Bladder leakage with exercise is NOT normal.
I had the opportunity to help a patient awhile back. Let’s call her Ashley. When I met Ashley, she told me her story, an all too common tale for many women. Here’s her story…
Ashley is a 31 year old mother of two kiddos under the age of 3. Her youngest was born 6 months prior to the time she came in to see me.
In the past, she exercised a few days per week varying her activity from walks around her neighborhood, to boot camp and strengthening classes at the gym, to the occasional run.
At 6 weeks postpartum, when she was cleared to return to exercise from her OB/GYN, she returned to regular walks pushing a double stroller. Her body felt pretty good overall.
At around 8 weeks postpartum, she returned to the gym for her first boot camp class. She realized quickly how little strength she had in her body, especially her abdomen. What startled her most was that she could not seem to do any jumping exercises without a trickle of urine coming out.
Ashley fully admitted she figured the leakage was a fluke- maybe she hadn’t emptied her bladder fully, or she drank too much water before class… but it wasn’t a fluke.
Ashley explained to me that her urinary leakage continued to happen every time she would jump during boot camp— jump squats, jumping jacks, even with mountain climbers. Then she noticed leaking urine when she would cough or sneeze. Her problem seemed to be getting worse, not better.
She was frustrated.
She couldn’t exercise like she wanted to, nor could she let out a cough or sneeze without fear she would pee herself. She eventually stopped going to boot camp classes and started wearing a pantyliner “just in case.”
Then one day, scrolling through social media, she read a post on how physical therapy could help with bladder issues. She figured it wouldn’t hurt to try. That’s when she called me at 6 months postpartum.
She told me her goal was to be free of leakage again— to not leak urine when she jumped, coughed, or sneezed. She wanted to return to bootcamp classes 2 times per week and potentially run a 5k in the future. She did not want to wear a pad every day. She did not want to feel limited by her bladder problems.
Ashley met with me for weekly appointments to start, then phased down to appointments every few weeks as she saw improvement in her urinary leakage. We worked together on focused strategies and exercises to target her specific problem areas.
By the end of our time together, she wasn’t leaking any longer with a cough or sneeze. Ashley had returned to boot camp classes without fear of bladder problems.
Ashley told me at her final visit, “I am so grateful that I found pelvic physical therapy. No woman should have to live in fear of her bladder. And I’m thankful I no longer have to.”
If you have a story similar to Ashley, we want you to know that you are not alone. 1 in 3 women will experience bladder leakage some time in their lifetime. You DO NOT need to live with it. Pelvic Physical Therapy can help. If you are experiencing bladder leakage with exercise, contact us at 636-225-3649 to set up a free discovery session to see if Pelvic Physical Therapy is right for you.
Sex feels usually feels great, but what if it doesn’t? Painful sex is more common than you think—nearly 3 out of 4 women have pain during intercourse at some time during their lives. For some women, the pain is only a temporary problem; for others, it is a long-term problem. Pain during intercourse is known as Dyspareunia. It can make women avoid, reduce the frequency, or outright stop having sex. Women of all ages can experience dyspareunia.
Have you ever struggled with painful sex? You are not alone. Many women suffer in silence when sex starts to get painful. Others may be brave enough to bring it up with doctors, only to be given unhelpful advice such as “drink some wine,” “just relax,” “you had a baby recently this is normal,” or “just use more lubrication.” Each of these statements are real quotes from patients of ours here at Legacy Physical Therapy. We want to spread the word that there is hope and help!
Earlier this fall owner, Brooke Kalisiak had the pleasure of joining Angela Skurtu M.Ed, LMFT (AASECT) Certified Sex Therapist on her podcast About Sex. During this episode we discussed some of the common causes of painful sex, potential treatment options, and how pelvic physical therapy can help.
To listen to the episode you can go to:
Or you can watch the LiveStream Video below. Brooke Kalisiak brought along her pelvic anatomy model to the taping. Watching the video you will get to have a visual of some of the anatomy she is discussing.
If you or someone you know is dealing with painful sex, please know, first and foremost that you are not alone, and second that there is help. If you would like to learn more about potential treatment options for painful intercourse, you can reach us at 636-225-3649 to talk with one of our experienced pelvic physical therapists.
THANK YOU SO MUCH FOR HELPING US HELP the HOUSTON FLOOD VICTIMS!!
