Generally, pelvic floor muscles (like any other muscle group in the body) can have hypotonic or hypertonic tendencies. Our nervous system plays a major role in managing muscle tone. If a client is living in a constant state of anxiety and stress or they find sex stressful, it’s likely their pelvic floor muscles will have a difficult time coordinating with the system. Regulating the pelvic floor will be especially difficult during sex.

Our pelvic floor muscles form the base of our spine and deep core. They wear many hats: bladder and bowel elimination, sexual activity, support and stability, pressure management, and shock absorption. I often refer to this group of muscles as Grand Central Station: there are a million convoluted routes to take! There is a TON going on down there. Not only are there about 16-20 muscles, but numerous ligaments, tendons, nerves, and fascial connections that help us complete ADLs/IADLs without the very embarrassing occurrence of urinary or bowel leakage and passing gas uncontrollably.

Let’s talk about what roles these pelvic floor muscles & organs play in our favorite occupation - sex!

When it comes to discussing sexuality with our clients, occupational therapy practitioners (OTPs) and other healthcare providers can come up with all sorts of justifications not to. But here's the thing: most of these justifications have more to do with our own biases than with the clients themselves. It's time to challenge those biases and ask ourselves, "Why am I avoiding this conversation?”

Welcome to the second part of our three-part series on addressing sexuality and intimacy after spinal cord injury (SCI). Today, we’ll delve deeper into the crucial role that Occupational Therapists (OTs) play in supporting individuals with SCI in this aspect of their lives. With their expertise and unique perspective, OTs can provide invaluable guidance and interventions to empower SCI patients and promote a positive and fulfilling sexual experience. The OT can be the shining light of comfort and advocacy! OTs are perfectly situated to lead these efforts in a clinical setting both for their patients and for the interdisciplinary team. Let's continue our exploration of the strategies and approaches that OTs employ in this domain.

As Sexuality and Intimacy Trailblazers, we know that sexuality and intimacy are important parts of our lives, bringing us joy and enhancing our overall well-being. However, when someone experiences a spinal cord injury (SCI), these aspects can be profoundly affected. Today, we'll discuss when to address these topics, the impacts of SCI on sexual health, specific complications that can arise, and the role of occupational therapy in supporting individuals on this journey.

Occupational therapy professionals will work with clients who may hire sex workers or who would benefit from working with a sex worker.

Here are 5 things OTs need to know to be prepared to address sex work with clients and to advocate for destigmatizing sex work:

Working with clients on their sexual routines is one of my top 5 ways I fall in love with OT again and again - every time. It reminds me how perfectly situated Occupational Therapy Professionals are to discuss sexuality in our clinical practice. We understand the impact of routines and specifically how occupations are sequenced together to facilitate participation, satisfaction, quality of life, and in some cases a great roll in the hay!

If you've been following along then you know this is the last post of my three part series: The Selfies, Sexplay and Sexual Communication. This post we're talking about Sexual Communication. Whether it's with a casual partner, one with relationship potential, or long time partner helping our clients learn how to establish sexual communication in their relationship is an important part of addressing sexuality and intimacy.

We've all seen them. The sex scenes in movies that too often portray those initial moments afterwards to be euphoric and filled with mutual pleasure and happiness. But, we know that just isn't always reality! It can actually be an awkward or uncomfortable time for couples. Add pain, difficulty with communication, or a physical limitation to the mix and it can really become a difficult time to figure out what to say. I often get asked by client's, "how do I ask for what I want?" and "what if I want my partner to do something different?" or often what is more likely is that I'll find out that sex just ends "bad" with one or all partners frustrated or feeling like there's a lack of connection.

Early on in my clinical practice I developed what I like to call, The 3 A's.

Documentation and billing are often the perceived showstoppers for doing sex and intimacy interventions. Let me tell you, I get a ton of questions about this, so you are not alone if you’re wondering,

“How the heck do I bill for, ‘Ronnie will mount Sammie during sex with mod I”?

So here is a quick and dirty blog post about documentation and billing to match the actual simplicity of this task.