The Pelvic Floor
Everyone has a pelvic floor! The Pelvic Floor is a group of muscles, tendons and ligaments that connect to the bones of the pelvis, creating a hammock or basket like support for the bladder, the uterus (womb), and the bowels. This support structure is designed to keep all of lower abdominal organs in optimal alignment.
The pelvic floor houses the openings of the urethra from the bladder, anus from the bowels and vagina from the uterus (in females). The pelvic floor helps to close these openings to prevent leakage and relax them for emptying.
In women, during sexual activity, the pelvic floor muscles help to increase blood flow to the genitals to promote arousal, lubrication, ease of penetration and orgasm. In men, the pelvic floor muscles help manage blood flow to the genitals by compressing the penile veins, trapping blood in the penis, creating an erection.
The pelvic floor is also activated in conjunction with the abdominal muscles and muscles of the back for activities like lifting, bending and carrying. These activities increase the pressure in the abdomen. The pelvic floor is particularly important in keeping the lower abdominal organs from being pushed downward and prolapsing.
The Need for Support
The following can indicate pelvic dysfunction:
urinary frequency, urgency, leakage or incontinence
bowel frequency, urgency or incontinence
hemorrhoids
pain during sex or pain on orgasm / ejaculation
lack of sensation during sex
recurring infections (bladder, urinary tract, kidney)
interstitial cystitis
endometriosis
fibroids
vulvodynia
yeast infections
pudendal neuralgia
prostatitis
erectile dysfunction
Peyronie’s Disease
pregnancy and postpartum
We provide comprehensive pelvic care for long term relief.
Dr. Krystal Couture is a holistic PT and licensed acupuncturist. Her approach to Pelvic Care includes the lenses of Eastern and Western Medicine. Combining the energetics of the body, biomechanics and tailoring treatments to your specific needs is recipe for success. The following is a window into what Pelvic Care with Dr. Krystal might include.
Diagnostics
The Biomedicine approach looks at the function of the body’s structures (muscles, bones, tendons, organs) individually and in relation to each other. The Traditional Chinese medicine approach identifies patterns that inhibit optimal function. We use the two methodologies to identify your needs.
Acupunture
Acupuncture addresses the energy of the body. We use acupuncture to create a foundation for treatments, by clearing blocks or barriers in the system that reduce its function within the meridians + organs and optimize the flow of qi in the system. Acupuncture helps us to restore function in the patterns we identified in the diagnosis. Furthermore, acupuncture is beneficial in getting to the root of any spiritual emotional considerations by working with the spirit of the points.
Trigger Points
While Dry Needling is thought to be a modern Western approach, it has actually been documented for thousands of years in Chinese Medicine. We use Trigger Point Needling or Ashi Point Needling to address local tender points in the pelvis and surrounding tissues that are either over or under active. This helps to restore both the muscular and energetic functions of the pelvic floor.
Nutrition
Exercise
Manual Therapy
& More
Chinese Nutrition is all about the energetics of food. Remember those patterns we found in the diagnostics? Often times, food choices contribute to the dysfunctional pattern. Eating and avoiding certain foods is a relatively easy way to support your pelvic and overall health.
Understanding your pelvic floor is the key to properly exercising it. Most often, the first exercise and the most powerful exercise I give to clients is a simple breathing exercise to engage the muscles of the PF with the breath. I also provide some qi gong and strengthening/relaxation exercises based on what’s happening with your PF.
Manual Therapy like abdominal massage, craniosacral therapy, myofascial release and joint mobilization are techniques I commonly use in my practice to address biomechanical or orthopedic issues within the pelvis and surrounding structures.
There are a wide range of additional modalities that I use in practice which include moxa, cupping, gua sha, electroacupuncture, pelvic streaming / smoking and more that are not always indicated for each client, but are used based on need. These modalities can really help to move the needle (pun intended) in some pelvic floor cases.
Myths versus Facts about Pelvic Health
Myth #1: Pelvic pain and dysfunction are normal parts of aging that I just have to accept.
Fact: Pelvic pain and dysfunction are NOT normal and you absolutely don’t have to accept them as your new way of life!
Myth #2: There’s nothing that can be done about pelvic health.
Fact: You can get pelvic care support with acupuncturists, physical therapists and holistic gynecologists. Interventions may include trigger point needling, acupuncture, moxa, cupping, gua sha, exercises, breathing activities, qi gong, diet and more.
Myth #3: Pelvic floor problems only occur in women who’ve given birth.
Fact: Pelvic floor problems can occur for a number of reasons in both men and women, including pregnancy, birth, gastrointestinal disorders, orthopedic issues or injuries, repetitive lifting, hormonal changes and obesity.
Pelvic Care Services
Pelvic Care Evaluation
PelvicCare+ is for all new pelvic care client sessions with Dr. Krystal Couture, PT, LAc. All PelvicCare+ sessions include full evaluation, initial treatment and infrared body treatment. Appointments run from 85-115 minutes. Sliding scale $255-285 per session.
Pelvic Care Follow Ups
PelvicCare is for follow ups with Dr. Krystal Couture, PT, LAc. PelvicCare allows for up to 20 minutes of consulting, acupuncture and holistic PT as indicated. All sessions include infrared body treatment. Appointments run from 55-85 minutes. Sliding scale $165-$195 per session.
FAQs
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We accept only private pay and HSA/FSA payments. This allows us to be guided by your body’s needs rather than general protocols, to take a much time per session as needed and to achieve results faster based on your individual goals.
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I treat all genders and ages with respect and honor.
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Honestly, we see clients on both ends of the spectrum. With great awareness to pelvic health, more and more young women in popartum or perimenopause are seeking preventative support. However, pelvic health has only just started to become more mainstream, thus lots of clients are coming in with pain, symptoms or dyfnction of the pelvic floor.
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YES! While pelvic floor weakness leading to urinary leakage is most commonly talked about, there are LOTS of other things that could be going on. There may be tightness of the pelvic floor on one side or both, there could be an issue with your surrounding structures like you back or hip, or there could even be an emotional block from miscarriages, fertility trials, or abuse. That’s what we do best is gently working into the pelvis to find out the source of its disharmony.
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Unfortunately, pelvic health, reproductive health and sexual health have been associated with shame and confusion. I’m not here to judge you. I want to listen, support, educate and offer help. We can go through this process at whatever speed is comfortable for you.