Many of you know that our receptionist Rosie is from the Houston area and she continues to have many family members and friends still living in Houston who were greatly affected by the flood. When we learned that Rosie and her husband, Norbert were going to be heading down to Houston to help out we immediately organized a supply drive at Legacy Physical Therapy. We were overwhelmed by the generosity of our patients, friends, and family.
Rosie and Norbert rented a minivan and filled it with all of the donated supplies to drive down to Houston. We were very impressed with the packing ability! Tetris has nothing on Norbert!
Besides all the supply donations, Rosie and Norbert also received $1600 in cash donations. They used this money to buy Home Depot gift cards to help people start to rebuild.
Once down in Houston they partnered with a church local to Rosie’s family’s neighborhood to help distribute items. According to Rosie the church workers did an amazing job and went above and beyond to get items to needy families. Many families lost their cars in the flooding so church volunteers took it upon themselves to drive supplies to those in need.
Rosie said she was glad that she was able to go down and help out. She wishes she could have done more because she knows that there is still so much to be done for these families to get back to their normal daily lives.
From all of us at Legacy Physical Therapy, we thank you from the bottom of our hearts for all of your generosity. It is awesome to see our community come together like this.
Do you need more zzzz’s? Or just better quality sleep??
If you’ve answered yes to the questions above then keep reading! Adequate sleep is essential for good health. Having healthy sleep habits is referred to as good sleep hygiene. If you would like to have better sleep hygiene resulting in improved sleep, then consider following some of these sleep practices below:
- Go to sleep and wake up at the same time every day. Easier said than done, but studies show that consistent sleep and wake times will help to set your natural biological clock.
- Set the environment to promote good sleep. Use your bed for only sleep and sexual activity to help train your body that if you are in bed, you should be sleeping. Keep the temperature of the room comfortable. Avoid eating or working in your bed. Lower the light and noise in the room. Use earplugs or eye masks if necessary to drown out uncontrollable noise or light.
- Avoid using light emitting electronics at least 30 minutes prior to bedtime. The blue light coming from your television, tablet, phone, etc. can disrupt sleep by suppressing melatonin production.
- Exercise earlier in the day. Moderate or vigorous exercise should be done at least 2-3 hours prior to bedtime. Exercise stimulates the body and brain, making it hard to fall asleep. Regular exercise has been shown to improve sleep, so keep moving, just preferably not in the few hours before bedtime.
- Avoid drinking alcohol or smoking 3 to 4 hours before bedtime. Nicotine in cigarettes acts as a stimulant that can make it difficult to fall asleep. Some believe that alcohol will relax the body before bedtime and help with sleep. Actually, it can increase the number of times you wake up during the night and make you wake earlier.
- Create a relaxing bedtime routine for yourself. A relaxing routine may include taking a warm bath, deep breathing, meditating, guided relaxation, doing some light reading, or even a yoga or stretching routine.
- Avoid heavy meals and fluids. Excessively drinking or eating a large meal 2-3 hours before bedtime to allow plenty of time for your body to digest.
- Avoid taking daytime naps. If you have to nap, limit the time you sleep during the day to 30 minutes so you are tired enough in the evening.
- Most everyone has the occasional sleepless night, but if you consistently have problems sleeping after trying to improve your sleep hygiene, it is best to contact your doctor or health professional.
Here’s to you getting more restful sleep. We find that for many people pain issues and/or their bladder may be a disrupting factor during the night. If you find yourself unable to sleep secondary to pain or woken up several times a night because of your bladder then give us a call to find out more about how we may be able to help! 636-225-3649
Most of us probably know someone affected by the flooding in Houston. This natural disaster has hit particularly close to home here at Legacy Physical Therapy. Our amazing office coordinator, Rosie, is originally from Houston. She continues to have several friends and family members that live in the Houston area and have lost their homes and possessions to the flooding. We want to do something to help.
Rosie and her husband, Norbert, will be driving down to Houston on Friday September 8th to see family and help with the relief effort. They are are hoping to collect some donations to take with them.
We know that this is short notice. However, Legacy Physical Therapy will have donation boxes available at our office on Friday September 1st and Tuesday September 5th through Thursday September 8th. (We are closed for the Labor Day Holiday on Monday.)
Most Needed Items
- Toiletries (toothpaste, toothbrush, deodorant….)
