So this time a year a lot of times people resolution is to get healthy and workout more which is awesome. We see a lots of exercise routines and new workouts started but unfortunately sometimes that can bring to light a problem that people don’t know that they have … pelvic floor dysfunction.
Today I want to talk to you about 10 signs that pelvic floor dysfunction may be affecting your workout.
- You have Bladder Leakage when you run, jump do burpees, jumping jacks, jump rope, Push ups, Squats any physical activities. Leakage with Physical activity is not normal, “It is not a badge of honor to leak while you exercise” it is a sign of pelvic floor dysfunction and there’s something that you can do about it.
- Low back, pelvic, hip or a Abdominal pain with or soon after your workouts, “Pain should not be a part of your workouts.” Yes should be pushing yourself hard but there’s a difference between muscles burn and pain. And if you’re dealing with pain any of these areas it may be a sign that your core muscles are not functioning well together and you need to make a change.
- If you need to pee, pre and post workout then this is a sign that your bladder and pelvic floor muscles may not be function optimally, if you’re doing a 40 to 60 minute workout you should be able to make it without having to urinate before or after class.
- You are experiencing pelvic heaviness, pressure or falling out feeling during or shortly after workouts, This can be a sign that you are experiencing pelvic floor dysfunction and/or pelvic organ prolapse and it’s a definite sign you need to modify activities in order to performed at a level that your core and pelvic support muscles can function at appropriately.
- Your belly bulges out or pushes out especially when you’re performing abdominal exercises. You should be able to maintain a gentle belly pull in during the exercises. If you feel that your abdominal wall is pushing out or your back arching off the floor then “you are not using right support muscles to perform the exercise and you’re actually not going to get the same benefit out of it” This also is putting more pressure down through your pelvic floor area. It can be a sign of dysfunction.
- You need to pee mid workout. Again going back to number 3, you should not need to pee before after or during workout and if it’s only 40 minutes to an hour long. So if you need to stop your workout to make sure that you don’t pee your pants then it’s a sign that you probably have some bladder or pelvic floor issues that need to be taken care of.
- You hold your breath to complete an exercise. Whether you doing crunches, plank, squats, lunges, bridges or any type of exercise, “If you find that you have to hold your breath to complete those exercises that is using a pressure system to create stability vs thoroughly engaging your core support muscles well”.
- You feel that your form fails you or you get exhausted easily from your exercises. Again it’s can be a sign that your core support muscles are not working the way that they should be and your body’s trying to compensate with other areas but it’s not able to do so.
- “You skip part of your workout because you know you will have bladder leakage if you do it”, So if you are avoiding the double unders, jump lunges, jump ropes, jumping jacks or squats because you will know you will leak when you do them, then that is a sign that you have pelvic floor dysfunction. There is something you can do about it so that you can get back to doing your entire workout.
- You have gas leakage while performing your exercises. So if you cannot hold the fart in while your are exercising then this is the sign that your pelvic floor muscles are not performing optimally.
So we just went through 10 signs that pelvic floor dysfunction may be affecting your workout. How many of these applied to you? If they do, Don’t worry. There something that you can do! Partnering with the pelvic physical therapist is one of the best options that you can do to make sure that your pelvic floor and core muscles are performing optimally to get you back to your exercise routine. We want to help you reach those new year resolutions and goal that you would like to achieve. So if you answered yes to anyone of these 10 signs then we’d love the opportunity to work with you. You can give us a call @ 636-225-36-49 and we can get you setup for a free discovery session to find out if pelvic physical therapy is right for you.
Today I want to clear up of some common misconceptions about bladder health that we hear all the time. Do you know how to keep your bladder healthy and happy? Check out below to learn 10 simple tips for a healthy bladder.
- Do not push to pee. We are not designed to strain or push to empty our bladder. Women especially tend to be what I called “Power peers.” They go as quick as they can because they hurry to get in/get out out and get back to their day.However forcing or pushing to urinate puts more strain on our pelvic floor and bladder. We are designed “just to sit and relax and let the urine come out”. Take a moment sit down and let the flow happen vs trying to strain or push.
- “To keep your bladder happy, you need to drink more water”. Most people, especially if they are dealing with bladder leakage, urgency or frequency will limit their fluid to reduce the amount of times that they have to go to the bathroom or that they leak. Unfortunately when we limit fluid it actually irritates the bladder. Concentrated urine is more irritating to the bladder, so we need to take in plenty water throughout the day to stay hydrated and keep the bladder happy. You can tell that you are drinking the right amount of fluids by looking at the color of your pee. Your pee it should be a pale yellow color. If it’s a dark yellow or even towards a brown side that is definitely a sign that you are not drinking enough water.
- Sit down on the toilet. Many women hover over the toilet because they are worried about germs. However, “we are designed to sit down and relax to urinate.” If you are worried about germs on public toilets, then use toilet seat covers or line the seat with toilet paper, because we need to sit to empty fully.
- Limit or avoid caffeine. Now this can be a sad one for lots of people. Don’t get me wrong I like my cup of coffee in the morning but “caffeine is a bladder irritant” and can cause increased urgency and frequency. If you’re dealing with urinary urgency and frequency the first thing I would recommend is to cut out caffeine. If you absolutely cannot cut it out then for every cup of coffee that you drink, you should also have a cup or 2 of water to try to dilute the bladder irritant.
- Be gentle when you wipe. Our tissue down in there is delicate. Wipe front to back and potentially just dab to be even more gentle.
- “Don’t ignore the urge to go”. Our bladder communicates with our brain to tell it when our our bladder. This usually occurs every 2 to 4 hours. “Listen to your bladder”. When you feel that need to urinate and it’s been close to or over the 2 hour mark then go. If you are going more frequently than every 2 hours then you may be dealing with urinary urgency and frequency.
