunction
that like tightness for example, that could be causing submerge.

(31:31):
With also frequency, looking are they peeing a normal amount
of day or are we getting sixteen twenty times a day?
Typically we want patient peeing five to eight times a
day is normal. So, yes, bladder reaps. Sorry didn't mean
to go off on a tangent, but with so with
bladder training that we want to allow them to let

(31:54):
their bladder fill more fully before they run to the bathroom.
So one thing we talk to them about too is
don't just in case. P I think that that a
lot of people do that. I know myself. I've been guilty.
If I'm going somewhere, I'm gonna pee just in case
so I don't have to go and I'm there. Well,
if your bladder is not full, you now have empty

(32:15):
too soon, and if that becomes a chronic issue, sometimes
that brain then will send that signal too soon and
tell you have to empty. So these patients will end
up well first, sometimes they'll get a really strong urge
it too soon when they've been not that full really
and then they have to get this back there. I'm
really really quick. They're afraid they're gonna leak and things

(32:37):
like that. So having them delay sometimes when they go
working on maybe some urge suppression techniques to help reduce
that like really bad sensation of needing to go, and
so training that bladder to let it feel more fully,
And we kind of do that over time, Like we
don't just say to typically what's normal is that you

(33:01):
should be able to hold it for like two to
three hours most of the time. So if they're going
every thirty forty five minutes, well let's try delaying it
five minutes, you know, something like that to help retrain
that bladder over time that you don't have to respond immediately,
kind of like slider fight. Right, it's like we've got
to get there. So that's right with downtrain that nervous

(33:23):
system to like wow your body to hold on wait
a minute, like just now felt it. I can wait
a second. I don't need to run. So I think
that's very very important with some of these conditions.

Speaker 1 (33:34):
Perfect well, I love I love the phrase the just
in case going. That's pretty that's pretty great, very accurate too. Yeah,
So we're going to take a final break here. I'm
going to remind everybody you are listening to Centered on
Health with Baptis Health here on news Radio eight forty
whas we're talking tonight about pelvic health and pelvit physical
therapy with Aaron Jenkins. Please remember to download the iHeartRadio app.

(33:58):
It's free, it's easy to use and gives you opcess
the tonight's show. We'll be right back. Welcome back to
Center It on Health with Baptist Health here on news

(34:19):
Radio eight forty whas. I'm your host, doctor Jeff Tublin,
and we're talking tonight about pelvic health and pelvic physical
therapy with Aaron Jenkins, physical therapist with the Baptist Hospital
Medical Group.

Speaker 3 (34:31):
You know, Aarin.

Speaker 1 (34:31):
One of the things that I think is really important
to talk about is pelvic pain because I think you know,
we can all it's not difficult for any of us
to understand that how much that might impact somebody to
be have a chronic pain in the pelvic area. So
how often is that something that you see and what

(34:51):
is your approach and what options are there for patients?

Speaker 3 (34:56):
Yeah, I think this is something we see quite often,
So go under the public point public pain umbrella. There's
definitely different diagnoses that we see. One common diagnosis is
just dys perruhnea, which is basically just pain with sexual
activity and intercourse. That we see that very commonly. Also

(35:18):
in the postpartum population. Some actually even in some women
who are even postmenopausal, sometimes like dryness and some like
the tissue quality down there changes of course with hormonal changes.
So with that that specific issue, there's in in the
women who are having more dryness issues things like that.

