Mary Ellen Kramp, DPT, CLT-LANA is a physical therapist and owner of Relief at Hand, LLC. She is also the president and co-founder of Pelvic Health Research Initiative, Inc, a non-profit developed to raise money for pelvic research. She has a doctorate in physical therapy from Boston University and is also a certified lymphedema therapist.
Fertility is complex. It involves a woman' s ability to ovulate (which includes a cycling of hormones), the egg to get into the uterine tube, sperm to find it and fertilize it, and the fertilized egg to implant into the uterine lining. In couples trying to conceive 57% will have success within 3 months, 75% at 6 months, and 85% at a year.
Couples who have been trying for one year without success to become pregnant are defined as infertile by the CDC. About 12% of couples fall into this category. Female infertility is the cause about 82% of the time and is due to ovarian issues, tubal problems, and uterine abnormalities.
Current treatments for infertility include hormone injections (such as Clomid), intrauterine insemination (IUI), and in vitro fertilization (IVF). These treatments tend to be invasive and expensive and do have risks.
A new theory currently being researched may prove to be of help to many women. Mechanical infertility is when infertility is due to mechanical issues which can be treated just like any orthopedic problem. If you injured your shoulder, a physical therapist would address the alignment of the bones, the ligaments, the muscles, the range of motion of the joint, and the swelling. Now let's consider the shoulder is a uterus instead.
1. The Bones
The bones of the pelvis help to protect the uterus, tubes and ovaries. The bones of the pelvis can become misaligned with traumas such as falls or car accidents. Therapists have multiple techniques to realign the bones of the pelvis.
The uterus is surrounded by connective tissue and suspended in the pelvis by ligaments. These ligaments attach to the sacrum (the triangular bone at the base of the spine) and the pubic bone in the front of the pelvis. Traumas to the pelvis such as falls (think about falling on ice, while roller skating, playing basketball, falling off a horse) can cause torsion through these ligaments and alter the position of the uterus. This can result in things like low back pain or painful periods. Just as physical therapy would work on someone with shoulder pain because of ligament strain, ligaments in the pelvis can be addressed the same way.
3. Blood Vessels
Blood vessels that feed the uterus travel through the connective tissue that surrounds and supports it in order to bring blood to it. If the ligaments surrounding the uterus are tight, then the blood supply to the uterus could be compromised. This could result in a less than optimal environment for a fertilized egg to implant or grow. By treating the ligaments and other connective tissue, the blood supply is improved to the uterus.
Lymphatics can become congested from prior infections (like STD's, bladder infections, and stomach flu). This congestion can create a back up of fluid and waste products within the pelvis. Women with this issue often note a chronic bloating. This can be treated with lymphatic drainage to decongest the lymph nodes and help to remove excess fluid from the pelvis.