Pelvic Therapy

As a pelvic therapist, one of the most common diagnoses I see is urinary incontinence. This sometimes can be called Over-Active Bladder Syndrome (incorrectly). One job of pelvic floor muscles is to be able to close the urethra (the tube that leads from bladder to outside the body) when you are not peeing. We need strong and healthy pelvic floor muscles so that you can jump and hop and sneeze and cough without leaking urine. We also need control of pelvic floor muscles so that we can avoid running to the bathroom with severe urgency. Here are a few things to keep in mind if you are struggling with urinary incontinence.

First of all, you do not need to deal with urinary leakage. Just because you had a baby, doesn’t mean you have to deal with leakage. Just because you are a woman older than 60 doesn’t mean you should be leaking. Kegels are not the only answer to gaining strength in pelvic floor muscles. Relaxation of these muscles is important too!

Restricting your water intake will not make you leak less! You should be drinking water all day, not coffee, not tea, not juice, but water. To figure out how much, take your weight and divide in half. Replace pounds with ounces and this is how much you should drink each day. For instance, If you way 140 lbs, divide by 2 for 70 lbs, change to 70 ounces. The inside of the bladder is lined with a mucus membrane. It likes to be awash with water, not acidic drinks or food like soda or coffee.

The bladder takes 2-4 hours to fill up. Are you peeing every 30-60 minutes? Then you are peeing too frequently. When you pee, is it only for a few seconds? A full bladder will take about 10 seconds or more to empty. Try counting next time! I give all of my clients a Daily Voiding Log to fill out. This tool helps reveal bad habits and patterns and it helps focus the therapy.

Many clients ask me, can incontinence be fixed. And the answer is “YES”. As long as you do your exercises, make modifications to your fluid intake and change your behavior surrounding frequent urination. Still have more questions? Make an appointment today with a pelvic floor specialist!

Also called Interstitial Cystitis, Painful Bladder Syndrome is a condition of chronic pain in bladder, pelvic floor, lower abdomen and low back that has persisted > 6 weeks with no infection present.  Urinary frequency and urgency are 2 additional symptoms. The average person urinates 7 times per day or every 2-4 hours. With Painful Bladder Syndrome, a person may go to the bathroom every 30-60 minutes. Urinating tends to be painful and incomplete. There is also an increased sense of urgency to get to the bathroom. While there is usually not any incontinence, there is an uncomfortable sense of urinary urgency. Women are 2-3 times more likely to suffer from this syndrome and there are many variables that may contribute to the pain syndrome including irritating foods and drinks, stress and dehydration.

Physical Therapy can help! If someone has been diagnosed with Painful Bladder Syndrome or Interstitial Cystitis, an evaluation by a specially trained PT should be performed. In this exam the PT is assessing for pelvic floor dysfunction including weak and/or tight muscles of the pelvic floor, reports of urinary frequency and urgency, reports of constipation or painful bowel movements, reported pain with intercourse and unexplained pain in pelvic region, bladder and lower back. Tightness, spasming and trigger points may be found in the 3 layers of pelvic floor muscles. These trigger points may refer pain to the bladder, low back or lower abdomen. Through soft tissue mobilization, the muscles can be restored to a normal state and Painful Bladder Syndrome symptoms can be reduced.

The treatment for painful pelvic dysfunctions differs from urinary incontinence issues. Treating a painful pelvic floor involves relaxing and lengthening the muscles of the pelvic floor whereas incontinence issues are treated with strength training. For someone experiencing a lot of pain from tight muscles, strengthening becomes part of the problem, not the solution.

To learn more about what PT can do for you, here is a helpful information from the Interstitial Cystitis Association. Read on…