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Manual Physical Therapy Can Help Reverse Female Infertility

Infertility is often times a very sensitive subject for couples who are struggling to conceive. In the US, there are approximately 6.7 million women who are facing challenges with getting pregnant. (CDC 2006). In 2015, a ten-year retrospective study examined the efficacy of manual physical therapy to treat female infertility and discovered significantly positive outcomes.

The study looked at data collected from 2002-2011, which included approximately 1,392 patients treated for infertility. It specifically included those with single or multiple causes for infertility that involved: 1) elevated FSH (follicle stimulating hormone) of 10 mIU/ml or higher 2) fallopian tube occlusion 3) Endometriosis- when the lining of the uterus grows outside of the uterus causing significant pain, abnormal bleeding, infertility 4) Polycystic Ovarian Syndrome (PCOS)- a condition that affects female hormone regulation at times producing multiple follicles that remain as cysts in and around the ovary 5) Premature Ovarian Failure (POF)-loss of ovarian function before a woman is 40 years old and 6) Unexplained Infertility (Rice, 2015)

Patients were treated using an individualized physical therapy treatment plan that was named the CPA (Clear Passage Approach) protocol. This protocol was tailored to meet the individual needs of the patients and to treat specific sites of restrictions and immobility within each patient’s body. Treatment included integrated manual therapy techniques focused on minimizing adhesions and decreasing mechanical blockages in order to improve mobility of soft tissue structures. Visceral manipulation was also used to help restore normal physiologic motion of organs with decreased motility.

The application of these specific manual therapy modalities are thought to activate the central nervous system by stimulating a local tissue response and thus increasing communication with higher control centers in the brain that have the ability to positively influence the activity of the ovary and uterus, as a result effecting hormone production and regulation.

The study compared manual physical therapy treatment to previously published success rates with standard, conventional treatments for female infertility. The results were astounding. Researchers discovered that with the application of the CPA manual therapy approach, fallopian tube patency of at least one fallopian tube was 60.8% successful. When compared with the reported success rates in the literature, “it was observed that the CPA performed as well as or at higher rates of success than surgery did.” The rate of pregnancy for those patients with at least 1 open fallopian tube was also very successful with an overall pregnancy rate of 56.64% post CPA treatment.

For those women with endometriosis (n=558), the success rates for pregnancy post CPA treatment was 42.8%. For those who underwent IVF (In Vitro Fertilization) after CPA treatment, the pregnancy rates were even higher at 55.4%. These findings were also comparable to or better than standard medical interventions published in current literature.

Manual therapy has even shown to decrease elevated FSH levels and improve pregnancy rates by almost 50%. Researchers acknowledge that, to date, there are no medical treatments that represent standard care for women with elevated FSH levels and require more investigation for comparative results.

Of the 59 women with PCOS, the overall pregnancy success rate was 53.57%. The only significant and direct comparison with standard of care literature was with the use of metformin. Comparably, CPA produced significantly higher rates of pregnancy than with metformin alone. No statistically significant outcomes were reported. Unexplained infertility and POF had the least success rates of pregnancy reported. This is most likely attributable to a lack in subject size and/or no published medical treatment in these specific patient cases, further warranting the need for future investigation.

In conclusion, manual physical therapy has been shown to reverse female infertility in cases such as occluded fallopian tubes, endometriosis, hormone dysregulation, and PCOS. With all of the conventional options available, it is wonderful to know that manual therapists specializing in pelvic health have a clinical significance in helping change the lives of women struggling with infertility.


Center for Disease Control and Prevention (2006-2010). Infertility. Retrieved from http://www.cdc.gov/nchs/fastats/infertility.htm
Rice AD, Patterson K, Wakefield LB, Reed ED, Breder KP, Wurn BF, King CR, Wurn LJ. Ten-year Retrospective Study on the Efficacy of a Manual Physical Therapy to Treat Female Infertility. Alternative Therapies. 2015.(21)3;32-40.

