Science is limited by what research has been done. So, I always like to keep my patients informed on what research is on the horizon. Here are pelvic health topics that are being studied in 2021:
Researchers are looking at both short and long-term effects of all sports on the pelvic floor. Running and pelvic health is a particular area of focus. Runners have unique nutrition and biomechanical needs. These needs require special attention from their healthcare providers. Runners often present to orthopedic specialists with knee and hip injuries. Often, these injuries do not resolve as expected due to pelvic floor impairments.
The section of physical therapy, originally known as “women's health” has shifted to "pelvic health". Now, they are expanding this category of expertise to pelvic and abdominal health. So much of the pelvis is connected with the organs, posturing, fascia, and pressure of the abdominal region. It’s fascinating to me that for so much of traditional PT --even massage--that the abdomen is such a no-go zone. Part of the inclusion path has been to train PTs to work with men. They have pelvises, pelvic pain, and incontinence too. The field is growing to include people of all gender identities, including transgender health. We are always looking to learn how we can better support people who are gender diverse. This includes pre and post-op support for gender change surgeries.
More research is being done on how to help support menopausal and perimenopausal women. Up to 30% of a woman's life can be involved in this process. Doctors are promoting the awareness that menopause is not a disease... and shouldn’t be treated as one.
Pregnant or postmenopausal women are not the only ones who get incontinence. Kids do too, for a variety of psychosomatic, environmental, and anatomical reasons. This is an important topic!
This is a hot topic for PTs and OBs alike. There are a lot of myths out there about it. No one likes the idea of the abdomen being separate. And the idea of preventing or fixing it is marketable. But current research says there aren’t any exercises (other than activating your transverse abdominis) that truly help close a separation. And unless the separation is significant, it may not matter at all. This is what has been discovered:
Women who perform routine daily exercise throughout their pregnancy are less likely to have sustained diastasis recti one year postpartum.
Researchers are currently looking at how ultrasounds may help relieve compressed milk ducts and prevent/relieve mastitis. There is really no evidence that milk ducts get “clogged” or blocked. The vessels are highly collapsible and thus easily affected by inflammation. Lymphatic drainage techniques are also being applied. There is a bundle of lymph nodes under the armpit. These are responsible for maintaining cellular fluid balance and fighting infections. Ensuring they are working properly has promising potential for breastfeeding support and breast tissue health.
Ultrasound imaging has been validated as a reliable and valid method to evaluate:
Therapists are using it to help with their accuracy. There is also research in training patients neuromuscularly. Basically, it's like, if you see it, you can believe it. Then you can use the muscle better since you're more confident that you are activating it “correctly”. This is called Rehabilitative Ultrasound Imaging (RUSI).
Yes, there’s telehealth. But there are also some pretty innovative apps out there.
The US has been slow in promoting preventative pelvic care. Countries like Canada, the Netherlands, Belgium, Finland, and Spain all have great practices we could learn from.
Here are some fascinating charts, put together by UNICEF in 2019, measuring how family-friendly different countries in the world are:
Sadly, the United States does not rank well. Let’s work together to make this hot topic even HOTTER and influence change in this department. Send me an email and let’s talk!
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