- Cleaning Supplies
- New socks/underwear
- Non-perishable Food
- Diapers &Wipes
- Baby Food/ Formula
- Cash (To be used to buy needed items)
- Gift Cards (visa, mc, target, etc)
Please stop by during our business hours to drop off your flood relief donations for Rosie and Norbert to drive down to Houston. They will be renting an SUV to take supplies down. We want to make our impact as big as possible so consider sending along smaller, lighter items to fill up the SUV.
Legacy Physical Therapy
2961 Dougherty Ferry Road Suite 105
Saint Louis MO, 63122
- Friday 9/1/17: 8:40am-4:20pm
- Tuesday 9/5/17: 9:20am-7pm
- Wednesday 9/6/17: 8am-6pm
- Thursday 9/7/17: 8am-6pm
Thank you ahead of time for your donations and willingness to assist. Our thoughts and prayers go out to all of the families affected by the flooding.
Wow! We had an amazing response to our last blog post about rehabbing the mummy tummy. If you missed it, please check out our take on the importance of considering many factors when rehabilitating the postpartum core and/or diastasis recti, before reading on.
Diastasis recti is a separation of the abdominal muscles that commonly happens with pregnancy. For some women this separation heals back up without much effort after delivery. However, many women still have a diastasis recti months or years after delivery.
“How do I know if I have a diastasis recti?” This is a question that we get asked all the time. There is a simple test that you can perform yourself to determine if you have a separation of your abdominal muscles? Check out our quick how-to video.
How to Test for a Diastasis Recti?
So, did you perform the test? Do you have a separation of the abdominal muscles? If you had trouble telling if you had a diastasis recti, please contact us at Legacy Physical Therapy for a free discovery session to help you.
Or maybe you performed the test and you realized that you do have a diastasis recti. Now what? There are things that you can do to rehab your core whether you are 6 weeks, 6 months, or 6 years postpartum. Call us to discuss your findings with one of our experienced women’s health physical therapists. We are here to help.
Yesterday my Facebook feed was inundated with multiple shares of this NPR article titled, “Flattening The ‘Mummy Tummy’ With 1 Exercise, 10 Minutes A Day.” After all, with a title like that who wouldn’t want to click on the article and and learn what seems to be such a simple fix for diastasis recti. The trouble is that the “Fix” is never this simple.
While I appreciate the awareness this article is bringing to the topic of diastasis recti and recovery of the partpartum core, Diastasis recti is far more complex than any one single exercise for one single muscle. Diastasis recti is not just about the abs, but moreover is about full body alignment and optimal intra-abdominal pressure regulation. One of the things that I talk to my patients about all the time is that I can give them the world’s best abdominal exercise program to perform 10-20 minutes a day, but what they are doing the other 23 hours and 40-50 minutes makes a bigger difference to their diastasis recti.
Core muscle function is so much more than static recruitment of a single abdominal muscle. Your transverse abdominal muscles, pelvic floor muscles, diaphragm, and deep back muscles form your deep core canister. They all work together to provide anticipatory stability. So few women realize that their breathing pattern is connected to their abdominal wall performance and their pelvic floor muscle function. My colleague, Julie Wiebe PT has a wonderful video about how all these muscles coordinate together on her webpage. Check it out. If we do not consider breathing pattern when rehabbing a diastasis recti, we are missing a big part of the picture. Chronic drawing in of the abdominal wall is not the answer! If we squeeze in the middle all the time, what are we doing to our pelvic floor down below… setting it up for issues down the road.
The research on diastasis recti is emerging and evolving. There is no way to prevent it during pregnancy by doing an exercise. It is a normal part of many women’s pregnancies. Don’t get me wrong, there are definitely things that you can do before and during your pregnancy to reduce your risk of a large diastasis recti and improve overall core function and support. However there other factors such as one’s genetics, overall tissue laxity, number and proximity in time of pregnancies, and singleton versus multiple pregnancy to name a few.
What’s a Woman to Do?
While this article is good to raise awareness, it barely scratches the surface of what is really needed to address the postpartum core rehabilitation. My best advice is to seek the care of a women’s health physical therapist to do a full assessment of core support system. At Legacy Physical Therapy, we see women all the time who think they are doing the right thing to rehab their core, but find that despite performing the exercises their symptoms are getting worse. If you cannot get to see a women’s health physical therapist, then please do your research when searching for solutions online. Below is a list of some of my favorite go to sites.
