Orthopedic Injuries Can Also Affect Sexual Health
Key Takeaways:
Overlooked Connection: Orthopedic injuries significantly impact sexual function but are often overlooked in traditional sexual health services
Physical Limitations: Knee, hip, and spinal issues can directly affect sexual positioning and mobility
Chronic Pain Impact: Pain from orthopedic injuries interferes with arousal, libido, and sexual satisfaction
Comprehensive Assessment: Effective sexual health services must evaluate both pelvic floor and musculoskeletal function
Goal-Oriented Treatment: Physical therapy should address specific sexual positions and movements affected by orthopedic injuries
Research-Backed: Studies show 60% of people with musculoskeletal disorders experience sexual dysfunction
Psychological Factors: Orthopedic injuries can cause body image issues and psychological barriers to intimacy
Multidisciplinary Approach: Best outcomes come from sexual health services that integrate orthopedic and pelvic floor expertise
Age-Inclusive Care: Sexual health remains important throughout the lifespan, regardless of age or injury status
Breaking Stigma: Open communication about orthopedic injuries and sexual health leads to better outcomes
Orthopedic Injuries Can Also Affect Sexual Health
When it comes to pelvic floor physical therapists, we are all well versed in discussing and treating dyspareunia, also known as painful intercourse. However, what I want to discuss today is the physical inability to have intercourse due to orthopedic injuries — a topic that's often overlooked in traditional sexual health services.
I've said it before, and I'll say it again: To be a good pelvic floor PT, you first have to be a good orthopedic PT.
There are lots of orthopedic injuries that interfere with one's ability to have a healthy sex life, including "bad knees," hip injuries, back pain, rotator cuff tears, and other musculoskeletal conditions. Yet this crucial connection between orthopedic injuries and sexual function remains under-addressed in most sexual health services.
A Life-Changing Case: When Orthopedic Issues Meet Sexual Health
This connection was first brought to my attention 7-8 years ago when I had a 75-year-old woman referred to me due to painful intercourse. Prior to meeting her, I had made the assumption that it would likely be atrophic vaginismus. However, upon meeting her and discussing why she was coming to PT, I learned it was because she was limited in her ability to have sex with her husband due to a "bad knee."
She told me that her husband had a surgically fused spine, so during sex she always had to be on top, but her knee was making it harder and harder to do so. I remember being so surprised that this was the reason she was coming in for treatment, but then she said something that changed my perspective forever:
"I might be old, but I'm not dead, and we still want a healthy sex life."
That was my first lesson that intimacy doesn't have to end as we age, and that everyone — young and old — should be able to enjoy it to the best of their ability. More importantly, it highlighted the critical gap in sexual health services that address the musculoskeletal component of sexual dysfunction.
The Treatment Success Story
We jumped into a full orthopedic evaluation of her knee, finding that she was significantly lacking in range of motion and hip strength. Happily, after 6-8 weeks of PT, she was able to make gains in all of these departments and reported that she was back to having comfortable intercourse again with her husband. He even sent along his thanks.
This case perfectly illustrates how comprehensive sexual health services must include orthopedic assessment and treatment to address the full spectrum of sexual dysfunction.
The Missing Link in Sexual Health Services
This experience got me thinking: in the medical community, so much is invested in things like erectile dysfunction, but there hasn't been much research into functional inability to have intercourse due to orthopedic injuries. I propose that these numbers are pretty high and greatly decrease people's quality of life.
Research supports this observation, showing that musculoskeletal conditions significantly impact sexual function. Studies indicate that orthopedic injuries can lead to sexual dysfunction through multiple pathways:
Physical limitations affecting positioning and mobility
Chronic pain interfering with arousal and pleasure
Psychological impacts from body image changes
Medication side effects affecting sexual response
There is something called "functional incontinence," which is where someone's disability prevents them from being able to make it to the bathroom in time. This could be short-term like a broken leg or longer-term, like being wheelchair bound. This seems very much on par with the topic we are discussing now: orthopedic injuries standing in the way of sexual function — but it doesn't need to be that way.
The Research Behind Orthopedic Injuries and Sexual Dysfunction
Studies show that approximately 60% of people with musculoskeletal disorders experience some form of sexual dysfunction. Orthopedic injuries can affect sexual health through several mechanisms:
Physical Limitations: Research demonstrates that spinal cord injuries, hip replacements, and knee problems can directly impact sexual positioning and function. Lower extremity trauma, in particular, has been shown to significantly affect sexual function in both men and women.
Chronic Pain: Orthopedic injuries often result in chronic pain, which can decrease libido and interfere with sexual arousal. Studies indicate that pain management is crucial for restoring sexual function.
Psychological Impact: Research shows that 10-20% of erectile dysfunction cases have psychological causes, often stemming from trauma or body image issues related to orthopedic injuries.
Comprehensive Sexual Health Services: A Holistic Approach
At Method Physical Therapy, our sexual health services take a comprehensive approach that addresses both pelvic floor dysfunction and orthopedic injuries that may be impacting sexual function. This integrated approach recognizes that sexual health is multifactorial and requires assessment of:
Pelvic floor muscle function
Hip and spine mobility
Core strength and stability
Pain patterns affecting sexual positioning
Psychological factors related to body mechanics
Research supports this multidisciplinary approach to sexual health services, showing that physical therapy addressing both pelvic floor and musculoskeletal issues provides superior outcomes for sexual dysfunction.
The Goal-Oriented Approach to Sexual Health
Sexual intercourse is a major part of someone's quality of life — so don't let an orthopedic injury prevent you from pursuing this important aspect of wellness.
If you want to see a PT for your orthopedic injuries affecting sexual function, be prepared to answer questions like:
What positions do you and your partner like to use?
How long do you need to be able to maintain certain positions?
What specific movements or positions are causing pain or limitation?
What orthopedic injuries or conditions are you currently managing?
PTs are very goal-oriented, and knowing these answers will help us cater the exercises and treatments to your specific needs. Our sexual health services are designed to be comprehensive, addressing not just pelvic floor issues but the entire kinetic chain that affects sexual function.
Breaking Down Barriers in Sexual Health Services
Studies show that many healthcare providers are not comfortable discussing sexual health with patients, and patients often feel embarrassed to bring up these concerns. However, sexual dysfunction is incredibly common, affecting 25-65% of adults at some point in their lives.
Sexual health services that address orthopedic injuries should include:
Comprehensive musculoskeletal assessment
Pelvic floor evaluation
Pain management strategies
Adaptive positioning education
Strengthening and mobility programs
Psychological support and counseling
The Integration of Orthopedic and Sexual Health
Research demonstrates that physical therapy is highly effective for sexual dysfunction, with studies showing significant improvements in sexual satisfaction, pain reduction, and functional ability when musculoskeletal issues are properly addressed.
Modern sexual health services must recognize that orthopedic injuries are not separate from sexual health — they are intrinsically connected. Whether it's a knee replacement affecting positioning, spinal fusion limiting flexibility, or chronic pain interfering with intimacy, these physical factors require specialized assessment and treatment.
Taking Action for Your Sexual Health
Let's take the embarrassment out of discussing sexual health and help people live their best life. Orthopedic injuries don't have to mean the end of satisfying intimacy. With proper assessment, treatment, and support, individuals can overcome physical limitations and maintain healthy sexual relationships.
Our comprehensive sexual health services address the intersection of orthopedic function and sexual wellness, providing the specialized care you need to reclaim this important aspect of your life.
Ready to address how your orthopedic concerns may be affecting your sexual health?
Contact us today to learn more about our specialized sexual health services.