Mary Cox Physical Therapy

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March 14, 2020 by Mary Cox

Successful Pregnancy after Pre-IVF Physical Therapy

Scars, Adhesions, Endometriosis and Infertility
Successful Pregnancy after Pre-IVF Physical Therapy

A 32 year old female patient of mine conceived twin daughters in January 2020 and was so excited she wrote to me and said:

What a gift after two prior failed IVF’s. I really feel like the work you did made it possible for me to have my miracle babies!! Thank you!!!”

Here is the Story of Her Journey:

This patient, who is a physical therapist by profession, was diagnosed with stage 3-4 endometriosis and subsequently had laparoscopic surgery October 2018 to remove the endometrial lesions and scar tissue. She had hoped the surgery would improve her fertility chances, reduce menstrual cycle and intercourse pain, as well as resolve the nagging discomfort in her lower abdomen.

But to her dismay, none of this happened. In fact, both Fallopian tubes were surgically removed as they were not salvageable. Her doctor recommended assisted reproductive techniques post surgery, IVF or in-vitro fertilization which became her only means to conceive.

What Studies Say About Reproductive Age and Endometriosis

According to The American College of Obstetrics and Gynecology (October 2012) One in 10 women of reproductive age in the United States has endometriosis—making it one of the most common gynecologic disorders.

The European Society of Human Reproduction and Embryology reports that 50% of infertile women have endometriosis. This disease presents when endometrial-;like tissue grows around the ovaries, on or in the Fallopian tubes, on the outside of the uterus, or on other pelvic or abdominal organs. Laparoscopic surgery is used to remove endometriosis. This is done by either cutting it out or by freezing, heating, or lasering to destroy the tissue. This technique removes the invasive endometrial cells but the down side is the post-surgical scarring and adhesions.

What you can you do when two rounds of IVF fail?

Through word of mouth, this woman heard about Cox PT for pre-IVF infertility assistance. Her goals for therapy were to reduce, soften and/or remove post surgical adhesions from the uterus to prepare the tissue for her final two female embryos.

Assessment:

By using an “insightful touch” I am able to identify lines of tension, adhesions, scar restrictions, tissue dryness and roughness, pain and simply looking for areas where there is loss of motion.

Findings:

We identified a lack of uterine mobility. The uterus was scarred down toward the left back wall on the sacrum and tail bone, compressing against the rectal colon and thus compromising stool elimination. Due to the left uterine scarring, pelvic organs had shifted. This created a great deal of cross tensional stretch on the right side of the pubic bone, right bladder and associated kidney pathway.

Other Concerns:

She reported having daily bowel elimination difficulties. Elimination was moderately painful, and the stools were pencil thin. Not only did it hurt to have bowel movements, the left pelvic floor muscles were in spasm which made sitting very uncomfortable, tolerable for about 30 minutes. She also had chronic daily lower abdominal pain with mild to severe bloating; this discomfort was described as sharp, pressure, cramping and a dull ache.

Reproductive Treatment Goals:

My treatments targeted removal of elements that could hinder or obstruct reproductive function and fertility. I worked the primary restriction by releasing the uterus away from the left sacrum and tailbone. Then I freed up the tension and adhesions binding the small bowels, sigmoid colon, rectal colon, uterus and bladder together. I worked locally on the uterus to soften all areas of thickness and fibrosis until soft, slippery and with a “marshmallow like” consistency with compression and decompression. I then finished globally with all associated fascial tissues, organs, muscle, ligaments, and tendons, especially the diagonal restrictions found on the right bladder, ureter and kidney.

As an expert in manual therapy, I want my work to any or all of the following:

  • Improve tissue elasticity and muscle function.
  • Increase range of motion, blood flow, and nerve function.
  • Increase organ, soft tissue and joint mobility.
  • Reduce tissue swelling.
  • Resolve pain, inflammation, post surgical scarring and adhesions.

Cox Physical Therapy can prepare the way for your future children with pre-IVF infertility assistance.

Filed Under: Adhesions, Infertility, Manual PT, Scarring

February 11, 2020 by Mary Cox

Is there a relationship between low back pain and infertility?

