Women’s Health

Christine Kearney, DPT Counterstrain Portland
Portland, Oregon


Pelvic health conditions are common in women due to hormonal changes or life events such as pregnancy, childbirth and pre and post menopause. Many factors can contribute to problems in pelvis including issues outside of the pelvis. For example, poor head and neck posture affects spinal alignment (slouching) which then leads to pressure into the abdomen and pelvis. This causes increase pressure onto pelvic floor muscles that can lead to urinary problems such as leaking, prolapse or pelvic pain. Physical and emotional stress levels can also have an impact on our pelvic functions via our nervous system. The three main categories of pelvic health conditions are urinary dysfunction, pelvic pain and pelvic organ prolapse. Within these groups are several different conditions and detailed descriptions are below. Because of the comprehensive nature of Fascial Counterstrain assessment and treatment it can help address all of these conditions.

Urinary Incontinence

Urinary incontinence is described as an involuntary loss of urine. The most common types of urinary incontinence are stress, urgency, and mixed. Stress urinary incontinence occurs during times of physical activity, such as coughing, sneezing, jumping, running or lifting, leading to increased pressure in the abdominal cavity and bladder. Urge incontinence occurs when a person experiences an urge to void and leaks urine because they are unable to recruit muscles properly or she may have a neurological dysfunction where the bladder and brain are not communicating well. Mixed urinary incontinence is a combination of both urge and stress incontinence.

Urinary Urgency/Frequency

Urinary urgency occurs when the signal that the bladder needs to empty is too strong and too often. Increase in bladder pressure, nerve sensitivity, and bladder irritants can exacerbate symptoms of urgency and frequency. Urinary urgency leads to urinary frequency where one voids more frequently than usual. Needing to visit the bathroom more often that every 2 hours or frequently getting up at night to pee are signs of urinary urgency/frequency.

Pelvic Organ Prolapse

Pelvic organ prolapse is described as the descent of pelvic organs, such as the bladder, uterus, rectum, and urethra, into the vaginal canal. This causes pelvic pressure or the sensation of something “falling out” of the vagina. Depending on the severity pelvic prolapse can be visible as a bulge at the vaginal opening. It can lead to urinary and bowel dysfunction and low back pain. This condition may be associated with connective tissue laxity, weakness, muscle hypertonicity, and loss of nerve, muscle, ligamentous, and fascial integrity. Positioning of the pelvic bone itself can have an affect on how the pelvic floor muscles stabilize the pelvic and organs. Risk factors for pelvic organ prolapse can include pregnancy, surgery, constipation, or a systemic disease.


Vaginismus is an involuntary contraction of the pelvic floor muscles that can make sexual intercourse, pelvic exams and use of tampons either very painful or impossible. Dyspareunia can be caused by vaginismus and is pain specifically with sexual intercourse (during or after). The cause of vaginismus is unknown but anxiety, a history of trauma, childbirth injuries and fear of sexual intercourse can all be contributing factors.


Endometriosis is a common condition that is painful especially during menstrual cycles. Endometrial tissues grow outside of the uterus and cause inflammation, swelling, and scarring of the surrounding tissues. This leads to dysmenorrhea, excessive cramping, and abnormal menstrual flow.

Fascial Counterstrain Treatment

Pelvic conditions are often complex and therefor respond very well to the multi-system whole body treatment approach of Fascial Counterstrain. It is important to find the area that is causing the dysfunction in order have lasting and positive results. During your initial evaluation, your practitioner will perform a thorough evaluation using a cranial scan to determine which systems and body parts are the main drivers for your symptoms and dysfunction. It is common to find fascia in multiple systems of the body that contribute pelvic pain. These systems can be visceral (organs such as intestines, bladder, uterus, rectum), musculoskeletal, venous/lymphatic, arterial and neural. By treating visceral and musculoskeletal fascia we can improve posture and mobility to reduce strain in the pelvis. By calming neural fascia we help the nervous system become less sensitive to reduce pain and improve brain to bladder communication. Treating the fascia of the veins and arteries helps any excess swelling and inflammation drain away and helps bring new blood flow to the area to promote healing. By utilizing a multi-system approach, such as Fascial Counterstrain, pelvic conditions can be treated very effectively. Many women with pelvic health conditions get relief with Fascial Counterstrain when more traditional approaches such as Physical Therapy have not helped.