Thanks for tuning in to the Armor Men’s Health Hour Podcast today, where we bring you the latest and greatest in urology care and the best urology humor out there.
In this segment, Donna Lee is joined by NAU Urology Specialists' partner, Dr. Angela Treadway, who specializes in pelvic floor physical therapy. Today, Dr. Treadway talks about the consequences of scar tissue in and around the pelvic floor. While there can be many causes of pelvic floor problems, particularly in women, any scar-causing medical procedures or trauma to the abdominal and pelvic regions can lead to the formation of problem-causing adhesions. The healing process that takes place when an incision is made, for instance, creates scar tissue that sticks to everything around it. When the scars shrink as they draw everything around them in, they can pull on other tissue and even organs, leading to pain and loss of normal function. Furthermore, adhesions can lead to life threatening situations and may need to be cut out to prevent blockages. Unfortunately, the surgical removal of adhesions will ultimately lead to, you guessed it, MORE adhesions. While this is often unavoidable, there can be alternatives. Dr. Treadway can use methods like myofascial stretching to encourage the body to lay down more tissue and to counter the "shrinking" effects of the existing scars. If you or someone you love is dealing with pain in an area of the body which already has scar tissue--even if those scars are years or decades old--give us a call to learn how pelvic floor physical therapy might help!
Dr. Mistry is a board-certified urologist and has been treating patients in the Austin and Greater Williamson County area since he started his private practice in 2007.
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Speaker 1:
Welcome back to the Armor Men's Health Hour with Dr. Mistry and Donna Lee.
Donna Lee:
Welcome to the Armor Men's Health Hour with Dr. Mistry and Donna Lee. That's me. That's yours truly. Dr. Mistry stepped away. Of course, you know, when he steps away, I always bring in a super special guest. So today we have our amazing Dr. Angela Treadway.
Dr. Treadway:
Hello.
Donna Lee:
Welcome back.
Dr. Treadway:
So good to be here.
Donna Lee:
And you have a doctorate of physical therapy.
Dr. Treadway:
I do.
Donna Lee:
And you have been with us for 13 years. And real quick, before I forget, I'll let people know. You can call us during the week at(512) 238-0762. We're located in Round Rock, North Austin, South Austin, and super cute Dripping Springs. Have you been out there lately?
Dr. Treadway:
No.
Donna Lee:
It's adorable. I love it.
Dr. Treadway:
I have to go visit.
Donna Lee:
Hays County is the fastest growing county in the country as of like, I think I read this last year, so I'm sure it's still up there in the top five. But if you haven't been out there in a while, you need to go. Amazing.
Dr. Treadway:
Do they have any pelvic floor PTs out there?
Donna Lee:
They don't You would be first. There's some physical therapy out there, but not pelvic floor physical therapy, which is what we're going to talk about today. So Dr. Treadway who's been with us for the 13 years, Dr. Mistry's super forward thinking, and having you come on board early on. I know other urology groups have pelvic floor physical therapy, but I feel like we were the first.
Dr. Treadway:
We were, yeah.
Donna Lee:
Yeah, because the other ones are fairly new....Yeah, for sure. But today we wanted to talk about something specific. We've had a lot of female listeners email us and say,"I know it's a men's wellness show, but I have a question," or"I know it's a men's wellness show, but could y'all talk about women's wellness every now and again?" So what a great time to have you. So let's talk about some chicks and some ladies. What can we talk about today? You wanted to talk about some pelvic floor...