(35:41):
We definitely can look at things to improve the dryness
and then just the tissue quality. So sometimes there O
B G I N. Doctor might refer or might order
them a type of vaginal estrogen via like a cream
or a suppository. Uh, if they don't want to do that,

(36:02):
because I know some women are nervous about taking hormones
and things like that. They are Also there's some high
hyaluronic acid suppositories and also gels that can be used
down there to help. Also, sometimes we'll recommend avulvar of
vulver cream to help with the dryness externally as well

(36:26):
for the patients who are having especially like specifically postpartum.
A lot of things happen when you deliver a baby,
and so sometimes sometimes well let's kind of go back
to sea section I guess sea section scar mobility can
be important. Several layers have got we're cut through to
get the baby out, so ensuring good tissue mobility and

(36:47):
a little absomin making sure that it's not affecting down
further into the pelvic floor. Was just with all the
fascial connections and things like that, sometimes they'll have discomfort
and of course just in the vaginal canal or internally
if they had a tear, we can teach them peranial
scarmusage to help reduce tension in the external tissue or

(37:09):
the tear area and scarmusage, and then internally working on
releasing the tightness via manual therapy from the therapist or
also we can there's public wands and things we can
help show them at home to help them with that.

(37:29):
M So sorry, I mean it's okay. Another thing is vaginismus. Basically,
these patients will get a very strong contraction of their
public floor muscles that are very very hard to release.

(37:51):
They'll be very tight, very sometimes they can't even insert
a tampon for these females, So working on dilater training
with them to help kind of over time stretch the
vaginal area out is important. With these patients. We have
to be very careful and cautious so they don't get

(38:12):
Also then another tightening again if there's anything that they
perceive as a threat to that area. So that's another condition.
And then also there's another there's a volvodinia as well,
just kind of the more external area of the vulva,
of the of the area outside. Different things we can

(38:33):
kind of go through with those patients, making sure that
they have clothing that's appropriate, any other external things that
are giving irritation to that area, but any any of this,
any things under the pelvic pain area. If we're definitely
not making the progress we would like in therapy, referring
them back to their doctor or a specialist. They can

(38:56):
offer sometimes like injections or pain blocks. There's the nerve,
the pugental nerve that innervates down there. Sometimes they will
try to address that in that way medically.

Speaker 1 (39:11):
Well, I think the important thing also is just that
people who are listening know that they don't have to
live with this pain, that there are things that can
be done.

Speaker 3 (39:20):
So that's great.

Speaker 1 (39:22):
Well, I just want to briefly touch because we don't
have a lot of time, but I don't want to
let the men off the hook completely. So can you
just tell us some of the more common things that
men should think about if they're struggling with that pelvic
physical therapy might help them.

Speaker 2 (39:38):
With you mean, like certain conditions they might yeah, yeah, yeah, yeah,
because we just had about like thirty seconds, but oh.

Speaker 3 (39:49):
Sure, yes, yeah, so definitely constipation or fecal incontinence, erectile dysfunction,
even looking at course here in your incontinence, if they've
been diagnosed with like prostatitis or something like that, getting
that treated of course, and then if they have any

(40:09):
lingering issues afterwards, and in any sensitivity, numbness, jingling, anything
weird in the testicular or even into the.

Speaker 1 (40:19):
Tips of the penis, that sounds perfect well, thank you.
I'm sorry to give that so little time. You're just
going to have to have you back and talk more
about everything. But Aaron, thank you so much. I know
how important this is. I know how much you're helping
people out there in our community that is going to

(40:39):
do it. For another segment of Centered on Health with
Baptist Health, I'm your host, doctor Jeff Toblin. I want
to thank Aaron Jenkins, physical therapist with the Baptist Hospital
Medical Group. I want to thank our producer, mister Jim Finn,
and of course you for listening every week. Tune in
next Thursday for another segment. I hope everybody has a
happy and healthy rest of the week and a great weekend.

(41:04):
This program is for informational purposes only and should not
be relied upon as medical advice. The content of this
program is not intended to be a substitute for professional
medical advice, diagnosis, or treatment. This show is not designed
to replace a physician's medical assessment and medical judgment.

Speaker 2 (41:21):
Always seek the advice of your physician with any questions
or concerns you may have related to your personal health
or regarding specific medical conditions.

Speaker 1 (41:29):
To find a Baptist health provider, please visit Baptistealth dot com.