Photographs: Xray © Nut – stock.adobe.com; others: contributed by HSS
Hospital for Special Surgery (HSS) and Stamford Health have teamed up to bring top orthopedic specialists right here to Westport and Wilton. One of those doctors is Dr. Elizabeth Brown, a physiatrist with expertise in pelvic health rehabilitation. “Pelvic health” is not a term we heard our grandparents utter. It’s probably not something people chatted about back in 1863, when HSS was founded (it’s the oldest orthopedic hospital in the country). But one quarter of women in the U.S. will experience pelvic floor disorders in their lifetime and men suffer too.
Dr. Brown is happy to take the conversation to the nether regions and offer some much needed relief.
Is the topic of pelvic health becoming less taboo?
It is. I think over time our society has become more open to discussing pelvic health and developing treatment options. With regard to the perinatal period especially, more literature has been coming out recently about treatment and guidance for the active pregnant and postpartum patient.
What are the common pelvic health issues women face?
At HSS Westport and HSS Wilton I primarily see perinatal patients, chronic pelvic pain, coccydynia and urinary incontinence. Pelvic health conditions span a wide spectrum of symptoms, including constipation, pain with defecation, pain with intercourse, urinary frequency or urgency and pelvic pain with daily activities.
What are some solutions?
The first step is a thorough evaluation and discussion of symptoms. This often leads to physical therapy or pelvic floor physical therapy (PFPT). In some cases, medications are indicated. There are various injection options, some of which target the pelvic floor. These can be trigger point injections or Botox injections, which are done at HSS Westport. Overall, I like to take a comprehensive and holistic approach and address any lifestyle or activity modifications that might reduce pain.
Is there anything women can do preventatively, before/during/after pregnancy?
I think the most important thing is to establish the team that is going to support you throughout your pregnancy and postpartum. In addition to your obstetrician, this might mean connecting with a pelvic floor physical therapist and/or pelvic health specialist who can see you before, during and after pregnancy to help manage your symptoms and safely guide return to activity. Staying active and exercising is essential to the health of the mother and baby. If there are any concerns about starting or returning to exercise in the perinatal period, the patient can be referred to the Perinatal Movement and Physical Well-being Resource Center at HSS.
Tell us about that.
This is a sub-group of the HSS Women’s Sports Medicine Center that supports the health and well-being of patients before, during and after pregnancy. It is a multidisciplinary group, including specialties such as physiatry, sports medicine, nutrition, exercise physiology and rehabilitation. The center offers a variety of resources, including nutrition consultations, physical therapy visits and physician guidance on return to exercise.
What about men? This is not exclusively a female problem?
Men certainly also have pelvic floors. Anyone with a pelvic floor can develop pelvic floor symptoms.
Are men hesitant to bring up these issues and what is your advice?
It can be challenging for anyone to bring up symptoms of pelvic floor dysfunction. My advice is to discuss any pelvic health concerns with your primary care physician, gastroenterologist, urologist and others. I frequently see men with pelvic floor symptoms in my practice. The prevalence of chronic pelvic pain in men is thought to be around 10 to 16 percent and most commonly affects those in their thirties to fifties (Schaeffer, 2008).
Tell us about the HSS Women’s Sports Medicine Center.
This is a group of clinicians at HSS committed to the care of the female athlete across their lifetime. The group comprises experts in sports medicine, physical therapy, exercise physiology, nutrition and psychology. They take a comprehensive approach to patient and athlete care, which might include discussion of pelvic health.
HSS Orthopedics with Stamford Health – Westport
276 Post Road West
Westport, CT
203.391.2270
hss.edu/locations
Specialties
Foot and Ankle
Hand and Upper Extremity
Hip and Knee Replacement
Physiatry
Spine
Sports Medicine
Services
Physician Office Visits
Radiology and Imaging
Patients can also see Dr. Brown at HSS Orthopedics with Stamford Health – Wilton
Wilton Crossing
195 Danbury Road
Whitlock Building, Suite 200
Wilton, CT
203.705.2950