- Julie Wiebe PT
- Mutu System
- Brianna Battles – Everyday Battles
- Jessie Mundell
- Healthy Habits Happy Moms
If you think that you are dealing with a diastasis recti or postpartum core weakness, we can help. Give us a call at 636-225-3649 to chat with one of our women’s health physical therapist to see how we can help. If you are not sure if you have a diastasis recti and want to be checked by a professional, call us to set up a free screening appointment. We are happy to help.
In our last blog post we discussed the 10 sign that you may have pelvic floor dysfunction.
If you missed that post, CLICK HERE to read it.
Did you answer YES to any of the 10 signs in our last post? Are you wondering what you can do about it? Read on…
5 things you can do today to help pelvic floor dysfunction
- Learn to kegel. A “kegel” is a contraction or squeezing of the pelvic floor muscles. Try to contract your pelvic floor muscles as if you are trying to stop the flow of urine or hold back gas. If you can feel a squeezing sensation or successfully stop a flow of urine, then you are likely able to kegel. If you cannot kegel or aren’t sure if you are doing a kegel correctly, a pelvic physical therapist can help assess your kegel and then teach you how to properly contract your pelvic floor muscles. It is worth saying that it’s not all about squeezing your pelvic floor muscles or kegeling! The pelvic floor muscles need to be able to relax too.
- Avoid bladder irritants such as caffeine, alcohol, fried foods, citrus fruits and fruit juices, spicy foods, tomatoes and tomato based products, and/or artificial sweeteners. Once you have eliminated the potential irritants for a couple weeks, you can try to add them back in one by one to tease out which substance seems to have the most effect on your symptoms.
- Avoid constipation and straining. Keeping your stools soft through a diet rich in fiber and plenty of fluids (ideally water) will reduce the strain and stress placed on the pelvic floor. Tools such as the “squatty potty” can position you properly to further reduce the strain on the pelvic floor making bowel movements easier. Pelvic physical therapy can also be helpful in teaching you how to properly relax your pelvic floor muscles to reduce constipation or straining with bowel movement.
- Breathe! A few repetitions of deep belly or diaphragmatic breathing throughout the day can help pelvic floor dysfunction. When you breathe diaphragmatically, as you inhale your diaphragm moves down and your belly expands, and as you exhale your belly retracts and your diaphragm goes back up. Deep breathing helps calm the nervous system and reduce urgency and pain symptoms. Not sure how to belly breathe? Pelvic physical therapists can teach you the proper technique.
- If you think you have a pelvic floor dysfunction, the best thing you can do is to have an evaluation done by a trained pelvic floor physical therapist. In your evaluation, you and the pelvic physical therapist will discuss what your symptoms and goals are; the therapist will perform an evaluation to determine the source of your problem; and you will decide together what the best treatment plan for you will be.
It is our mission at Legacy Physical Therapy to help people overcome pelvic floor dysfunction. We would be honored to partner with you in your care. If you are wondering if you are dealing with pelvic floor dysfunction and you would like to talk with one of our talented pelvic physical therapists, you can email or call us at 636-225-3649 to set up a free discovery session.
“Pelvic floor dysfunction, what’s that? I have never heard of pelvic floor dysfunction. Sure I have had a few kids, but I doubt that I have any pelvic issues. Pelvic issues only happen to little old ladies, not me”
Does this sound like what is running through your head right now? You are not alone. Many women suffer from pelvic floor dysfunction, but are unaware that the symptoms they are experiencing are related to their pelvic floor.
Have you ever experienced any of the follow?
- Bladder Leakage– Whether it be a small drop with a sneeze or a complete loss of urine while on the way to the restroom, bladder leakage is NOT NORMAL. However it is common. One in three women will experience bladder leakage in their lifetime.
- Urgency and Frequency– Do you know where all the bathrooms are in town? Do you urinate more than 7 times a day? Do you constantly feel like you need to pee? Are you getting up at night to pee? If you answered YES to any of these then you are probably dealing with urgency, frequency, and pelvic floor dysfunction.
- Fecal Incontinence– This can come in many forms: inability to control gas, staining or smearing on the underwear, fecal urgency, or complete loss of stool.
- Bladder pain or Burning with Urination– Many women think that they are dealing with frequent recurrent UTIs and subject themselves to countless rounds of anti-biotics only to have the symptoms not go away. The missing factor may be pelvic floor dysfunction.
