Hypertonic pelvic floor dysfunction is an umbrella term for a variety of pelvic floor disorders like Paradoxical Puborectalis Syndrome, Vaginismus, Pudendal neuralgia, vulvodynia, Pelvic floor trigger points, and Dyspareunia. Paradoxical Puborectalis Syndrome (PPS) is a spastic pelvic floor syndrome, and it is recently described as a subtype of dyssynergic defecation in which the puborectalis muscle either paradoxically contracts or fails to relax during attempted defecation, leading to a lack of straightening of the anorectal angle and resulting outlet obstruction. Vaginismus is defined as the psychologically mediated recurrent or persistent involuntary spasm of the vaginal muscles including the levator ani muscles and/or the thigh adductor muscles. This results in an inability of a penetrative pelvic examination or intercourse. Physical Therapy for hypertonic pelvic floor dysfunctions can help overcome symptoms and improve the quality of life for women who complain of these dysfunctions. Assessment tools like the MyotonPRO device and EMG Biofeedback are valid, reliable, and objective methods. The rehabilitation program includes Stretching exercises, Relaxation training, and Electrophysical agents like EMG Biofeedback, Magnetic stimulation, LASER, Extracorporeal Shockwave Therapy, and Pulsed Shortwave Diathermy may be the first-line approach in conservative management of such dysfunctions.    

Dr. Mohamed G A. Ali Shehata. BSc PT, MSc PT, PhD PT Lecturer of Physical Therapy, SVU, Egypt. Associate Alumnus, Harvard Medical School, USA. Former PhD Researcher, SRT, Queen's University, ON, Canada. Licensed Physical Therapist, New York State, USA. Lecturer of Physical Therapy for Women’s Health, South Valley University, Egypt. Bachelor of Physical Therapy, Faculty of Physical Therapy, Cairo University 2008. MScs physical therapy, Cairo University 2015. PhD studies, Queen's University, Kingston, Ontario, Canada March 2022- March 2023. Ph.D. in Physical Therapy for Women’s Health (Joint Supervision, Cairo University and Queen’s University, Ontario, Canada) May 2023. Associate Alumnus, Harvard Medical School, USA. Licensed Physical Therapist, New York State, USA.