Legacy Physical Therapy 2961 Dougherty Ferry Road Saint Louis, MO 63122
Call: 636-225-3649 Fax: 888-494-7074 Email: info@legacytherapystl.com

Posts Tagged ‘pelvic physical therapy’

10 Signs Pelvic Floor Dysfunction is Affecting Your Workout

10 Signs Pelvic Floor Dysfunction is Affecting your WorkoutSo 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.

  1. 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.

  2. 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.

  3. 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.

  4. 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.

  5. 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.
  6. 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.
  7. 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”.

  8. 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.
  9. “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.

  10. 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.

10 Tips for Healthy Bladder

10 Tips for Bladder HealthToday 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.


10 Tips for Healthy Bladder

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

10 Tips for Healthy Bladder

  1. Don’t strain or push to empty your bladder. Forcing urine out will put strain and stress on your pelvic floor and bladder.
  2. 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.
  3. 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.
  4. 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.
  5. Limit or avoid caffeine. Caffeine can irritate your bladder causing increased urinary frequency or urgency.
  6. 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.
  7. 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!
  8. 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.
  9. 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.
  10. 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, Can You Relate?

Female Exercise Class

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.

Let’s Talk about Sex- Painful Sex That Is

Painful Sex

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 SexDuring 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.

I think I have Pelvic Floor Dysfunction- Now What?

Pelvic Floor Dysfunction

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

  1. 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.
  2. 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.
  3. 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.
  4. 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.
  5. 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.