- Constipation and/or Straining to Have Bowel Movement– We are designed to push to have a bowel movement, but not to strain. Our pelvic floor needs to relax appropriately to let the bowel movement pass We should be having regular bowel movements that are the consistency of soft log.
- Pain with Sex, Tampon Use, or Gynecological Examination– These things are not supposed to be painful. Too many women, “grin and bear it” thinking that pain with sex is just part of it. I am here to tell you that it is NOT!
- Vaginal Heaviness, Bulging, or Feeling of Falling Out– These symptoms are common signs of a pelvic organ prolapse, where one or more of the pelvic organs starts to push into the vaginal canal and cause these symptoms. TOO MANY WOMEN are told that these symptoms are normal after having children and they just need to live with it until the symptoms are bothersome enough that surgery is needed. This is NOT THE CASE for many women. By identifying and working to rehabilitate their pelvic floor dysfunction, many women can alleviate these symptoms.
- Low Back Pain, Abdominal Pain, or Pelvic Pain– Many women are surprised to learn that their low back pain may be caused by pelvic floor dysfunction. The pelvic floor is part of our core support system, so if it is not working appropriately then we can get extra stress and strain on our low back, abdominals, or hips.
- Difficulty Starting Urine Stream or a Hesitant Urine Stream– We were not designed to push to pee, but many women feel like they need to push to get the urine to come out.
- Inability to ‘Kegel’– A kegel exercise is the generic name for a pelvic floor muscle contraction. Contracting the pelvic floor prevents urine or feces from escaping. Research has shown that over 40% of women think they are doing a Kegel exercise correctly, but they are not.
If you answered YES to any of the above then you may have pelvic floor dysfunction. The National Institutes of Health found that pelvic floor disorders affect 10% of women ages 20-39; 27% of women ages 40-59, 37% of women ages 60-79 and nearly 50% of women over 80.
If you have experienced any of the 10 signs listed above you are a perfect candidate to explore the possibility of your pelvic floor being the cause or a contributing factor.
Remember there are treatment options for you! Don’t suffer and compromise your quality of life when the treatment is so easy! If you believe you or someone you know may be dealing with
pelvic floor dysfunction, call our office at 636-225-3649 and
we will help you determine your best treatment options.
Fibromyalgia is a clinical condition of unknown etiology characterized by chronic generalized body pain associated with fatigue and psychological distress. It typically presents in young to middle aged women and can result in sleep disturbance and significant impairment in activities of daily living.
While medical therapy for fibromyalgia exists and may to a limited extent be beneficial in managing pain, physical therapy plays a major role in treatment and rehabilitation. The aim of physical therapy is aimed at deconditioning and muscle weakness. There are different modalities of physical therapy aimed at treating different aspects of fibromyalgia.
1. Cadiovascular Fitness Training
Patients suffering from fibromyalgia are generally inactive and often become physically inactive over time. Exercise has shown benefits in long term management of fibromyalgia, with studies even showing an improvement in pain. In recent years, exercise remains one of the most commonly recommended treatments.
Exercises are ideally low impact and could include Tai Chi, water exercise, and Qi Gong. Water based exercises seem to offer a small degree of advantage over exercises performed on land, but sometimes are not as convenient to perform. Based on patient function prior to initiating therapy, exercise programs can be tailored to the patient specifically.
2. Physical Therapy
Treatment is aimed at increasing overall muscle strength, and is aimed at reducing muscle weakness. Common advice and treatment may include:
- Avoid muscle overloading- ie lifting heavy weights
- Correcting body alignment
- Muscle conditioning and stretching
- Encouraging general activity
3. Muscle Massage
While this provides both psychological and physical relief to some extent, there is no strong evidence that it is useful as an individual treatment modality; rather it is better used in combination with other therapies.
Randomized controlled trials have shown that acupuncture can provide significant improvement in pain reduction and a reduced perception of pain. However its long term benefits have not been adequately studied, and there is no clear guidance on how often treatment should be administered. It may be more beneficial as an adjunct therapy.
5. Transcutaneous Electrical Nerve Stimulation (TENS)
TENS is an electrical based pain reliever. It is more useful for localized pain, and hence its use for fibromyalgia may be limited. However it is an easy therapy that the patient can self administer at home.
Exercise and physical therapy are mainstay treatment options for fibromyalgia. Treatment options need to be tailored to the individual. With optimal therapy, patients can experience a significant improvement in symptoms.