- Squeeze before you sneeze. When we have warning that a sneeze, a laugh or a cough is coming we want to pre-contract our pelvic floor to brace and prevent bladder leakage. To contract your pelvic floor, try to pucker around the anus or draw the vagina up and in. If you’re having through doing this or not sure that you are doing it right, then this is a great opportunity to connect a pelvic physical therapist to figure out how your pelvic floor muscles are working. We need the pelvic floor muscles to be on and ready to accept that extra pressure that is going to happen when we cough, laugh, or sneeze.
- When you finish peeing, rock side to side and back and forth on the toilet to funnel fluid down in the bladder to make sure that you are emptying completely. Rock ‘n’ roll on the toilet instead of trying push or strain to get that last a little bit of urine out.
- “Don’t Rush”. Sit down, “Relax and let your body do it’s thing”. Rushing can prevent completely empty your bladder fully. While sitting on the toilet take 5- 10 deep breaths to help everything empty out fully. If you have trouble slowing down try setting a timer on your phone for 1 minute to get you to sit for a little longer.
- Partner with a pelvic physical therapist. A pelvic physical therapist can help you evaluate your bladder habits and assess your pelvic floor muscle function. They can help you identify potential bladder problems and come up with a plan to address issues.
After reading these 10 tips for healthy bladder, how many are you practicing? Could your bladder use some healthier habits? We are here to help. Feel free to call us at 636-225-3649 to talk with one of Legacy Physical Therapy’s pelvic physical therapists to get your questions answered.
It is three days into January, have you made your New Years Resolutions for 2018?
If not, that is okay because I want to share with you something a little different today.
I want to put a little twist on the New Year’s Resolution. For years I set [loose] goals and never really achieved them, resulting in me feeling horrible and like I had failed. I’d write them here and there, on scraps of paper, put them somewhere in the house or office, and forget about them. I would find those goals later in the year and realize I didn’t even come close to achieving them.
What’s worse, because my goals never became a plan — I was certain the problem was me, which led to me feeling EVEN worse. So, eventually I grew exhausted feeling this way, I wanted to do something about it….. I really wanted to figure out a way to make these goals of mine become a reality. So I started small, not with a goal or a resolution, but with simple habits.
Set Small Habits To Get Big Results
I began a daily gratitude journal where every day I write down at least one thing I am grateful for to help me stay focused on the positive in life.
I blocked out time in my day to work on the things that mattered to me most, AND to make sure I got to spend quality time with my family.
I started carrying a water bottle with me every day, in order to make sure that I am getting in enough water in on a daily basis and to help me curb cravings.
And soon enough, these small habits became a part of my daily life without thinking twice!
SO, here is my challenge to you…….Start a small habit or two this year. Can be something as simple as drinking 5 glasses of water a day, eating fruits instead of sweets, cutting out soda or stop eating fast food— A SIMPLE habit/goal that is easily obtainable. Stay clear of making drastic changes quickly, as that will lead to frustration and cause you to want to quit. Instead, begin by adding small habits into your day until you do it without thinking. Once you are successful, the feeling of accomplishment and the feeling of improved health with build momentum for the next small habit.
The Power Of Daily Habits
Once I learned the power of daily habits, I could begin setting goals again. And you know what? It’s been FUN to start obtaining goals.
It’s possible to achieve things in life you’ve always wanted by setting big goals to get there – the trick is understanding that they don’t happen overnight, or within a couple of weeks. Goals require daily practice with small daily habits along the way to get there.
So, what habits are you going to set yourself for 2018?
November is National Bladder Health Awareness Month. Earlier in the month we shared Ashley’s story about bladder leakage and her return to #LifeWithoutLeaks. Today, we are sharing our top 10 tips for healthy bladder.
10 Tips for Healthy Bladder
- Don’t strain or push to empty your bladder. Forcing urine out will put strain and stress on your pelvic floor and bladder.
- Drink more water. Limiting fluids actually irritates the bladder rather than helps it. Drink plenty of fluids (primarily water) throughout the day to stay hydrated and keep your bladder happy.
- Avoid the JIC or “just in case” pee. Going to the bathroom “just in case” can train your brain and bladder to think you need to urinate more frequently than you actually have to.
- Sit down on the toilet. Sitting all the way down on the toilet allows your pelvic floor muscles to fully relax improving your ability to empty your bladder.
- Limit or avoid caffeine. Caffeine can irritate your bladder causing increased urinary frequency or urgency.
- Dab, dab, dab. Our tissue “down there” is very delicate. Wiping front to back might make you feel clean and dry, but it’s abrasive and can be irritating to the tissue. Instead dab front to back.
- Don’t ignore your urge. Your bladder and brain communicate when the bladder is full and it’s time to urinate every 2-4 hours. Listen to your bladder (and brain). When you feel that sense to urinate (and it’s been at least 2 hours), then go!
- Squeeze before you sneeze. Don’t get caught off guard! Squeezing the pelvic floor muscles before you cough, laugh, or sneeze can minimize or eliminate leaks and dribbles.
- Rock and tilt on the toilet. Rocking your pelvis front, back, and side to side can help empty the bladder to get any last dribbles out.
- Don’t rush. Sit down, relax, and let your body do it’s thing. Rushing the process can prevent you from completely emptying your bladder.
We hope this helps you improve your bladder health! Here at Legacy Physical Therapy, helping people achieve and maintain healthy bladders is our specialty. If you are experiencing urinary leakage, frequent urination, and/or urinary urgency, feel free to give our office a call at 636-225-3649 to find out how we can help you.
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.
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
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.