“This book is inspired by a patient I treated in 2011. As a direct result of questions asked and insights gained in her treatment, my physical therapy treatment for a patient with pelvic problems changed and shifted, gradually developing into the unconventional, but effective approach presented in this book.
Her pelvic story revealed there was more to be explored. In her 9 years of problems there were questions that had not been asked, symptoms that had not been included or explored. As I expanded my questioning further and listened to her responses, it became abundantly clear that I could not use my regular, and generally accepted “routine," pelvic physical therapy approach with her. She had already worked with 3 excellent pelvic physical therapists in the area with no lasting improvements. I needed to bring in a different set of physical therapy tools if I was to help her.
As she described how her symptoms changed, it began to sound familiar. The positions and activities that made her symptoms feel better -and- those that made them feel worse were similar to the pattern I repeatedly saw in my patients with low back pain. It seemed important to take into account that the first symptom she noted 9 years prior was low back pain. So, it seemed reasonable to explore if applying my low back pain approach to her pelvic problems would change anything for her.
As an orthopedic and pelvic physical therapist, I knew of one unique area of the spine near the lower rib cage that could cause "both" her persisting pelvic and low back pain. I was hopeful for her.
After using spinal exercises assessed to be her direction of preference, and using those exercises to target that unique spinal joint region, her symptoms began to change. The pelvic and low back problems that had been sabotaging her life for nine years completely resolved in a matter of weeks. The pain, bladder issues and other pelvic symptoms that had persisted despite multiple treatments from several therapists were gone. A recent note from her informed me that all her symptoms have remained resolved, thirteen years later.
This book explores and explains what can change when spinal motion testing and treatment is included in the care of patients with persistent pelvic symptoms. Life-altering symptoms such as leaking of urine, constipation, tail bone pain, urinary frequency, a prolapse of the bladder, rectum or uterus, and pain with sex noted by the patients in this book - that had not changed with prior treatments- improved when the spinal mobility losses in key regions were addressed.
The potential role the spine plays in pelvic problems is rarely researched, considered, taught, or practiced. This book hopes to change that, and in doing so, may provide a means of change for others who ask; “Why am I still having problems in my pelvic floor area?” or “Why aren’t Kegels helping?”
At the persistent plea and encouragement of many of my patients, I am writing this book.”