Pelvic Rehabilitation The manual therapy and exercise guide across the lifespan

258 Pages·79.802 MB·English

by  Mason, Maureen

Pelvic Rehabilitation
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PELVIC
REHABILITATION
The manual therapy and exercise
guide across the lifespan
Maureen M. Mason
DPT, MS, WCS, PYT
Illustrated by Bruce Hogarth
Foreword by Ginger Garner
First published in Great Britain in 2023 by Handspring Publishing, an imprint of Jessica Kingsley Publishers
An imprint of Hodder & Stoughton Ltd
An Hachette UK Company
1
Copyright © Maureen Mason 2023
The right of Maureen Mason to be identified as the Author of the Work has been
asserted by her in accordance with the Copyright, Designs and Patents Act 1988.
Foreword copyright © Ginger Garner 2023
Illustrated by Bruce Hogarth
All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or
transmitted, in any form or by any means without the prior written permission of the publisher,
nor be otherwise circulated in any form of binding or cover other than that in which it is
published and without a similar condition being imposed on the subsequent purchaser.
Disclaimer: The information contained in this book is not intended to replace the services of
trained medical professionals or to be a substitute for medical advice. The complementary therapy
described in this book may not be suitable for everyone to follow. You are advised to consult a
doctor before embarking on any complementary therapy programme and on any matters relating to
your health, and in particular on any matters that may require diagnosis or medical attention.
A CIP catalogue record for this title is available from the British Library and the Library of Congress
ISBN 978 1 91342 609 5
eISBN 978 1 91342 610 1
Printed and bound in China by Leo Paper Products Ltd
Jessica Kingsley Publishers’ policy is to use papers that are natural, renewable and recyclable
products and made from wood grown in sustainable forests. The logging and manufacturing
processes are expected to conform to the environmental regulations of the country of origin.
Handspring Publishing
Carmelite House
50 Victoria Embankment
London EC4Y 0DZ
www.handspringpublishing.com
Contents
Foreword by Ginger Garner. . . . . . 7 Section Three: Pelvic Challenges
and Health Across the Ages
Preface . . . . . . . . . . . . . . . . . 9
9. Urinary Incontinence . . . . . . . . 167
10. Gastrointestinal Health, Pelvic
Section One: Pelvic Anatomy,
Health, and Dysfunction . . . . . . 177
Function, Movement
Foundations, and Pain
11. Pelvic Health: Midlife into Elder
Years . . . . . . . . . . . . . . . . . . 188
1. Pelvic Anatomy and Function . . . 15
2. Pediatric Pelvic Health. . . . . . . . 34
Section Four: Integrated
3. Pelvic Health in Teens and Young
Provider and Client Care
Adults . . . . . . . . . . . . . . . . . 55
12. Mindfulness and Meditation for
4. Pelvic Pain . . . . . . . . . . . . . . . 77
Pelvic Health
Pauline Lucas
(phoenixyogaandmeditation.com) . . 203
Section Two: Perinatal
Changes, Challenges, and 13. Sexual Health . . . . . . . . . . . . . 210
Resilience in Pelvic Health
14. Integrative Pelvic Health Care
5. Pregnancy, Birth, and Early Co-authored with
Postpartum: Profiles in Resilience Jessica Drummond
Co-authored with J. Michelle (integrativewomenshealthinstitute.
Martin (jmmhealthsolutions.com) 101 com). . . . . . . . . . . . . . . . . . . 223
6. Diastasis Rectus Abdominis. . . . . 120
List of Acronyms. . . . . . . . . . . . 240
7. Pelvic Girdle Pain. . . . . . . . . . . 135
Subject Index. . . . . . . . . . . . . . 242
8. Pelvic Organ Prolapse . . . . . . . . 149
Author Index . . . . . . . . . . . . . . 252
Acknowledgments . . . . . . . . . . . 256

