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.
Is it safe to exercise during your pregnancy? The simplest answer is YES. Lets explore this in more detail.
For the vast majority people exercise is safe during pregnancy and it is a wonderful thing that you should be doing. Unfortunately, a recent study has shown that only 1 in 4 women are getting enough exercise during their pregnancy.
There are many factors that contribute to women not exercising during their pregnancy. Sometimes, it’s fear of the unknown. Sometimes, with their bodies going through so many changes during the pregnancy women are unsure of what they should be doing or what they should be feeling. Oftentimes, women can get discouraged because their body is changing so much that they just figure the will get big during the pregnancy, and deal with it afterwards.
MOVEMENT IS MEDICINE
It is important to know that comfortable exercise during your pregnancy and focusing on food nutrition can actually give you more energy and can lower the rates of gestational diabetes, hypertension and depression. We want to find comfortable ways that you can move and exercise to have a healthier pregnancy for you and your baby.
Some of the main benefits of exercise during pregnancy include:
- Reduction in the amount of cortisol, the stress hormone.
- Improvement in muscle strength
- Improvement in cardiovascular health
- Mood improvement
- Better energy levels
What are some of the best exercises that you can be doing during your pregnancy?
What type of exercise you do during your pregnancy depends on many things. A main factor to consider is how physically active you were prior to your pregnancy. Many women may use their pregnancy as a time to start to be more healthy and active. And that is a great thing to do. However, if you have never been very active, this is not the time to start training for a marathon.
Especially if you are just starting out, try engaging in more lower impact activities such as swimming or walking, biking. All of these things have a little bit less impact to the body. During the pregnancy, our ligaments loosen up some because of the hormonal changes and this make us a little bit more susceptible to injuries.
Another good rule of thumb is don’t force through pain. If some things not comfortable while you’re exercising, then STOP. This is not a time for no pain, no gain. Muscle burn from working hard is okay, but that soreness should only last for a day or two. If you’re experiencing more intense pain while you’re doing something or shortly there afterwards, please stop and consult your healthcare provider about it.
If you would like assistance trying to figure out what exercises are going to be best for you during your pregnancy, please contact us to talk with one of our skilled therapists. We are happy to help you be active!
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.
Did you know that there are physical therapists who focus especially on female issues? In fact, there are physical therapists here in St. Louis who are Board Certified in Women’s Health Physical Therapy (WCS).
There are multiple times in a woman’s life in which physical therapy may be appropriate. We will talk about 2 important time periods in this article: 1) during pregnancy, and 2) postpartum
Physical therapy can be a wonderful adjunct care provider during pregnancy to help with common pain complaints such as:
- Low back pain
- Sacroiliac joint dysfunction
- Carpal tunnel syndrome
- Pelvic and pubic pain
- Foot pain
- Incontinence (bladder leakage)
- Round ligament pain
Physical therapy treatment during pregnancy may include:
- Posture education to avoid injury and decrease pain
- Manual therapy to restore alignment and improve soft tissue guarding
- Therapeutic exercises for improving muscle performance and posture
- Abdominal and pelvic floor training
- Fitting for various support belts to help with stability and pain
If you are like many pregnant women, you may have concern about what exercises are appropriate during pregnancy. A physical therapist is a great resource for instruction on the do’s and don’ts of exercise during pregnancy.
The stresses of pregnancy, vaginal deliveries, and C-sections may lead to myofascial complications following the birth of the baby. Many women suffer in silence because they feel their symptoms are “Normal” after they have a baby. Fortunately, many of these symptoms can be easily treated by a physical therapist specializing in postpartum care.
Common Postpartum Complaints include:
- Low back and lower extremity pain
- Upper back and neck pain associated with breastfeeding
- Upper extremity pain or numbness associated with child care
- Diastasis recti: Separation of the abdominal muscles which commonly occurs during healthy pregnancies.
- Pain with intercourse or orgasm
- Clitoral, vaginal, rectal, pubic, or tailbone pain
- Pain and decreased mobility at scar of C-Section, episiotomy, or perineal tear
- Pelvic floor weakness
- Urinary or fecal incontinence
- Urgency and frequency
- Pelvic pain
How Physical Therapy Can Help:
- Soft tissue mobilization, myofascial release, deep tissue massage
- Therapeutic exercise for improving abdominal and pelvic floor muscle performance
- Posture, lifting techniques and biomechanics
- Home exercise program
- Abdominal binder/brace fitting
- Scar massage
- Therapeutic ultrasound to breakup clogged milk ducts
- Modalities for pain control
- Instruction in return to exercise safely
- Instruction in proper lifting/carrying of baby, stroller walking, and other activities of daily living to avoid injury
Pregnancy, childbirth and childcare are all events that result in significant physical changes and new stresses on a woman’s body. Women’s Health Physical Therapists are specifically trained to meet the special needs of women during this time of their lives and beyond.
Call us today at 636-225-3649 to set up your FREE SCREENING to see if physical therapy is right for you.
I have been wanting to get classes together for my pregnant and postpartum clients for awhile now. The childbearing years bring about so many changes in women’s bodies that can set them up for problems down the road. There are so many preventative things that women can do to avoid these problems.
I am excited to say that I will teaching 2 different classes geared towards pregnant and postpartum women in the St. Louis area. On the 3rd and 4th Wednesday of the month from 6:30 to 7:30 pm I will be teaching at the Town & Country Cottonbabies.
Mommy and Me
This class is intended for moms in their last trimester or new moms. In the class you will learn how to regain muscle strength in key areas, “back, bellies, and bottoms,” how to get tone back in the abdominal muscle, and how to minimize back pain. We will teach ways to incorporate your baby into your work-out and how to protect your body from common overuse injuries that new moms encounter.
In this class participants will learn musculoskeletal changes during pregnancy, understand reasons for back pain during pregnancy, learn techniques to minimize pain, and get self help ideas for comfort. This is great class for expecting moms and their partners.
Space is limited. Please register for this class by calling the CottonBabies Store at 636-220-7720