Heal Pelvic Pain: A Proven Stretching, Strengthening, and Nutrition Program for-Relieving Pain, Incontinence, IBS, and Other Symptoms Without Surgery. Amy Stein, MPT. New York, NY: McGraw Hill; 2008. Soft cover, 202 pages, $16.95.
Amy Stein, MPT is a physical therapist and the founder and owner of Beyond Basics Physical Therapy located in New York City. She specializes in the treatment of pelvic pain and pelvic floor dysfunction. Ms. Stein serves on the board of the International Pelvic Pain Society.
This patient education book begins with an overview of both the female/male pelvic floor anatomy, the associated dysfunctions that can occur, and the effects these dysfunctions may have on an individual. Included at the end of Chapter 2 is a symptom monitor questionnaire from the International Pelvic Pain Society that may be a helpful tool for the reader. The chapters are well written and easy for a lay person to understand.
Chapter 3 focuses on the education and instruction of stretching and strengthening of the pelvis and surrounding joints and musculature for pain and hypertonic diagnoses. Part 1 includes 11 flexibility exercises to be performed on average 2 to 4 times a day. These include deep breathing, hip flexor, hip rotator, adductor, hamstring, gluteal, low back, and abdominal stretches to name a few. Part 2 is designed to begin when there is a 50% to 100% decrease in pain and symptoms. The 4 exercises included in Part 2 are the tranverse abdominus contraction, bridging, quadruped, and squats. Advanced modifications have also been included. The photos with each exercise are helpful and the exercises appear to cover a broad range of commonly tight muscle (although there is no evidence sited). Throughout the entire program, a cardiovascular component is recommended for 60 minutes each day. At the end of Part 2, Part 3 transitions a reader to slowly return to physical activities previously enjoyed, but had previously caused pain.
Chapter 4 outlines weakness diagnoses and describes kegels and various other core strengthening exercises. Chapter 5 is dedicated to the instruction on external self-massage of the abdomen, hip, buttock, and the perineal body of the pelvic floor. Instruction on internal self-massage both vaginally and rectally are also included and discussed in limited form. Readers are encouraged to seek a health care provider to get a proper diagnosis and a proper evaluation and treatment plan.
Chapters 6 and 7 discuss nutrition and its effects on the bowel and bladder and the relation to pelvic floor dysfunctions, as well as stress reduction techniques and suggestions. These sections give a general overview which can be helpful as an introduction to dietary effects on the pelvic floor and highlight the importance of a holistic approach with respect to stress, as well as the importance of proper alignment and posture.
Chapters 8 through 11 give a general overview on the pelvic floor and sex, pregnancy and delivery, children, and men respectively. There were many topics touched upon which, due to the respective complexities of each, the reader is encouraged to discuss the material further with an appropriate health care professional. Chapter 12 touches on the role of traditional medicine and gives a general wrap up of the book. Appendix A includes definitions of pelvic floor diagnoses and associated signs and symptoms. Appendix B lists Web site and book resources. Appendix C includes patient comments and success stories. The last section lists a few references for chapters 3, 5, 8, 9, and 11.
This book touches upon many different aspects of pelvic floor pain and dysfunctions and can offer knowledgeable insight for the lay person. It would be a helpful resource to have in the clinic as a reference and introduced to the client when appropriate.