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Being A New Mom: How To Improve Your Health Post-Partum

Dr. Susane (Susie) Mukdad is the founder of Healing Hands Physical Therapy, Inc., located in Willow Springs, IL.

Being a new mom is such a blessing, a new chapter in a woman’s life filled with joy, happiness, and many surprises! But giving birth can also bring about many changes in a woman’s physical, emotional, and social health. Increased level of sex hormones can result in physiological, cognitive, and musculoskeletal changes. These fluctuations continue to occur after birth, placing a new mom, who is now faced with many physical and emotional challenges at risk for burn out. In addition, new moms have to worry about their careers and relationships, suffer sleep deprivation, and the availability for support from their family and friends all of which can affect a new mom’s self-esteem, mood, and most importantly parenting ability.

According to a recent CDC survey, approximately 8-19% of women experience postpartum depression. In most cases, this occurs during the first 3 mo postpartum.

So, how can a new mom improve her well-being after having a baby?

"The number of women who were 'at risk' for postpartum depression prior to the treatment, dropped by nearly 50% at the end of treatment"

A recent study published in the Journal of the American Physical Therapy Association reports that participating in an individualized exercise and education program can significantly improve postpartum well-being. The researchers performed a Randomized Control Trail that looked at 161 new moms all of which were randomly selected into two groups: 1) Mom & Baby Program + Education 2) Education Only. The Mom & Baby Program consisted of an individualized postpartum exercise regimen for 60 min/1x per week conducted by a licensed physical therapist. In addition, participants received 30-minute educational sessions from various healthcare professionals that included, physical therapist, health psychologists, nutritionists, midwives, and speech pathologists. The Education Only group received informational material mailed to them over an 8-week period. Treatment lasted for a total of 8 weeks.

When the two groups were compared, the results were significant! Moms that were in the Mom & Baby Program + Education group reported significantly better well-being and depressive scores and the number of women who were “at risk” for postpartum depression prior to the treatment, dropped by nearly 50% at the end of treatment.

So what does this all mean?

It means that having a support group, someone coaching you through a safe exercise program and educating you on the ins and outs of being a new mom can be extremely beneficial to your health and overall well-being, reducing your risk of the postpartum blues. Having a team of well rounded healthcare practitioners such as physical therapists, doulas, midwives, and nutritionists can significantly improve your experience of being a new mom and provide you with the lasting support that you need to not only take care of yourself, but also your new baby.

For more on postpartum patient health, consider attending Herman & Wallace's Care of the Postpartum Patient course. The next event will be in Seattle, WA on March 12-13, 2016.


Norman, et al. An Exercise and Education Program Improves the Well-Being of New Mothers: A Randomize Control Trial. PHYS THER. 2010; 90:348-355

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Upcoming Continuing Education Courses

Male Pelvic Floor - San Diego, CA (Postponed)

Dec 4, 2020 - Dec 6, 2020
Location: FunctionSmart Physical Therapy

Chronic Pelvic Pain - Medford, OR (Postponed)

Dec 4, 2020 - Dec 6, 2020
Location: Asante Rogue Valley Medical Center

Pediatric Functional Gastrointestinal Disorders - Ann Arbor, MI (Postponed)

Dec 4, 2020 - Dec 6, 2020
Location: Michigan Medicine

Sacral Nerve Manual Assessment and Treatment - Madison, WI (NOW REMOTE)

Dec 4, 2020 - Dec 6, 2020
Location: SSM Health

Yoga for Pelvic Pain - Phoenix, AZ (Postponed)

Dec 5, 2020 - Dec 6, 2020
Location: St. Joseph's Hospital - Phoenix

Yoga for Pelvic Pain - Remote Course (SOLD OUT)