Foreword
The book is a treasure for anyone who has strug- system today. Chapters 2, 3, 5, and 11 provide a
gled personally, or who has a loved one, with pel- chronological journey across the lifespan of pelvic
vic health issues. It is also a foundational book for health, and explore the challenges, from infancy
those interested in learning about pelvic health, and early childhood through to adolescence, and
for students studying anatomy, physiology, and from pregnancy, birth and midlife through to
pathology, for parents, teachers, fitness instruc- elder years. Pelvic expert Dr. J. Michelle Martin
tors, movement therapists, and working health provides insight as a mother of three, doula,
care providers who want a big picture on pelvic and sexual health educator in her contributions
health across the lifespan. Dr. Mason logically to the pregnancy, birth, and early postpartum
introduces the level of information presented, chapter. She addresses disparities in maternal
starting with introductory concepts and moving care and pelvic health in regard to minority and
through to advanced paradigms. The progressive lower socioeconomic group status, with facts
knowledge base advances through the chapters, addressing increased maternal morbidity and
which spikes curiosity and interest as the topics mortality due to inadequate care, and a call to
are developed in the book. action to improve skilled care for all. She also
The adept presentation at tackling pelvic includes perinatal fitness programs and safety
health issues across the lifespan is apparent profiles. These specific chapters are foundational
throughout the book, and reflected in Dr. Mason in understanding specific health challenges and
and colleagues’ extensive clinical experience in solutions in relation to the seasons of life, as well
pelvic health. This book does a wonderful job of as providing wellness pearls for each life phase.
elucidating the team approach, as there are so Additionally, pelvic problems may be considered
many medical specialties that may be called upon as “part of aging” and must be accepted, which is
to treat pelvic health challenges, and there are simply not true.
many interrelationships in teasing out best care Chapters 4, 6, 7, and 8 tackle the difficult
practices for pelvic floor dysfunction. From self- topics of pelvic pain, postpartum abdominal, pel-
care to health care strategies, the reader can glean vic joint, and organ support system challenges.
preventative as well as wellness care knowledge Chapter 13 covers sexual health concerns, well-
in managing their individual health across the being, and healing. Pelvic health topics are often
lifespan. regarded as taboo, and overlooked, shamed, rid-
Chapter 1 encourages empowerment toward iculed, or marginalized, especially in the lesbian,
educating people about how their bodies work, gay, bisexual, transgender, and queer (LGBTQ+)
something many feel is missing in our education communities. Safety, comfort, and pleasure with
7
8 PELVIC REHABILITATION
sexual function can be improved with strategies Another important tenet is the treatment of
portrayed in this book, as well as continuing edu- men, women, and non-binary individuals with
cation with the reference list which is provided. regard to pelvic health. This population is well
Chapters 9 and 10 address bladder and recognized as underserved, under researched,
bowel health and dysfunction, including gastro- and under attended to today. People with pain
intestinal (GI) function and the gut microbiome or other pelvic health challenges are too often
influence on overall health. Providers may take a disregarded or shuffled through the health care
course on one of these topics, or specialize in one system without being truly listened to. Listening
field (urology, gastroenterology), however these is a hallmark of connection. And because many
two functions are anatomically, structurally, and pelvic health disorders begin with trauma or
physiologically interconnected, and the interplay microtrauma, listening, connection, and com-
of the two is clarified in this book, including top- passion is requisite for healing.
ics such as pressure systems and inflammation. This book will take down barriers to receiving
Chapters 12 and 14 cover meditation, mind- pelvic care and help the reader understand that
fulness, and complementary and integrative critical topics like environmental contributors
approaches to health care. Expert insight on to health, including but not limited to clean air,
self-care is provided from Dr. Pauline Lucas, water, soil, food, beauty products, and household
pelvic health therapist, yoga, and meditation cleaners, matter in pelvic health. Additionally,
instructor (Chapter 12) and editing from Dr. other exciting areas of development addressed
Jessica Drummond, founder of The Women’s are the influence of the gut microbiome, epi-
Integrative Health institute (Chapter 14). genetics, the gut-brain axis, and functional
An example of the integrative approaches endocrinology. Together, these variables are part
covered in this text is the concept of the “three of what is evolving pelvic health.
diaphragms,” with sample exercises to sense We should all be passionate about pelvic
those connections. I originally presented this health, and after having served in multiple capac-
concept in my Medical Therapeutic Yoga text ities over the years in policy and academics in
(Garner 2016). I used the term “thoracic dia- pelvic health at state, federal, and global levels,
phragm” in reference to the laryngeal area (see it is deeply satisfying to see this textbook arrive,
Figure 1.1); however, the reader may see many one that is finally dedicated to empowerment of
other names for the uppermost of the three the individual and the health care system itself
diaphragms, including cervical, laryngeal, vocal, through pelvic health education. I expect the
and cervico-thoracic. reader will delight, as I did, in reading it, in the
After working in pelvic health and orthope- journey toward their best self, whether for their
dics for nearly three decades, I have found that own self-care, or in providing mind-body client
one cannot treat pelvic health conditions with- or patient care. This book is a welcome addition
out using both a biomedical and integrative, bio- for embracing person-led, compassionate pelvic
psychosocial approach. Put quite simply, using health care.
mind-body interventions such as yoga, Pilates,
and mindfulness make pelvic health physical Dr. Ginger Garner PT, DPT, ATC/L
therapy intervention far more effective, with Living Well Institute & Garner Pelvic Health
clients learning insight, self-care, and sustain- Greensboro, NC
able nutrition, stress management, and fitness
routines. This book does a wonderful job of
addressing these topics.