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Hand Therapy Center NJ

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Pelvic Health & Wellness Center Logo
Atlantic Hand Therapy Center

Women’s Health PT

Women’s Health PT

From prenatal and post-partum care to perimenopause and menopause, many changes that women go through come with uncomfortable changes that are written off as “normal”. Freehold Physical Therapist, Theresa Wilk, has become passionate about trying to change the care that women traditionally receive throughout their life by expanding her own education and scope of treatment. She is excited to be able to offer help to women experiencing issues in all stages of life.

Incontinence (the involuntary loss of urine or feces)

Stress incontinence: the involuntary loss during coughing, laughing, or sneezing

Urge incontinence: the inability to make it to the bathroom in time

Mixed: both stress and urge

Nocturia: waking more than 1 time at night to use the bathroom when you are under 60 years of age, more than 2 times after the age of 60

Pelvic Organ Prolapse

This is when one or more of the organs in the pelvic floor begin to descend into, and sometimes out of the vaginal canal, due to loss of support.  It is estimated to affect up to 50% of women. 

Symptoms of prolapse can include:

  • heaviness in abdomen or vaginal area
  • low back or pelvic pain
  • difficulties urinating or completely emptying the bladder
  • a bulge at the vaginal opening.  

Prolapse is described by the organ that is descending.  It is also possible to have more than one organ descending.

Cystocele: bladder (most common)

Rectocele: rectum

Uterine prolapse

Urethrocele: urethra

Endocele: small intestine

 It is graded by how far the organ descends into/or out of the vaginal canal, using the hymen as a reference point.

Grade 1: organ descent into the vaginal canal, no further than 1cm from the hymen

Grade 2: organ descent at least 1 cm from the hymen, or at most 1 cm further

Grade 3: organ descent 1-2cm from hymen

Grade 4: organ descent greater than 2 cm from hymen

There are many treatment options for pelvic organ prolapse, including surgery.  

Conservative interventions include:

  • strengthening of pelvic floor and hip musculature to improve stability
  • management of constipation (constant bearing down encourages descent)
  • pressure management during transfers, squatting, sit/stand to decrease valsalva and bearing down effect
  • pessary: orthotic for the vaginal wall, prescribed and fitted by a urogynecologist


is when tissue similar to the uterine lining is found outside the uterus.  

Symptoms include:

  • pain in the lower abdomen/pelvis and/or back,
  • pain with menses, pain with and/or intimacy, and
  • pain with bowel movements

This condition affects about 5 million women in the US, and is often hard to diagnose, or misdiagnosed.  It can take up to 10 years to diagnose this condition in some women.

Physical therapy can help to reduce pain symptoms associated with endometriosis with gentle stretching, manual therapy and relaxation techniques.

Dyspareunia (painful sex)

This can be persistent or recurrent pain that occurs with vaginal penetration.  It can be deep or superficial pain, occurring before, during or after intercourse.  The causes of this vary, and can be related to the menopause transition, other urogenital diagnosis, physical, or physiological.  Pelvic floor physical therapists are trained to use relaxation, soft tissue techniques and a variety of self-care options to resolve pain with intercourse.


These are terms that refer to pain at a specific location of the female genitalia:

Vaginitis – pain inside the vaginal canal

Vulvodynia – pain at the vulva, external area of the vaginal opening

Vestibulodynia – pain at the entrance of the vaginal opening (most common)

Any of these areas can become inflamed and irritated, and symptoms include burning, stinging, dryness and rawness.  This can be caused by inflammation (internal or external), nerve irritation, muscular, and hormonal changes.  It can be provoked (direct touch, intimacy, tampon use) or unprovoked (insidious, sitting postures, tight clothing).  Physical therapy treatments include manual technique, vaginal/vulvar care and pain education.