Christmas Day gift, born on 12/25/2016.

My patient conceived her son, after just one visit of physical therapy for low back pain. She had been living with moderate lower back pain. Since it was not resolving, she sought medical help. Her doctor ordered a MRI and the results indicated that she had mild lumbar 3-4 and 4-5 disc herniations. Complaints were moderate low back pain, generalized body tightness, and right leg traveling pain to the knee.

She came to physical therapy to help with her back pain and right leg radicular symptoms, treatment was not for fertility assistance. Her spouse encouraged her to come down for treatment, even though it was about one hour away from their home. She had tried many modalities for the low back pain but with little to no improvement. So decided to try Cox PT since her husband had good past results with treatment for his back.

The Unexpected, but Miraculous Results of Lower Back Treatment

I was later informed by the husband who was elated, reporting “We are pregnant!” He said it had to have happened the weekend after treatment and explained why conceiving was so astonishing. This was her very first pregnancy at age 38. They had been trying to conceive naturally for two years. She changed her diet, added nutritional supplements, reduce her stress and workload, started gentle exercises, acupuncture, reduced electrical magnetic waves in the bedroom and home, menstrual cycle and hormone monitoring, ovulation test strips and a myriad of suggestions she found online.

Unexplained infertility is a journey filled with many trials and tribulations, old wives tales, lifestyle changes, education, and anything that creates the right environmental for you to conceive. Infertility is defined as not being able to get pregnant despite having frequent, unprotected intercourse for at least one year.

Physical therapy can help with unexplained infertility

This is true, especially if it is related to mechanical restrictions from adhesions and scarring. Adhesions and scars can form after falls on the back side, a fractured hip or pelvis, pelvic infections, pelvic inflammatory disease, appendicitis, endometriosis and from surgeries to the back, abdomen or pelvic organs. Adhesions are a frequent cause of unexplained infertility and are difficult to diagnosis because ultrasounds, x-rays, CT or MRI scans do not show adhesions. You literally have to do surgery, usually laparoscopic, to look inside at the tissues and organs as they are lifted, moved, separated and spaces are parted open to see and identify if there are adhesions.

The Treatment:

By using an “insightful touch” the whole body is assessed to help identify lines of tension, adhesions, scar restrictions, tissue dryness and roughness, pain and simply looking for areas where there is loss of motion. Soft tissue, connective tissue/fascia, muscles, ligaments, tendons, bones, visceral organs, nerves and vessels need to move! All these tissues have inherent motion and should painlessly move with a touch and rebound when compressed.

Once body restrictions are identified, treatment begins!

Manual physical therapy is a specialized type of modality that is delivered with the hands versus a device or machine. As an expert in Physical Therapy, my goals are to produce any or all of the following: improve tissue elasticity, increase range of motion, increase blood flow and nerve function, reduce tissue swelling, increase mobility and motility of organs, mobility of soft tissue and joints, induce relaxation, improve muscle function, reduce and/or resolve pain, inflammation and movement restrictions.

Scar tissue is not inherently permanent. The tissue can undergo a process known as remodeling in which abnormal clumps of cells, called adhesions, are gradually loosened and replaced with a more normalized cellular arrangement. Scar tissue remodeling occurs with prolonged stretching, the “direct method” or working into the direction of resistance helps align collagen fibers. This realignment of the collagen fibers makes the tissues able to tolerate normal functional forces that are placed on them. Working “indirect methods” works well with nerves and blood vessel pathways to optimize blood flow, oxygenate and clear toxins from the target tissues and organs. Treatments may involve treating the body from head to toe with focus on the primary concerns and restrictions; or it may be a very localized specific area that will be addressed. With that being said, each treatment is tailored to the individual client.

What an honor to have helped this couple become a family.

Filed Under: Adhesions, Infertility, Scarring Tagged With: Infertility, Lower Back Pain

Helpful Resource Links

Pelvic Health
  • On Pelvic Pain
  • Pelvic Pain Support Group
  • On Coccyx Pain
  • On Endometriosis
  • On Adhesions

For Men
  • On Men's Pelvic Pain
  • Men's Pelvic Pain Support Group
  • On Chronic Prostatitis

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