Dec 5, 2020 - Dec 6, 2020
Location: Replacement Remote Course

Male Pelvic Floor - Satellite Lab Course

Dec 5, 2020 - Dec 6, 2020
Location: Replacement Remote Course

Male Pelvic Floor - San Diego, CA Satellite Location (SOLD OUT)

Dec 5, 2020 - Dec 6, 2020
Location: FunctionSmart Physical Therapy

Male Pelvic Floor - Washington, DC Satellite Location

Dec 5, 2020 - Dec 6, 2020
Location: Georgetown University Hospital

Pelvic Floor Level 1 - Satellite Lab Course

Dec 5, 2020 - Dec 6, 2020
Location: Replacement Remote Course

Pelvic Floor Level 1 - Little Rock, AR Satellite Location (SOLD OUT)

Dec 5, 2020 - Dec 6, 2020
Location: Core Pelvic Physical Therapy

Pelvic Floor Level 1 - Burlington, WA Satellite Location (SOLD OUT)

Dec 5, 2020 - Dec 6, 2020
Location: Northwest Physical Therapy

Pelvic Floor Level 1 - Self-Hosted (SOLD OUT)

Dec 5, 2020 - Dec 6, 2020
Location: Self-Hosted Course

Pelvic Floor Level 1 - Canton, OH Satellite Location (SOLD OUT)

Dec 5, 2020 - Dec 6, 2020
Location: Mercy Hospital

Male Pelvic Floor - Minneapolis, MN Satellite Location (SOLD OUT)

Dec 5, 2020 - Dec 6, 2020
Location: Fairview Institute of Athletic Medicine

Pelvic Floor Level 1 - Medford, OR Satellite Location (SOLD OUT)

Dec 5, 2020 - Dec 6, 2020
Location: Asante Rogue Valley Medical Center

Male Pelvic Floor - Self Hosted

Dec 5, 2020 - Dec 6, 2020
Location: Self-Hosted Course

Pelvic Floor Level 2A - New Orleans, LA Satellite Location

Dec 5, 2020 - Dec 6, 2020
Location: Ochsner Therapy and Wellness/Ochsner Health System

Pelvic Floor Level 2A - Self-Hosted

Dec 5, 2020 - Dec 6, 2020
Location: Self-Hosted Course

Pelvic Floor Level 2A - New Orleans, LA (SOLD OUT)

Dec 5, 2020 - Dec 6, 2020
Location: Ochsner Health System

Pediatric Functional Gastrointestinal Disorders - Remote Course

Dec 5, 2020 - Dec 6, 2020
Location: Replacement Remote Course

Pelvic Floor Series Capstone - Washington, DC (POSTPONED)

Dec 12, 2020 - Dec 13, 2020
Location: The George Washington University

Pelvic Floor Level 1 - Tallahassee, FL (Postponed)

Dec 12, 2020 - Dec 13, 2020
Location: Tallahassee Memorial HealthCare

Breathing and the Diaphragm - Remote Course

Dec 12, 2020 - Dec 13, 2020
Location: Replacement Remote Course

Manual Therapy for the Abdominal Wall - Remote Course (SOLD OUT)

Dec 12, 2020
Location: Short Form Remote Course

Pelvic Floor Capstone - Washington, DC Satellite Location

Dec 12, 2020 - Dec 13, 2020
Location: Georgetown University Hospital

Pelvic Floor Capstone - East Norriton, PA Satellite Location

Dec 12, 2020 - Dec 13, 2020
Location: Core 3 Physical Therapy

Pelvic Floor Capstone - Salt Lake City, UT Satellite Location

Dec 12, 2020 - Dec 13, 2020
Location: Pagnani Physical Therapy

Pelvic Floor Capstone - Self-Hosted

Dec 12, 2020 - Dec 13, 2020
Location: Self-Hosted Course

Pelvic Floor Capstone - Greenville, SC Satellite Location (Postponed)

Dec 12, 2020 - Dec 13, 2020
Location: Restore Pelvic Health and Wellness