From the Blog

What is Low Intensity Extracorporeal Shockwave Therapy?

Low Intensity Extracorporeal shockwave therapy

Read more … What is Low Intensity...

Issues We Treat

At Fusion Wellness & Physical Therapy, we specialize in treating these conditions that are all too often misunderstood by the medical community.

Pelvic Floor Issues

  • Endometriosis (Endo)
  • Interstitial Cystitis (IC)
  • Pelvic Floor Prolapse
  • Urinary & Fecal Incontinence
  • Bowel & Gut Issues
  • All Pelvic & Core Issues
  • All Types of Pelvic Pain

Pregnancy & Postpartum

  • Pelvic pain, Low Back Pain, Hip Pain
  • Incontinence During & After Pregnancy
  • Diastasis Recti
  • Ligament and Joint Pain
  • All Manner of Core and Pelvic Issues
  • C-section Healing & Pain Management

Orthopedic Issues

  • Neck & Shoulder Pain
  • Lower Back Pain
  • Hip Pain
  • Hip & Knee Replacements
  • Knee Pain
  • Foot & Ankle pain
  • Pre-op Prep & Post-op Care

Let the therapists at Fusion Wellness & Physical Therapy help you along the journey back to wellness and function! Make an appointment today and let’s get started.

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Diagnoses of Male Pelvic Floor Issues

Diagnoses of Male Pelvic Floor Issues:

Pelvic Pain Conditions:

  • Chronic Pelvic Pain Syndrome
  • Nonbacterial Chronic Prostatitis
  • Pudendal neuralgia
  • Penis pain
  • Testicle pain (chronic orchialgia)
  • Rectal pain
  • Coccyx pain
  • Levator ani syndrome
  • Painful erection
  • Painful ejaculation

Bladder Conditions:

  • Urinary incontinence
  • Urinary incontinence (Post-prostatectomy)
  • Chronic Prostatitis (Nonbacterial)
  • Voiding dysfunction/Urinary retention
  • Urinary urgency/frequency

Bowel Conditions:

  • Fecal or gas incontinence
  • Constipation issues
  • Difficulties with defecation
  • Incomplete defecation
  • Bowel frequency/urgency
  • Rectal prolapse
  • Painful bowel movements

Post Surgical Conditions:

  • Scar tissue pain management:
    • colon resections
    • ileostomies
    • colostomies
    • vasectomies
    • prostatectomies
  • Strengthening of the abdominal wall
  • Post abdominal surgery hernia prevention
  • Parastomal hernia prevention

Meet Our Team

About Heather Jeffcoat, DPT | Los Angeles Pelvic Floor Doctor

Heather Jeffcoat, DPT - los angeles pelvic floor doctor

Read more … About Heather Jeffcoat, DPT...

About Laureen McVicker, PT, CLT

Laureen McVicker, PT, CLT

Read more … About Laureen McVicker, PT,...

About Kasia Gondek, PT, DPT, CSCS

Read more … About Kasia Gondek, PT, DPT,...

About Sarina Karwande PT, DPT, CAFS

sarina

Read more … About Sarina Karwande PT,...

About Stephany Tritt, PT, DPT

Stephany Tritt, PT, DPT
pediatric pelvic floor therapy

Pediatric Pelvic Floor Therapy: What To Expect on the First Visit

Pelvic floor issues including constipation and incontinence can affect kids as well as adults. At Fusion Wellness & Physical Therapy our therapists work with you and your child to make a safe and comfortable environment to treat these common issues to help your child function at their best and prevent pelvic floor issues in later childhood and adulthood.

The first visit is a thorough 85 minute evaluation. This gives the therapist time to get to know the parent and child and allows for a complete a thorough evaluation. Pelvic floor conditions, especially in the pediatric population can be complicated. There are many factors which could be contributing to the problem, including chronic constipation, bowel/bladder habits, movement patters, toileting positioning, among other things. Once we understand the root causes your child's pelvic floor issue, we will come up with a treatment plan to help your child feel better and get back to the activities that they care about like school and recreation.

These days, getting 85 minutes alone with a practitioner is pretty rare. At Fusion Wellness & Physical Therapy, we believe in the importance of having time to get to know you and your child, understand the complete medical history, perform a thorough orthopedic exam, as well as a pelvic floor exam.

In this article we will outline exactly what to expect on a first visit for pediatric pelvic floor therapy.

Part One: Listening to Your Story and Education About Pelvic Floor Therapy

Therapists will interview both the parent and the child regarding symptoms, issues, and medical history. We want to tease apart what the different layers are that may be contributing: bowel/bladder habits, diet, orthopedic or sensory issues.

Our therapists will then educate both you and your child about pediatric pelvic floor therapy (don't worry, we can do it in a kid-friendly and parent-friendly way). What is the pelvic floor? What does pelvic floor therapy look like? How will this therapy help? We will address any questions and concerns at this point so both you and your child understand how we can help.

Part Two: The Orthopedic and Whole Body Assessment

Most pelvic floor conditions involve other parts of the body. At Fusion Wellness and Femina Physical Therapy, we believe in treating the whole person, not just individual areas or muscle groups.

Following the discussion of medical history, your therapist will screen the entire body of your child, looking for tight muscles, dysfunctional movement patterns, neuropathic, and orthopedic issues that might be playing a part in your pelvic floor issue.

We will evaluate your posture, pelvis position, hip and spine flexibility and range of motion, position of the sacrum, and muscle tone throughout your abdomen, back, hips, glutes, and thighs.

