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

December 18, 2019 by Mary Cox

Scars Restrict, Adhesions Attach: Treating Structural Issues Promotes Agility, Overall Health, and Peels Off Aging

My client, Mare, suffered for years with painful limitations from pelvic scarring and adhesions. My treatment program yielded marked improvement; and ultimately we reduced her treatment sessions to only a few times per year. In fact, she was doing so well, she decided to resume her old favorite pastime of horseback riding!

Mare said, “I had so much limitation from my scars and adhesions that I never imagined I’d be riding again.


After her first few rides, however, she noticed that her central abdominal muscles did not seem to be as sore as the rest of her muscles. She knew something wasn’t working correctly and scheduled a visit for my help. I felt the lines of tension to her pelvis and hip joints especially the left. Sure enough, old pelvic scarring was preventing normal hip and pelvic range of motion. So instead of the bones moving separately, as they should, they were moving as one piece. Her central abdominal muscles from lower ribs to pubic bone could not engage properly because of adhesions restricting the pelvis from tipping upward. It is a good thing that Mare noticed her abdominals were not working as expected. Her inner thigh muscles and associated pelvic muscle groups, which help maintain her in the saddle, were not engaging properly. This compromised Mare’s security and balance.

The pelvis holds our center of gravity and transmits forces of motion from our limbs to and from the ground. The pelvis is like a transportation station that distributes most of the body’s movement through the spring-like “S” curve of our vertebrae, and the jelly-filled cushions between them. The lower five sacral vertebrae are fused and insert into a complex joint. Extensive wrapping of various muscles and tissues around the bones allow the pelvis to absorb and stabilize are movement. This stabilization contributes to our overall functional balance and agility for activities such as horse back riding.
The stabilizing role of the pelvis can be compromised by surgery, injuries, scarring, adhesions, repetitive movements, and hours of desk or computer work. When the pelvis cannot move properly, as in Mare’s case, muscles compensate and adapt through unnatural movement patterns. Eventually over time, scars and adhesions restrict tissues and joint cartilage which can lead to arthritis.

Treatment Strategy

I let the body guide my treatments rather than following predetermined protocols. I started to release her hip capsules to get the head of the thigh bones moving freely in their sockets. When possible, I work paired organs and bones to balance both sides of the body.
There is usually a visceral component to many dysfunctions! Mare not only had restriction in her hips and pelvis but in her digestive organs as well. These abdominal organs can also be bound down by scarring and adhesions. The large intestine is very close to the hip joints, and attached with strong fibers called ligaments. Freeing the tissues in and around Mare’s pelvis actually improved pelvic mobility and digestive health. With better digestion she could absorb nutrients more efficiently as well as stay more safely on the horse.

Now Mare claims to be feeling much better, and is more confident in her riding. Without treatment for her scars and adhesions, Mare says she would never have considered riding horses again. She didn’t have the fluidity of movement or range of motion. Mare claims she feels twenty years younger than she did when starting treatment. She is tuned into her body and notices when something is not right, seeking help, as she did in this case.

Filed Under: Adhesions, Manual PT, Scarring

January 11, 2016 by Mary Cox

How Can a Physical Therapist Help Me?

Picture of patient on table getting pain relief treatment

How can a physical therapist help improve my quality of life?

As a licensed manual physical therapist since 1981, I have have been able to help thousands of people just like you whose pain was interfering with their quality of life.  Physical therapy can:


  • Improve your mobility and motion,

  • Become an alternative to surgery,

  • To reduce the need for prescription medications, when possible.

Improving Mobility and Motion:

Motion is essential to your patients' quality of life. Whether it is an everyday task such as emptying the dishwasher, a sports activity like golf, or an essential activity such as performing their job, therapy can help your patient experience improved mobility and function. Therapy also help prevent injuries and promote a healthy lifestyle by improving strength, flexibility, balance, and coordination.

Physical Therapy: A Conservative Option to Surgery:

While surgery can be the best course of treatment for certain diagnoses, there is evidence to indicate that physical therapy can offer an alternative. Considering conservative options to surgery is a hallmark of good care.
When there is a need for surgery, therapy can enhance the outcome both before and after surgery. Additionally, for those individuals whose health conditions prevent surgery from being an option, physical therapists can be invaluable in helping them improve or maintain the quality of their lives; managing pain effectively without long-term medication.

Reducing the Need for Medications:

A physical therapist can help patients control pain, often reducing the need for long-term use of medications. While recognizing that it is an essential component in the management of many acute and chronic conditions, therapy can provide an alternative to the long-term use of medications for the management of pain.

Filed Under: Adhesions, Manual PT, Pain Management

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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24352 Acaso #1
Laguna Hills CA 92656
Tel: (949) 226-9681
Fax: (949) 220-7819
Coxpt@icloud.com

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