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.
Low back pain during pregnancy is very common but it is not normal. Just because your pregnant does not mean you are doomed to experience back pain and there are things that you can do about it.
A recent study surveyed 950 pregnant women. Over 68% of them reported having low back pain. However only 32% of them told their healthcare provider that they were experiencing low back pain. And of those, who did tell their health care provider, only 25% of the health care providers recommended any type of treatment. Many women, unfortunately, are simply told that low back pain is a normal part of pregnancy that they just need to deal with it.
It is not normal, you can do something about it.
One of the main reasons why it’s important for you to do something about it during your pregnancy is that when you are experiencing low back pain during the pregnancy, it does puts you potentially more risks for continued low back pain issues in the postpartum period and beyond.
Low back pain during pregnancy can feel like many different things. It can be pain in the central low back area or maybe it’s more right or left sided. Some women experience the pain more down in their buttocks area, or pain that shoots down the legs. Some women describe it as sharp, stabbing pain and to others, it is more of the persistent dull ache. Some women experience a pins and needles sensation or they might even feel like their legs are getting weak or giving way.
Oftentimes, back pain during pregnancy occurs with different types of movement.
Common movements during which women experience pain include:
- Getting up and down from chairs
- Getting in and out of cars
- Rolling over in bed
- Prolonged sitting or standing
- Lifting kids, laundry, or groceries
- Putting on clothes
What Can you Do if you are experiencing pregnancy back pain?
- Try heat or ice over the painful area for 10-15 minutes at a time. Both heat and ice can help with pain so try each and see which one helps you more. Some people may find benefit by switching back and forth between ice and heat for that 10 to 15 minute period with each.
- Try massage over the painful area. You could ask your partner to give you a massage. If your partner is not available, another option that I recommend is using a tennis ball to massage over the painful area. Sometimes it’s easier to put 2 tennis balls together in a sock and knot off the end of the sock. Then place the tennis ball sock between you and the back of a chair or a wall and rock back and forth over the balls to help release some of the tension in the back.
- Try gentle core muscle activation. One way to protect your back and provide more comfort is making sure that your deep abdominal muscles are still working way that they should be. To correctly activate your deep abdominal muscles try to give your baby a gentle hug with your belly as you exhale. Practice doing this for 10 repetitions at a time. This is also good to do any time before you are going to lift your toddler or get up and down from a chair.
If you try some of these techniques and your not seeing any changes in symptoms this is when you should partner with a specialist. A women’s health physical therapist can help you figure out what is causing your pain, help alleviate the pain, and make recommendations to help you function better. Our goal is to help you have as comfortable and pain free a pregnancy as possible.
Remember the study from the beginning of this article: 68% of women reported having low back pain but only 32% of them told their healthcare providers and only 22% of the healthcare providers recommended any type of treatment. Don’t rely on your healthcare provider to recommend physical therapy to you. You might have to be an advocate for yourself to seek out care that’s going to help you.
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.
“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.
Vaginal pain is a condition that millions of women will deal with at some point in their lives. Unfortunately many women will never seek treatment or if they do they will be told that there is nothing wrong or nothing can be done. An article in The New York Times urges women to be persistent in seeking treatment, because there are things that can be done.
One of the treatment options recommended is pelvic physical therapy. Check out our website for more information on how physical therapy can help.