Dr. Treadway:
I wanted to talk about something that comes across my radar a lot, and it is scar tissue. Specifically, I have a lot of women that have had C-sections or hysterectomies, or some sort of abdominal procedure. And typically what they'll present with is pain. And they'll say,"Well, how could this be related to my surgery? Because I had my surgery 10 years ago?" Well, this is why: when you have a surgery, a cut, a bruise, any kind of insult to the tissue, you have to have an inflammatory response to start healing it. And during that inflammatory response, all of the cells that start to rebuild tissue come in and they start building scars. A scar is nature's glue, puts everything back together, but it's eight doesn't behave the same as the original tissue, number one. Number two, everything that's close to wherever that surgery was, is now all stuck together, because the scar that the inflammation affects everything in the neighborhood and that scar will stick to everything. So let's say you had a C-section. So a C-section is going to come in to the uterus. The uterus sits right on top of the bladder, and like on top on the roof of the bladder, but in front of the small intestine. So now you can have problems where the bladder can't do its full excursion to fill and empty. And the small intestine gets a little bit slowed down with the way it processes food. And that will affect bowel and bladder. Depends on how bad the scar was, it depends on how emergency the C-section was. If it was an emergency, it's a mess. If it, if it was not, then it's a little more strategic and a little more clean, but it's, it hurts because it has shrunk. It has shrink, wrapped everything in there.
Donna Lee:
Right, from scarring?
Dr. Treadway:
Mhmm, from the scarring.
Donna Lee:
Can you build scar through those 10 years? Or are you saying it scars up in the beginning and then the pain can...?
Dr. Treadway:
It scars up in the beginning and then the scar shrinks. So you think about, if you have a wound on skin, you have like this big gaping burn or something, and you see it's, you see it pink up, you see it scar, you see it scabs, whatever. And then over the years, the profile of that wound gets smaller and smaller and smaller. You ever notice that?
Donna Lee:
So the same thing is on the inside?
Dr. Treadway:
Yes. Exact same thing on the inside.
Donna Lee:
I've never thought about that.
Dr. Treadway:
There'd be no reason to think about that. So what happens? The original laying down of the scar tissue is the fibers of the collagen. And it's actually collagen, and it's got collagen and keloid and various tissues in there, but they're not organized. They are laid down sort of like if you've ever seen plywood, it's like every direction. So it's strong in every direction. And you can't pull apart a wound that's strong in every direction, but you also can't move it. Luckily the structure of scar has a little bit of a crystaline structure at its root and, crystal structures--I know you like talking about crystals.
Donna Lee:
I love crystals, and my good Juju. But this is a different crystal.
Dr. Treadway:
Differe crystal, but crystal, nonetheless. And they respond to something called the piezoelectric effect, which is if it's compressed, it'll shrink. If it's got tension put through it, which is a pull-apart kind of force, it'll grow. It'll actually stimulate the body to lay down more, more tissue. That's what we go after, because if you do nothing, that's the same as a compressive force. It'll shrink, shrink, shrink, just like that wound. But if you start putting a tension force, like pulling, tugging at two ends of a tug of war rope, you will start to get the body fired up to start constructing tissue again, and this time, if you put those tension lines through the fibers will line up along those tension lines. So you can actually tell it how long to be and in which direction.
Donna Lee:
Oh, so if you're okay, let me put it back on the outside. If I have a scar on my hand and what you're saying, this is on the inside after surgery. So if that scar was given some sort of avenue to lessen up a little bit, it causes the pain to diminish because it's looser?
Dr. Treadway:
It could because it's not tugging on structures that don't like to be tugged on.
Donna Lee:
Gotcha. Okay. That makes sense.
Dr. Treadway:
It won't pull on the bladder. It won't pull on the small intestine. Because they're not used to that. They're used to having free and mobile capability. Because if the colon can't move, then food can't move through. So you end up with these, so that's why some people get blockages. They will get a bowel obstruction from an old adhesion, because that's what these are. When scars get like that, and they shrink on down, they're called adhesions, because they're adhered. And a lot of times surgery will be done to lice to cut those adhesions, which unfortunately make more because another cut another scar, another whole process. However, sometimes those bowel obstructions are life-threatening, so you have to do it. But I had a patient once a while ago, she was in her eighties and she had had multiple abdominal surgeries, one hysterectomy and one C-section, and it was back in the day when this incisions would go from naval to pubis, you know, it was the up and down as opposed to the side to side. So she had everything affected. And she came in every six weeks for me to do myofascial stretching. And we kept her out of the hospital, because she kept having to go in to have these things cut, so she wouldn't have a bowel obstruction and die. Yeah. But we maintained her for a long, long time.
