At Comprehensive Therapy Services we treat pelvic pain and dysfunction in both men and women. There are several women's support groups available through various national organizations such as the National Vulvodynia Association ( nva.org) and the Interstitial Cystitis Association ( ICHelp.org) but for our male patients there is a paucity of support groups regardless of where you live.

We are happy to announce that a men's support group is starting here at CTS.

One of our patients is going to be the lead and it will be primarily a safe place for prior, current and potential male pelvic pain/dysfunction patients to have a voice, listen to other's stories and gain information. It will be a monthly meeting on a week night at 6pm here at the clinic. To start we would like to invite any of our male patients that would like to just have a conversation, share their journey, discuss therapy options and meet with other men who understand what you are going through. Eventually we plan to have speakers from various professional fields to provide their expertise on a general level and help continue the flow of information and professional options that are available. If you think or know you have painful intercourse or genital pain, painful bladder or bowel dysfunction, or aren't even sure what is going on in your pelvic region, please consider coming to one of these sessions.

This will be a place where men can come and talk about their problems/pain in a relaxed, nonjudgemental and more casual atmosphere with other men who have experienced similar problems.

Our first meeting will take place on Monday, April 16th at 6pm at CTS, where we specialize in the treatment of pelvic floor pain and dysfunction.

Pam Dehne, PT, MPT

Chronic constipation is the most common digestive problem in the US, affecting approximately 63 million people every year.

In children, this problem is even more prevalent, with up to 30% of all children experiencing chronic constipation, accounting for up to 5% of all pediatrician visits.

Laxatives plus education on dietary changes is the most common medical approach to treat constipation. However, even with these strategies, it is not uncommon for constipation to become chronic, persisting for months or years. Fortunately, there is another option; Pelvic physical therapy a safe and effective treatment of constipation in children (and adults!). In fact, a 2017 study found pelvic physical therapy was effective to relieve constipation in 92.3% of children, versus 63.0% who received only laxatives and education.

If you or your child is struggling with constipation, here are a few tips for simple lifestyle changes that can help reduce symptoms:

• Proper hydration is key! For kids, an easy rule of thumb is 1oz of water per pound of body weight.


• Ensure a diet rich in fresh, colorful foods and adequate amounts of fiber.


• Establish good habits: Regular meal times, schedule "potty breaks" into routine, and get plenty of regular physical activity.

While lifestyle changes can improve symptoms for some, chronic constipation often requires professional help. Here are a few techniques a physical therapist might use to help with constipation:

• Effective toileting posture - Sitting in the wrong position can change the alignment of the pelvis, making it more difficult or impossible for the pelvic floor muscles function properly, resulting in pain or straining on the toilet.


• Relaxation techniques - When humans are stressed, fearful, or in pain, it is common for our bodies to enter a state of alert; we tense up, our breathing becomes rapid and shallow and digestive processes stall as our body reroutes blood flow to other areas. If we are in this state for extended periods, the digestive system can be impacted, resulting in constipation which can further contribute to the cycle of pain and stress. Focused training in relaxation and breathing can help the body to "reset" to a more balanced state.


• Sensory techniques - It is common some kids (and adults, too) may need specialized training to become more aware of the sensations in their bodies. It is not uncommon for children to delay going to the bathroom because they are distracted playing. Over time, if the body's natural reflexes to go to the bathroom are repressed or ignored, the brain may need help to re-learn and interpret the body's signals and sensations.


• Manual therapy and exercise - Hands-on techniques like abdominal massage can help "move things along" and exercises to strengthen legs and core muscles can also decrease symptoms.


• Abdominal and pelvic floor muscle training - Just like other muscles of the body, the muscles that control going to the bathroom need to be flexible, strong, and have control to relax and contract at the right times. Pelvic physical therapists have a variety of tools to assess and train these muscles for optimal function.

Reference
Marieke L van Engelenburg-van Lonkhuyzen,Esther M J Bols,Marc A Benninga,Wim A Verwijs,Rob A de Bie. Effectiveness of Pelvic Physiotherapy in Children With Functional Constipation Compared With Standard Medical Care. Gastroenterology. 2017, Vol.152(1), p.82-91.

Jen Fasching, SPT