MUSC: A True Pain In The Pelvis

Erin Pigge & Sherry Heiden

A True Pain In The Pelvis

Pelvic Floor Rehabilitation

Therapy is helping women & men live a pain-free life.

story by John Russell, MUSC Health Florence Medical Center

Sherry Heiden didn’t know what exactly was wrong with her. All she knew is that she was in pain - and it was getting worse, even life-changing. Heiden is overall the picture of health in her mid-40’s, staying active, going to the gym regularly, and busy being a mother. However, the ‘pain’ started in 2018. “I was having a lot of pain in my pelvic area,” as Heiden describes. “It was hard because I’ve always been active and not been one to sit around and be idle.” She said at first, her doctor thought it was kidney stones, which she has had before. Talk to anyone who has ever had a kidney stone, and they’ll tell you it’s very painful. A month went by as she and her urologist monitored her symptoms, eventually sending her to get a scan for kidney stones. The test result came back negative – no stones present. Heiden and her doctors were baffled. “It [the pain] got to be so bad I could hardly get out of bed in the morning, or any other time of day. I can only describe it as excruciating. It’s nearly impossible to describe the pain I was in,” she said. “It was so bad my husband called my gynecologist for me. Before I knew it, I was scheduled for laparoscopic exploratory surgery. I was also informed both my gynecologist and urologist would be doing the surgery.” Surgery can be scary, but she said surgery with two doctors didn’t exactly put her at ease. Heiden’s mother died at an early age of cancer in the pelvic area. Women over the age of 50 can be at higher risk for pelvic cancer, but Sherry was in her mid-40s. On the day of her surgery, in mid-2018, she said her urologist didn’t find anything to be worried about. Her gynecologist, however, found endometriosis and treated it

with endometrial ablation. Endometriosis occurs when tissue similar to the womb grows outside of the uterus and possibly other areas of the body. It can also show up in the ovaries, fallopian tubes, bladder, and with tissues holding the uterus in place. Endometrial ablation is a procedure to destroy the endometrial tissue. “After the surgery, I was very hopeful my problem was solved. I thought, ‘yay, I’m going home and will feel better.’ Unfortunately, I didn’t feel better. I actually felt worse. I went back for another surgery, and they took out an ovary, both fallopian tubes, cervix, and my uterus. Once more I thought I’d get better, but it didn’t happen,” she said. In the last surgery, she had her other ovary removed and removed more endometriosis. This time she said she felt better, but it was the third surgery she had in nine months. Fast forward to 2019, and the pain was coming back. “It got to be so bad I couldn’t sit down, and I was having a lot of bladder issues. I felt like I had a kidney stone. I constantly had the urge to go to the bathroom,” she said, reflecting back on the experience. “I couldn’t ride in the car. It got so bad I had to hire someone (for a whole year) to pick my child up at school because I couldn’t sit in car line, go on a vacation, drive to Columbia. At night trying to sleep was horrible.” In the middle of the global COVID-19 pandemic, Heiden went for a follow-up appointment with her gynecologist, who told her she had a lot of scar tissue in her pelvic area. The doctor told her the pain was caused by endometriosis, scar tissue, and a tightening of her pelvic muscles. “Oddly enough, I was good with the pandemic because I could stay home, and no one would wonder why I couldn’t go out to do things. But, it was getting to the point where I wasn’t sure if I could live,” she said tearfully. “I was told I needed a pelvic floor therapist. Both my doctor and I looked everywhere but couldn’t find one nearby. The closest one was at least an hour away, and there’s no way I could ride in the car that long; it would be too painful.” Through social media, someone in Florence let Heiden know about Erin Pigge, a pelvic health physical therapist at MUSC Health Outpatient Rehabilitation Center in Florence. Pigge is trained to help women and men with pelvic health and specialized therapeutic treatment for women of all ages. “I was so relieved to have found someone that could help me finally – and they were local,” Heiden said with excitement. “I immediately called my gynecologist, who set me up with an appointment the next week with Erin.” “I help people with bowel and bladder dysfunction, urinary or stool leakage, and pain in the pelvic region. Depending on what the issue is, rehabilitation requires different approaches to therapy,” Pigge said. “When someone is in pain for years, like in Sherry’s case, the muscles can stay in a tightened position. I describe it as carrying several bags of groceries at a time. Once you set them down, your muscles are still tense. The goal is to get muscles to relax back into a lengthened state.” Pigge said education is the first part of therapy. Going over anatomy, why things happen in the pelvic area, how it works, and talking through everything is essential. “I really believe if you understand your body and understand what we’re doing, then you are a better consumer of what I’m doing. We do breathing techniques, exercises, stretching, muscle retraining, and use manual muscle relaxation techniques. For many women, this therapy doesn’t feel good at first. I’d compare it to tense shoulders or knots you might have in your shoulders. Sometimes it hurts even to touch.” As Pigge pointed out, the pelvis is the muscular base of your body. Sitting, posture, legs, back, and hips all involve the pelvis. “It’s more than just focusing on one specific muscle. It’s more about addressing the entire system. That’s why this therapy is different,” she said. “I have to applaud Sherry because many of my patients and those with pelvic issues are very quiet about it. It’s a sensitive topic you don’t want to talk to other people about.” Sherry’s therapy is ongoing, and she feels optimistic about her path to a pain-free life. For more information about pelvic health and women’s therapy services, or to speak with Erin Pigge please call the MUSC Health Outpatient Rehabilitation Center at 843-661-4360 or go to MUSChealth.org.

“I am a new person, and it’s only been two months. I still have a way to go. I’m back to working out again, going on trips, and just doing everyday things. I’ve taught my daughter some of these breathing and relaxation techniques. I feel all women can benefit from these techniques. My life is 95% better because of this. I can live now!”

-Sherry Heiden