Donna Lee:
Wow. How long is a long time? Like you saw her for a few months?
Dr. Treadway:
I saw her for years.
Donna Lee:
Years. Wow.
Dr. Treadway:
Every six weeks.
Donna Lee:
That's incredible.
Dr. Treadway:
And we kept her out of the hospital and she had been going in quarterly.
Donna Lee:
That's amazing. There's so much involved with pelvic floor physical anything. When I first started with this practice three years ago, I did not know what pelvic floor physical therapy was. I mean, I knew what physical therapy was, but then when you think about it, because you treat men and women, mostly probably men because there's more male patients?
Dr. Treadway:
Now it's 50/50.
Donna Lee:
50/50. That's incredible.
Dr. Treadway:
I've been asked,"What's your target target group?" I'm like,"Anyone with the pelvic floor." I prefer not to do children because I don't have that training. But, yeah, it's true. And it's kind of great to have patients across the spectrum, because I see the craziest sets of problems and they're always predicated on the person's history and people come from all walks of life with all various types of injuries, and experiences, and activity levels and whatnot, and their background. So the more different kinds of people I can treat across the age groups, the better my arsenal of problem-solving.
Donna Lee:
Right. For sure. And how much time do you spend, like a good hour with a new patient? Well, maybe more than that with a new patient.
Dr. Treadway:
You've noticed that?
Donna Lee:
You go into a room sometimes I'm like,"She's not coming out. She's in there for two hours."
Dr. Treadway:
Some are a little more labor intensive than others. You know, sometimes they come in and I got to talk them off the, off the ceiling. I have to get them out of the rafters, because they're scared and they're crying and everything else.
Donna Lee:
Yeah, and everything, like from an accident, to sexual trauma to well, the first anything...
Dr. Treadway:
Well the first area of our bodies that we get control over is bowel and bladder. So when things go wrong in that area, it's devastating. It can, it can take you back to childhood triggers and you know, it just never know what Pandora's box is going to open. So I just, I listen, and I kind of go with it.
Donna Lee:
So you're part therapist, like listening therapist.
Dr. Treadway:
I am.
Donna Lee:
We should make your bartender, too.
Dr. Treadway:
Full spectrum, right there.
Donna Lee:
Well thank you so much for that talk. I hadn't thought about it. And I think it's fascinating for the patient, especially female. I'd like to have you come back in a different segment and we can talk about another female topic or pelvic floor in general. We are blessed to have two pelvic floor physical therapists. We have you and Kendel, Dr. Lipe. So they go to all of our locations, Dr. Lipe's going down to our South location now. So we have presence everywhere for y'all, in Round Rock, North Austin, South Austin. And then we also have a sex therapist. So all of these things kind of tie in, hand and hand, you know, they're tie in together. So if you have any questions though, you can call us during the week at(512) 238-0762. Aside from that, we have four MDs who are surgeons. We have five PAs, nurse practitioners now. What else do we have Dr. Treadway? We've got like, we have a whole[ inaudible].
Dr. Treadway:
Did we mentioned that?
Donna Lee:
Yeah, we have Shefaly Ravula, one of our PAs, who's an integrative wellness provider. She's incredible, too. So give us a call. You can check out our website at armormenshealth.com. You can send a question to armormenshealth@gmail.com. You can ask Dr. Treadway questions. We'll answer them on air anonymously and I can have you come back for that. Of course. So you can answer it, because I can't, but thanks so much for listening to the Armor Men's Health Hour and you can check out our podcasts wherever you listen to podcasts. And we are known across the world and the land. We'll be right back.
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The Armor Men's Health Hour is brought to you by Urology Specialists for questions, or to schedule an appointment, please call(512) 238-0762 or online at Armour men's health.com.