Are you experiencing bladder leakage? Have you tried kegels exercises, but are not noticing any improvement in your bladder leakage?
Many of our patients ask when they come to see us… “aren’t you just going to teach me how to do Kegel exercises? I have already been doing those exercise and they are not helping. I am still leaking so what are you going to tell me that’s different.”
I am going to give you 3 reasons why Kegel exercises may not be helping your bladder leakage.
First, a brief explanation:
A Kegel exercise is the Layman’s term for a contraction of the pelvic floor muscle. When our pelvic floor muscles contract, they lift up and into our body and they close off around the urethra, vagina, and anus preventing pee and poop from coming out. These muscles are working all day for us but they need to work extra hard in situations where there’s more the load through the pelvis such as when we cough, laugh, sneeze, jump, run, or lift. Therefore, if a person is experiencing bladder leakage, they are told by their doctor, or they read in a magazine that they should be doing Kegel exercises to stop the leakage.
You maybe doing the exercise incorrectly. Research studies have shown that of women who are told to do Kegel exercises, about 40% of them are doing the exercise wrong. They think they are contracting the pelvic floor muscles but they may actually be pushing out on the muscles instead or using all together different muscles.
Your pelvic floor muscles might be too tight instead of too weak. A tight, tense muscle is not a muscle that does its job effectively. A muscle needs to be able to contract relax and move. Some women keep their pelvic floor tight all day long and they do not even realize that they are doing it. If the pelvic floor muscles are already too tight, doing more Kegel Exercises, tensing the muscle more isn’t going to help. You need to first learn to relax the pelvic floor and teach it how to move better before you can strengthen it.
Your leakage might not be a strength issue at all. It might be a timing issue. You may not be recruiting the muscles at the right time. You may need to work with someone to help you figure out how to get the pelvic floor muscles to contract at the right time. Many women can do Kegel exercises just fine when they are laying down or sitting still, but when they have to coordinate them with other movements the timing goes out the door.
So if you are experiencing bladder leakage and have tried Kegel exercises and they don’t seem to be working, it may be time to partner with a pelvic health physical therapist to help you figure out the root cause of your leakage and get you on the right path to dry days.
Pelvic physical therapy is something that is unfamiliar to many people. I would say for about every 10 new patients that come to see us here Legacy Physical Therapy, about 7 or 8 of them start out their evaluation by saying that they have never heard of Pelvic Physical Therapy and they are not sure how we can help them.
We are passionate about helping women & men of all ages enjoy active, healthy lifestyles, by restoring confidence and dignity in pelvic, bladder, bowel, and sexual function, without relying on medications or surgery. We provide conservative treatment options for many conditions that people may be unaware that they even can do anything about.
Conditions Pelvic Physical Therapy Can Help
- Bladder Issues:
- Leakage, Urgency, Frequency, Painful Urination, Urinary Retention
- Bowel Issues:
- Constipation, Fecal Leakage
- Pain Conditions:
- Back Pain, Pelvic Pain, Tailbone Pain, Sacroiliac Joint Pain, Vaginal Pain, Rectal Pain, Vulvar Pain, Abdominal Pain, Penile Pain, Painful Sex
- Pelvic Prolapse Issue:
- Cystocele, Rectocele, Uterine Prolapse, Vaginal Vault Prolapse
- Pregnancy/Postpartum Related Issues:
- Low Back Pain, Sciatica, Diastasis Recti, Clogged Milk Duct, Episiotomy or C-section Scar Tissue Adhesions
Many people are surprised to learn that all of the above conditions can be helped by pelvic physical therapy. One of the things that we commonly see happen is that a patient will be referred to us by their urologist for bladder issues. Then once we get talking with them, we find out that they also have some back pain or hip pain issues that despite treatment aren’t going away. We teach the patient how all everything can be related.
Aren’t You Just Going to Teach Me to Kegel?
One of the things that we get asked all the time is, “I’m already doing Kegel exercises. It doesn’t help, why would coming to pelvic physical therapy help?” For those of you who don’t know a Kegel exercise is simply a contraction of the pelvic floor muscles like you are trying to hold back gas or pee. Muscle function is not simply about contraction. We need to make sure that we have a variety of different movements with the muscles. Muscles need to be able to contract, relax, stretch, and coordinate with other muscles.
As pelvic physical therapists, our job is to figure out how your pelvic floor muscles are working and coordinating with other muscles. We really take the whole body approach to looking at how things are coordinating together. It is never simply just about Kegel exercises. Those may be a part of your treatment plan, but it may not be. For some people, the problem is that they are doing pelvic floor muscle contractions or Kegel exercises incorrectly and that is actually causing more of the problem. For other people their pelvic floor muscles may be too tense or tight and trying to squeeze them more isn’t going to improve their symptoms. Instead, we need to actually teach them to relax and let go.
Pelvic PT Can Help Before or After Surgery
Another thing we hear commonly when we talk with patients on the phone is that I’m planning them to having the surgery so why would I need to see pelvic physical therapy. Our simple answer to that is if you’re planning on having shoulder surgery, neck surgery, back surgery, or knee surgery; 9 times out of 10, you’re going see a physical therapist either before or after the surgery to help make sure that you rehabilitate the muscles and that everything is working well together. Similarly, working with the pelvic physical therapist after you’ve had surgery for a bladder sling, prolapse repair, hysterectomy, or giving birth can promote return to optimal muscle function allowing you to have better, longer lasting surgical outcomes.
Pelvic PT Helps During Pregnancy & Postpartum
Females who have given birth are at a greater risk for pelvic dysfunction. Here at Legacy Physical Therapy, we feel strongly that every women should see a pelvic physical therapist for at least for 1 visit postpartum to identify any musculoskeletal issues that may be preventing her from improving her core and pelvic function postpartum. This should happened before she starts out with any type of exercise regimen, especially a high level one, to make sure that the pelvic and abdominal muscles are functioning the way that they should be. The therapist will also review movement patterns to make so she doesn’t develop any bad habits that will potentially lead to problems down the road such as bladder leakage or pelvic prolapse.
Pelvic physical therapists also work with women during their pregnancy. We help make sure that the pregnancy progresses as comfortably as possible and that you are able to be as active as you want to be. Pregnancy is a time that can be very stressful on the abdominals and pelvic floor because of the changes in your body. Working with the pelvic physical therapist to help you maximize pelvic and abdominal support and control can really make a big difference for a comfortable pregnancy.
You May Need Need to Advocate for Yourself
So now that you have learn a little more about what pelvic physical therapy is, you may be wondering why you haven’t heard of it before or why your doctor has not told you about it despite you mentioning some of the symptoms. Unfortunately, many doctors are unaware that pelvic physical therapy is an option out there to help their patients. Even the ones who do refer to pelvic physical therapy already may not be aware of all of the different thing that we can be doing to help patients. Because of this, you may have to be an advocate for yourself if you feel like you need to see a pelvic physical therapist. Don’t be afraid to ask your doctor for a referral to pelvic physical therapy.
If you feel like you’re dealing with any of these issues that we’ve been talking about, you may have to be the one to advocate for pelvic PT. You as a consumer, have the right to go wherever you want to go for your treatment. You do not have to necessary to go only to a place that is in your doctor’s office. You can seek healthcare from a pelvic physical therapist with whom you feel comfortable.
So, that is the brief introduction to pelvic physical therapy. If anything you have read about seems like something you are dealing with, give us a call at 636-225-3649. We are happy to chat with you about what you are experiencing to see if pelvic physical therapy would be a good option for you.
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.
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.