CONTACTING US: Please feel free to email us with any questions you have regarding our program: ppcr@hdphysicaltherapy.com

AS FEATURED ON WCBS - NEW YORK'S CBS AFFILIATE

View the 90 second feature by CBS 2's Dr. David Marks on H&D's therapy for chronic pelvic pain (May 11, 2005)

FREQUENTLY ASKED QUESTIONS ABOUT PELVIC PAIN & INCONTINENCE

Pelvic Pain FAQs

 

Incontinence FAQs (coming soon)

PROGAM OVERVIEW:

H & D Physical Therapy’s Pelvic Pain & Continence Rehabilitation program is a unique and comprehensive program committed to dealing with the healthcare needs associated with  

·        Male/female pelvic pain, and

·        Male/female incontinence.

We currently have five physical therapists who have extensive training and knowledge in Pelvic Pain & Continence Rehabilitation. In fact, we are one of the few NY practices that accepts insurance for these conditions.

PELVIC PAIN & CONTINENCE REHABILITATION SERVICES

ARE DIRECTED TOWARDS CLIENTS WITH:

·    Pelvic Pain:  Pelvic pain, vaginismus, dyspareunia, vulvodynia, vestibulitis, interstitial cystitis, piriformis syndrome, coccydynia, abdominal pain, chronic constipation, levator ani syndrome, non-bacterial prostatitis, among others

·    Continence Rehabilitation:  Stress incontinence, mixed incontinence, urinary incontinence, urinary urgency, fecal incontinence, & urinary frequency, as well as organ prolapse

GETTING A PRESCRIPTION: We would be happy to be in contact with you ahead of your appointment, but before we can see you, NYS Law requires that you have a prescription from a referring physician who practices in New York State or within 25 miles of NY State. If you do not already have a doctor that you are comfortable with, we have an extensive network of gynecologists, urologists, urogynecologists, internists, pain management doctors, et al that we can refer you to: ppcr@hdphysicaltherapy.com

Urologists & Urogynecologists:

Dr. David Kaufman - Central Park Urology

Dr. Margherita Sassone - Clock Tower Gynecology

TREATMENT AT H&D PHYSICAL THERAPY:

As you progress through H&D Physical Therapy’s Pelvic Pain & Continence Rehabilitation Program, it is our mission to provide you with the best care available from our experienced professional team. H&D’s philosophy begins and ends with you. 

Healing Partnership You will be taught the techniques that are necessary to help you control your health issues and prevent relapses in the future. Practicing these methods outside of our facilities – which will take 15-30 minutes a day - is important. Your insights and feedback along the way are appreciated and extremely valuable.

Holistic, Patient-Centered Approach In addition to working with an experienced physical therapist, you will have the option of supplementing that work with a highly-trained Yoga teacher who customizes practices for people with pelvic floor disorders.

What to Expect from Your Physical Therapy Treatments

 

What to Expect from Your Yoga Sessions (optional)

 

Feedback from a Pelvic Pain Client

Prior to your first visit In order for us to get the most out of our time together, we ask that you complete some information about your condition in advance of your first visit.

□   (Men & Women) Internal Assessment & Related Treatments Consent

□   Send the completed forms to H&D Physical Therapy:

By fax to: 212.499.0753

By mail to: H&D Physical Therapy,

               12 E. 46^thSt, NY, NY 10017.

Making Progress with this Program With pelvic floor disorders, progress does not typically happen in a straight line. There are sometimes improvements followed by what appear to be steps back. Likewise, as part of the healing process, there are sometimes flare-ups either during or shortly after treatment. Know that you are in experienced hands and that we will do whatever we can to minimize the frequency and duration of your discomfort.  We are committed to helping you find relief to your Pelvic Floor Disorder.

 

Your Role in this Process We cannot emphasize enough how valuable we believe your role is in your own healing process. Your efforts and your feedback that will drive this process.  Your treatment team will adapt according to your condition and will seek out whatever knowledge is required to help you improve and maintain your health inside and outside of our office so that you can stay healthy day in and day out.   

 

We Are Here to Listen If you ever have any questions about your physical therapy program, if you are concerned about any part of your treatment, we encourage you to call us, email your therapist, stop in, or ask us questions during your session.  We truly believe that your active participation in your treatment from all standpoints is the key to your healthy recovery.

 

So welcome once again to H & D Physical Therapy.  If you have any questions, please do not hesitate to ask (ppcr@hdphysicaltherapy.com).

 

For an extensive report from a patient who had pelvic pain...

Dell's experience with H&D Physical Therapy

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What to Expect From Physical Therapy Each physical therapy treatment plan is customized; however, there are certain consistencies you can expect. 