Part Three: The Pelvic Floor Assessment

After your orthopedic exam an external evaluation of the pelvic floor muscles will be performed with your informed consent. Our pediatric pelvic exams are external.

The therapist will leave the room so that your child can undress from the waist down and put on an examination gown. After the therapist returns to the room they will perform an external pelvic floor examination.

This will begin with a skin check, looking for any irritation or dryness of the tissues. After that, there will be an external palpation of the pelvic floor muscles from the outside, the therapist will palpate around your pubic bone and sitting bones, assessing pelvic floor activity and looking for dysfunction. After palpation, the therapist may ask your child to do a kegel (contract the pelvic floor muscles as if you are stopping the flow of urine) and they may also ask your child to bear down as if you are passing gas or a bowel movement. This is in order to see if muscle control is normal and to screen out possible conditions such as dyssynergic defecation (read my blog about that by clicking the link).

All the therapists are very compassionate and will constantly checking in with both the parent and child, to ensure comfort and safety.

Part Four: Treatment on the First Visit

Since our evaluations are a full 85 minutes, there is often time to start treatment on your first visit. Your therapist will communicate to you what they are finding and will start treatment that day, often prescribing you some “homework” to work on right away, to start improving your condition.

What does the treatment look like?

Pelvic floor physical therapy is a great option for kids with toileting issues, because treatments pose a low risk of side effects and treatment can be very effective.

The physical therapists at Fusion Wellness and Physical Therapy can help kids with incontinence and pelvic floor dysfunction in the following ways:

  • Patient Education: educating the child and parent in the bowel and bladder, listening to body signals, positioning, and hygiene.
  • Identifying behaviors that may be contributing to the problem: the child and parent will complete a voiding diary that tracks diet and toileting habits for a few days. With the help of the therapist, the child and parent will start to see patterns of behavior and dietary factors that may be making the problem worse.
  • Bowel management: The therapist will teach the child and parent regarding hydration, dietary factors, proper toileting positioning, and proper pushing technique to relieve constipation which may be contributing to pelvic floor dysfunction.
  • Pelvic floor biofeedback: Biofeedback is a medical technology used in pelvic floor therapy that helps the brain and body re-establish healthy coordination patterns. Computer sensors are used to measure activity of the pelvic floor muscles while a screen gives live visual feedback as to what the pelvic floor muscles are doing. From the perspective of the patient, it basically looks like you are playing a video game with your pelvic floor. With this “game” the client is taught how to properly contract and relax the pelvic floor. Additionally, it is used to train proper pushing technique. Correct function of the pelvic floor is essential for both bowel and bladder function. This study by Richardson and Palmer (2009) shows that biofeedback is a safe and effective intervention for kids with voiding dysfunction.
  • Manual therapy including soft tissue massage, connective tissue manipulation, muscle energy techniques, and myofascial release to treat connective tissue dysfunction and myofascial trigger points
  • Visceral mobilization (gentle massage techniques that loosen internal adhesions and restore movement to the organs including the intestine, bladder, uterus, and ovaries) to improve motility and GI organ function

Pediatric pelvic floor issues can lead to more serious symptoms later on in life. Pediatric pelvic floor therapy can help your child get on track with normal bowel and bladder function. Let the therapists at Fusion and Femina Physical Therapy help you along the journey back to wellness and function! Make an appointment today and let’s get started.

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About Fusion Wellness PT

Fusion Wellness & Physical Therapy are licensed physical therapists specialized in treatments for male, female, transgender and nonbinary pelvic health conditions, sexual health, chronic pain disorders, sexual dysfunction, prenatal and postpartum symptoms, bowel and bladder issues and general sports and orthopedic diagnoses. We also specialize in Pediatric pelvic health.
Certified Attain Specialist 

Sherman Oaks

13425 Ventura Blvd.
Suite 200
Sherman Oaks, CA 91423

Telephone:
(818) 877-6910

The Sherman Oaks office is adjacent to Studio City and serves the Bel Air, Brentwood, West LA, Mulholland, Beverly Hills, Encino, Calabasas and San Fernando Valley area.

Map to Fusion Wellness PT Sherman Oaks Location

Hours:

Monday 7:30-6:00
Tuesday 7:00-6:00
Wednesday 7:00-6:00
Thursday 8:00-6:00
Friday 7:00-6:00

Glendale/Montrose and Pasadena Areas

3702 Park Place
Montrose
California 91020

Telephone:
(818) 873-1403

The Montrose area of Glendale is located minutes from Pasadena, Burbank, Silver Lake, Atwater Village, Los Feliz, Echo Park, and Eagle Rock.

Map to Fusion Wellness PT Montrose Location

Hours:

Monday  7:00-6:00
Tuesday 7:00-4:00
Wednesday 7:00-6:00
Thursday 7:00-4:00
Friday CALL

Beverly Hills

9012 Burton Way
Beverly Hills, CA 90211

Telephone:
(310) 871-9554

The Beverly Hills office is convenient to Mid-Wilshire, West Hollywood, Hollywood, Beverlywood, Korea Town, Downtown LA, Culver City, Century City, Santa Monica and Malibu.

Map to Fusion Wellness PT Sherman Oaks Location

Hours:

Monday 12:00-5:00
Tuesday CALL
Wednesday CALL
Thursday 7:00-6:00
Friday CALL
Saturday CALL
Sunday CALL

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