Facebook LIVE with Ignite Wellness: prevention vs. reaction

On Wednesday, October 31st, Dr. Nazari spoke with Ignite Wellness on prevention vs. reaction as it pertains to pelvic floor health.

“Sometimes we wait for crisis to hit before we take action. For example, you have lingering back pain that comes and goes and you try out yoga classes to help. However, the pain never really goes away. Then one day, you’re bending over to help your son with homework, and all of a sudden you can’t move. Crisis has hit. Now you are forced to react and make choices when you are in an anxious state, just to survive. Usually in this situation, the choices are not desirable, and you have limited options.

How can you avoid this scenario? By working on prevention techniques. What might these be, you ask?” Take a look at the recorded version of the conversation to learn more about the answer.

Beyond assault: sexual trauma and the pelvic floor

WARNING: This post includes experiences and rhetoric relating to sexual assault, sexual violence, PTSD, and physical repercussions of sexual trauma.

Not a day passes without us hearing about another case of sexual assault. While I don’t like to get political, it’s important to talk about these subjects, especially in light of today’s confirmation. The past few weeks have been disheartening, but it is encouraging to see that we, as a society, are paying a closer attention to this subject. Sexual assault is one of the most unreported crimes due victims’ belief that their report(s) will not be validated or deemed credible.

As for my own personal experiences as a pelvic floor physical therapist and an educator, I encounter individuals with histories of sexual abuse and trauma on a weekly basis. This extends outside of the clinical setting; when I teach other clinicians, there is always at least one person in the room that shares a personal story related to abuse.

Whether the incident of abuse/trauma occurred in childhood/adolescent ages or adulthood (for example, among men and women in military), sexual dysfunction and chronic pain conditions are often common side effects. Bornefeld-Ettmann et al., (2018) reported of signs of post-traumatic stress disorder (PTSD) as directly related to sexual dysfunction among those who have experienced childhood sexual abuse (CSA).

Female adults with a history of CSA not only have problems with sexual desire and arousal, they may also suffer from complex cognitive complications, such as increased sympathetic nervous system activation (the fight or flight system), shame, guilt, low self-esteem and poor body image (Pulverman, Kilimnik & Meston, 2018).

It is important to understand that a variety of other chronic pain diagnoses could be associated co-morbidities of the sexual trauma. In a large-scale retrospective study by Cichowski, et al., (2018) on military women veterans, this assertion was explored and validated. The women in the study suffered from a variety of conditions such as irritable bowel syndrome, chronic pelvic pain, back pain, dyspareunia (painful sexual intercourse), joint pain, fibromyalgia, chronic abdominal pain, and headaches.

Pelvic floor dysfunction, such as vulvodynia and other sexual dysfunction, become the integral part of treatment when survivors are seen by pelvic floor physical therapists. These therapists, myself included, have special training to address many of the above physical disorders, confirm that the signs and symptoms the individual is experiencing are indeed from a deeper root, and subsequently provide a safe environment for these patients to reach their optimal physical (and mental) strength.

As mentioned in my previous blog posts, pelvic floor-related issues (pain, urinary/fecal incontinence or other related issues, and/or sexual dysfunction) are not gender specific. Men and women suffer silently from these issues, regardless of the origin of problem. I am proud to work with amazing people, many who are survivors of assault – they have each made me stronger and I will forever believe them, support them, and help them reach the goals they want to achieve in physical therapy and life itself.