Hour Long Treatments Your physical therapy treatments will be an hour long and the entire session will be conducted  with a physical therapist specializing in Pelvic Pain & Continence Rehabilitation. Personal care requires personal attention, and we owe you the most comprehensive service available.

 

Initial Evaluation Your treatment will begin with an initial examination during which you and your therapist will get acquainted with one another and with the specifics of your condition. To make the most of this time, it is helpful for us to have as much information about your history of pelvic pain as well as your general health history before this first meeting.

Optional Yoga Evaluation During your initial evaluation, your physical therapist will also suggest you schedule a 30-minute consultation with our Director of Yoga, at no additional charge. Even if you do not choose to follow-through with a Yoga Treatment Plan, the information that is collected in this session is helpful for your physical therapist.

 

Physical Therapy Treatment Plan Your physical therapist will give you an overview of what your specific treatment plan will involve. You will be taught skills that give you more knowledge about your condition and that help you improve on your own.

Physical therapy skills to be learned by the patient:

Neutral postural alignment/postural re-education

Daily at-home program that includes:

    Self-administered myofascial trigger point release

    Pelvic floor muscle re-education

    Stretching & strengthening exercises

Additionally, your Physical Therapist will utilize various therapeutic methods in each session.

 

Physical therapy techniques to be administered, as needed:

Biofeedback

Myofascial trigger point release

Abdominal massage

Stretching & strengthening exercises

Ultrasound, electrical stimulation and other modalities as needed

 

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What is Myofascial Trigger Point Release?  It is common for people with pelvic pain to have trigger points in various muscles around the trunk, hips, abdomen and pelvis.  A trigger point is a palpable nodule within a specific fiber or fibers of a muscle.  Reasons for the presence of painful trigger points can be quite varied, ranging from stress to injury to physiological or hormonal imbalance.  Quite often, upon palpation, a trigger point can cause what is known as ‘referred pain’.  This is pain that is not directly at the site of palpation, or compression, but spreads out from it, or is even quite remote.  For example, some of the thigh muscles have been shown to cause a sensation of fullness in the rectum.

There are several techniques for the release of a trigger point.  Manual techniques by your physical therapist may include compression, contract-relax, breath facilitated release, local stretching and stretching of the entire muscle.  It is sometimes necessary to work on other aspects of the soft tissue before progressing to trigger point release.  There are also some self-administered release techniques that you might learn to perform at home or work.  On occasion more aggressive approaches to release the trigger point are needed: this would include dry-needling and trigger point injections.  New York State does not allow for physical therapists to perform these more aggressive treatments.

Trigger point release can sometimes cause soreness locally.  Drinking an adequate amount of water and taking Vitamin C supplements can, to a degree, prevent this soreness.  After your treatment, you may find that moist heat to improve the local circulation is beneficial. 

 Consistent with the teachings of Travell & Simons, your physical therapist will try to identify ‘perpetuating factors’ that, left unaddressed, are likely to cause the trigger point to flare up again.  These perpetuating factors are often related to poor posture and muscle imbalance.  Other perpetuating factors may be related to poor diet, smoking or even low iron in the blood.  Your physical therapist will work closely with you and your referring physician to remediate all of the factors that may be involved.  We strive to address your health from a holistic perspective and myofascial release is one part of our hands-on personal care approach.

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What to Expect From Yoga Treatments Our approach to Yoga does not involve training you to perform extreme physical exercises, nor is it rooted in any particular religious or spiritual beliefs. Like the Physical Therapy Treatment Plan, each Yoga Treatment Plan is individualized. In general, your Yoga Treatment Plan will include Breath Training, Guided Relaxation & Tension Reduction Exercises

Yoga skills to be taught:

Self-guided progressive relaxation

Moment-to-moment awareness

Myofascial-friendly Yoga postures adapted to individual

Diaphragmatic breath-training

Costs for the Yoga Treatments:

Initial Yoga Evaluation                         No additional charge

Each 30 minute session thereafter              $75/session

Each 60 minute session                             $120/session

 

We recommend a minimum of four (4) 30-minute sessions per month in order to begin to benefit from these modalities and to feel comfortable practicing them on your own.

 

We believe that relaxation and breathing techniques play a valuable, complementary role in the relief of pelvic pain. However, because insurance companies do not reimburse patients for the cost of these Yoga sessions, we consider them optional. (Whether or not you can pay for these sessions with money from a Flexible Spending Account is worth exploring with your accountant or tax specialist.) 

 

Our Director of Yoga's web site

 

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Contact Us

 For more information about this program, please feel free to email us (ppcr@hdphysicaltherapy.com) or call and speak with one of the therapists at 212.499.0848