Is there a case for direct PT intervention in the acute postpartum phase? After c-section?
Answer
On the bedside, I would say absolutely that women can benefit from intervention on the bedside. This is an acute abdominal surgery. Providing them with an abdominal binder, teaching them about how to assess the health of their incision, how to monitor the incision, and how to start beginning contracting the abdominal muscles. Yes, the had a C-section, but they can still contract the abdominal muscles? Can they perform isometric contractions? Letting them know that after six weeks there should be no more pain and that the scar should move normally. Teaching them huffing, the bridge and twist is possible. All those things can be performed on the bedside. Unfortunately in the acute hospital environment, you don't get any extra reimbursement for more physical therapy, so there needs to be a philosophical support for intervention for pregnant and postpartum women from a leadership level.
Cynthia Neville, PT, DPT, WCS, BCB-PMD
Dr. Cynthia (Cindy) Neville, PT, DPT, WCS is Assistant Professor of Physical Therapy, Mayo Clinic Alix College of Medicine, in Jacksonville, Florida. She is a Women’s Health Certified Specialist (WCS), board certified by the American Board of Physical Therapy Specialties. She serves on the faculty of the Mayo Clinic Florida Orthopedic Physical Therapy Residency Program, and advises multiple medical specialty programs at Mayo Clinic Florida. Her outpatient clinical practice at Mayo Clinic Florida serves women and men with pelvic floor disorders. Dr. Neville has authored and co-authored several research articles and book chapters on the topics of pelvic health rehabilitation, pelvic pain, and urinary incontinence. She has presented her research and provided rehabilitation and medical education nationally and internationally. She has developed successful Pelvic and Women’s Health Rehabilitation Programs at premier healthcare organizations including the Rehabilitation Institute of Chicago (now the Shirley Ryan Ability Lab) and Mayo Clinic Florida. At Brooks Rehabilitation in Jacksonville, Dr. Neville developed the first institutional pelvic health rehabilitation program across all levels of care, and the first credentialed physical therapy women’s health residency program in the state of Florida. She has trained more than a thousand physical therapists, occupational therapists, physical therapist assistants, and physicians in pelvic floor examination and pelvic health rehabilitation.
Related Courses
1https://www.physicaltherapy.com/pt-ceus/course/physical-therapist-management-pelvic-floor-4358Physical Therapist Management of Pelvic Floor Tension Myalgia: When Your Patient Has Pain Down TherePelvic floor tension myalgia can cause a range of symptoms including pain in the vagina and rectum, feeling of sitting on a ball or stick, and pain during intercourse. This course will explore why and how pelvic physical therapy is first line treatment for pelvic floor tension myalgia. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT/PTA. Editor's Note: Regarding Pennsylvania credits, this course is approved by the PA State Board of Physical Therapy for 1 hour of general and 1 hour of Direct Access CE credit.auditory, textual, visual
Pelvic floor tension myalgia can cause a range of symptoms including pain in the vagina and rectum, feeling of sitting on a ball or stick, and pain during intercourse. This course will explore why and how pelvic physical therapy is first line treatment for pelvic floor tension myalgia. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT/PTA.
Editor's Note: Regarding Pennsylvania credits, this course is approved by the PA State Board of Physical Therapy for 1 hour of general and 1 hour of Direct Access CE credit.
2https://www.physicaltherapy.com/pt-ceus/course/ehlers-danlos-syndrome-and-hypermobility-4151Ehlers-Danlos Syndrome and Hypermobility Spectrum Disorders in Women's Health Physical Therapy: Look For the ZebraWomen with Ehlers-Danlos Syndrome (EDS) and Hypermobility Spectrum Disorders (HSD) have a high rate of pelvic floor disorders, and EDS and HSD are highly prevalent in women with pelvic health impairments. This course provides physical therapists with an evidence-based update on EDS, HSDs, and pelvic health and will explore clinical reasoning in pelvic physical therapy treatment for this diverse patient population. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT/PTA.auditory, textual, visual
Women with Ehlers-Danlos Syndrome (EDS) and Hypermobility Spectrum Disorders (HSD) have a high rate of pelvic floor disorders, and EDS and HSD are highly prevalent in women with pelvic health impairments. This course provides physical therapists with an evidence-based update on EDS, HSDs, and pelvic health and will explore clinical reasoning in pelvic physical therapy treatment for this diverse patient population. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT/PTA.
3https://www.physicaltherapy.com/pt-ceus/course/wag-your-tail-pelvic-floor-4164Wag Your Tail! Pelvic Floor Disorders and the Importance of the CoccyxMRI studies show that with the performance of correct pelvic floor muscle contraction, the coccyx should move cranially, and with adequate pelvic floor muscle relaxation, the coccyx should move causally. This course examines the importance of the coccyx to the function of the pelvic floor muscles, discusses how coccyx impairments may contribute to pelvic floor muscle disorders, and explore physical therapy treatment options for coccyx impairments. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT/PTA.auditory, textual, visual
MRI studies show that with the performance of correct pelvic floor muscle contraction, the coccyx should move cranially, and with adequate pelvic floor muscle relaxation, the coccyx should move causally. This course examines the importance of the coccyx to the function of the pelvic floor muscles, discusses how coccyx impairments may contribute to pelvic floor muscle disorders, and explore physical therapy treatment options for coccyx impairments. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT/PTA.
4https://www.physicaltherapy.com/pt-ceus/course/physical-and-occupational-therapy-treatment-4757Physical and Occupational Therapy Treatment Of Abdominal Scars, Adhesions, And Abdominal Cutaneous Nerve Entrapments. Quit Your Belly Aching!Abdominal scars, adhesions, and nerve entrapments are a source of abdominal and pelvic musculoskeletal pain symptoms. This course will examine and discuss physical and occupational therapist examination and treatment of musculoskeletal symptoms that may be caused by or associated with abdominal scars, adhesions, and abdominal cutaneous nerve entrapments.auditory, textual, visual
Abdominal scars, adhesions, and nerve entrapments are a source of abdominal and pelvic musculoskeletal pain symptoms. This course will examine and discuss physical and occupational therapist examination and treatment of musculoskeletal symptoms that may be caused by or associated with abdominal scars, adhesions, and abdominal cutaneous nerve entrapments.
5https://www.physicaltherapy.com/pt-ceus/course/basic-physical-therapy-treatment-constipation-3737Basic Physical Therapy Treatment of ConstipationThis basic course will introduce clinicians to the physical therapy treatment of constipation. Participants will gain skill and knowledge in simple interventions to improve bowel evacuation that they will be able to apply immediately in the clinic. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT/PTA. Editor's Note: Regarding Pennsylvania credits, this course is approved by the PA State Board of Physical Therapy for 1 hour of general and 1 hour of Direct Access CE credit.auditory, textual, visual
This basic course will introduce clinicians to the physical therapy treatment of constipation. Participants will gain skill and knowledge in simple interventions to improve bowel evacuation that they will be able to apply immediately in the clinic. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT/PTA.
Editor's Note: Regarding Pennsylvania credits, this course is approved by the PA State Board of Physical Therapy for 1 hour of general and 1 hour of Direct Access CE credit.
