NYC Gazette

A recent study by the National Institutes of Health indicates that nearly 25% of women in the United States will encounter pelvic floor disorders during their lifetime. These conditions, which are common during and after pregnancy, can include symptoms such as pelvic pain, urinary incontinence, constipation, discomfort during intercourse, and a sensation of pelvic pressure. Elizabeth E. Brown, MD, a physiatrist at Hospital for Special Surgery (HSS) in Connecticut who specializes in pelvic health rehabilitation, highlights an increasing demand for care among young adults to older post-menopausal patients.

The pelvic floor consists of muscles extending from the pubic bone to the tailbone that support organs like the bladder and uterus. It plays a role in stabilizing the pelvis and spine, aids sexual function, and supports bowel and bladder control.

Dr. Brown explains that changes related to pregnancy can cause pain in areas such as the lower back, hips, and pelvis due to hormonal shifts leading to joint laxity. "Pregnancy-related hormonal changes can lead to joint laxity, increasing stress on the joints," Dr. Brown said. "An expanding uterus places considerable pressure on the pelvic floor. During delivery, the expansion of the pelvis and the pelvic floor stresses the supporting muscles which can lead to pelvic pain."

At HSS Orthopedics with Stamford Health – Westport in Connecticut, Dr. Brown primarily employs physical therapy for treating these disorders but collaborates with gynecology, gastroenterology or urology specialists when necessary for comprehensive care. Some patients may also benefit from psychological support addressing emotional challenges associated with these conditions.

"Patients are feeling more confident and comfortable with discussing their symptoms," says Dr. Brown. "A factor driving increased awareness is that we are developing better pathways for patients to reach pelvic health specialists for diagnosis and treatment."

Physical therapists specializing in this area provide services at several HSS Sports Rehabilitation locations across Norwalk and Stamford through collaborative efforts.

The HSS Perinatal Movement and Physical Well-being Resource Center assists patients pre- and post-pregnancy by offering personalized care addressing issues like back pain during pregnancy or postpartum return to exercise. Additional services include massage therapy, nutrition advice or Pilates sessions aimed at supporting overall health goals.

Emphasizing postpartum return to exercise is crucial according to Dr. Brown: “Many studies show a decline in physical activity among women after childbirth which is a public health issue." She aims towards noninvasive treatments encouraging mothers' active lifestyles benefiting both themselfs along with their children.

"I think we are headed in a positive direction regarding pelvic health rehabilitation," concludes Dr.Brown."With increased access toward specialists,research,and education,we'll be able provide much-needed care."