A case study by J. Kurz and Diane Borello-France (1) followed a 31-year-old woman with Pelvic Organ Prolapse (POP) and mixed urinary incontinence who began PT 53 days postpartum. The authors used a Sahrmann movement system approach to assess her pelvic floor dysfunction—looking at posture, hip strength, and movement patterns.
Apply for Free Samples
Apply for Free Samples
Her symptoms included:
-
Feeling like a tampon was falling out
-
Constipation and straining
-
Vaginal dryness
-
Lower abdominal pain
-
Incontinence and dribbling
-
Incomplete bladder emptying
She had low fiber/water intake, minimal caffeine use, and was breastfeeding while taking a daily prenatal vitamin.
Objective findings included:
-
Swayback posture, posterior pelvic tilt, and knee hyperextension
-
Weak hip external rotators and glutes
-
Overuse of psoas, DRA (3-finger width)
-
Positive left SI joint tests
Movement diagnoses:
-
Underactive pelvic floor
-
Pelvic tissue impairment
-
Movement coordination deficit
Treatment included:
-
Education: toileting posture, hydration, childcare positioning
-
Manual therapy: colon massage, pelvic floor facilitation, fascial mobilization
-
Exercises: pelvic floor holds (5–20s), DRA-focused core work, hip strengthening
-
Functional training: diaphragmatic breathing, resisted sit-to-stand, step-ups, trampoline jumping
Results:
After 14 sessions over 18 weeks, her PFDI-SF-20 score improved by 56 points, surpassing the 45-point MCID—showing significant reduction in symptom distress.
💡 This case highlights the value of a movement-system-guided approach in shaping effective postpartum treatment. With so many systems impacted during pregnancy and delivery, assessing both structure and movement is critical to lasting improvement.
1. Kurz J. Borello-France D. Movement system impairment-guided approach to the physical therapist treatment of a patient with postpartum pelvic organ prolapse and mixed urinary incontinence: case report. Phys Ther. 2017;97:464-477.
Pelvic Wands
Apply for Free Samples
