Nicole Hebert, doctor of physical therapy, provides pelvic floor therapy for men and women in the rehabilitation department at Little Falls Hospital in Little Falls, a subsidiary of the Bassett Healthcare Network. Recently, senior staff correspondent Barbara Pierce spoke with Hebert about her profession and outlook on health care.
By Barbara Pierce
Q.: What is pelvic floor therapy?
A.: It has been my experience that there is a lack of knowledge in men and women in regards to pelvic floor therapy, what it entails and what types of diagnoses a pelvic floor therapist can treat.
The pelvic floor refers to the numerous muscles that attach to the pelvic and thigh bones. These muscles provide support for our pelvic organs, maintain control of our bladder and bowel function and are responsible for healthy sexual activity.
These muscles may have become weakened, tightened, or spastic due to many circumstances. We focus on strengthening or relaxing the pelvic region of men and women.
Many of us aren’t comfortable talking about something this personal.
It is the comfort level of the patient that always guides my evaluation and treatments. I provide a thorough explanation of what the evaluation and treatment may entail and why. I find this goes a long way in easing a patient’s apprehension. Knowledge is power and patient education is a major part of what I do.
These are very common medical problems and patients usually quickly get results.
Q.: What are some the treatments you utilize?
A.: There simply is not a cookie-cutter approach to treatment of pelvic floor issues. The pelvic floor exercises appropriate for one patient may be completely wrong for another patient. This is such an individual issue. We perform an examination and determine which treatments are appropriate for your specific issue.
Treatments include exercises to increase strength in the muscles near the bladder, bladder retraining to assist with holding and releasing urine voluntarily, electrical stimulation to increase muscle strength and decrease symptoms of bladder irritability, education to identify food and beverages that aggravate the bladder, and biofeedback to train the pelvic muscles.
Q.: When would one benefit from this therapy?
A.: Many people, both men and women, suffer from pelvic floor dysfunction. There are many types of pelvic floor dysfunctions.
We see women for several reasons, the first being for pelvic pain. It is estimated that at least 20 percent of women have pain in their pelvic area at some point in their lives. As this pain is often caused by the musculoskeletal system, physical therapy plays a major role in its diagnosis and treatment.
Urinary incontinence can be relieved by pelvic therapy.
Also, women can experience a range of conditions due to the stress pregnancy places on the body. Pelvic floor therapy can be effective in treating these symptoms during pregnancy and following delivery.
Q.: You have been instrumental in expanding the pelvic floor therapy program to include male patients. When would a male need this therapy?
A.: Men who are experiencing pelvic pain and urinary issues may also benefit from an individualized therapy program. Urinary incontinence, including stress and urgency, are not issues exclusive to women. Some men may experience incontinence issues or pain following prostate surgery. Urinary retention, or inability to completely empty the bladder, is an issue for many patients and can also be addressed through a pelvic floor program.
Q.: How did you become interested in pelvic floor therapy?
A.: In all honesty, I wasn’t very interested in doing this type of therapy. However, the hospital offered to pay for education in order to expand services to this population and I did not want to turn down a learning opportunity. Once I started treating this population, I was pleasantly surprised at how quickly some of my patients saw results and a significant amount of them got better.
Q.: What are the rewards of your career?
A.: There is nothing more rewarding than to see your patients get better and improve their quality of life. Some of my patients have struggled with pelvic floor issues for years, but there was no one in this area that specialized in pelvic floor therapy.
Editor’s Note: Last year, Hebert was awarded the President’s Excellence Award by Little Falls Hospital. Hebert was chosen for this award because of her overall excellent performance.
Lifelines
Birth year: 1978
Birthplace: Cooperstown
Current residence: Richfield Springs
Education: Doctor of Physical Therapy degree, Utica College; Bachelor of Science degree in health studies, Utica College
Personal: Married; two children
Hobbies: Spending time with family, skiing, camping, hiking, swimming; also an avid runner who loves competing in races