Let's talk about Urinary Incontinence

Since no one wants to talk about urinary incontinence, we will break the ice.

Yes, it can be an uncomfortable and personal topic, but we want you to know that you have options.

And we’re here to support you in any way that we can as you navigate your journey with leakage, urgency, or experience while you are going or attempting to go to the bathroom.

First, let’s learn about what urinary incontinence is.

What is Urinary Incontinence?  

Urinary incontinence refers to the inability to control the urine flow, which can cause slight to significant leakage.  

Many women and men mistakenly believe it's an inevitable part of aging, but it's not!  

With the help of a trained pelvic health physical therapist, you can gain the necessary strength and learn techniques to minimize or prevent urinary incontinence. 

There are 4 main types of Urinary incontinence: Stress, Urge, overflow, and functional.  

Stress Incontinence is classified by the inability to control the flow of urine with increased intraabdominal pressure or higher-impact activities. It occurs during activities like coughing, laughing, jumping, running, or lifting.  

Urge Incontinence is classified by a sudden, intense need to urinate, often leading to leakage on the way to the bathroom. This urgency can significantly affect confidence in public situations.  

Overflow Incontinence occurs when you leak urine because your bladder is too full. It may feel that you haven't completely emptied your bladder at the time of voiding. Overflow incontinence can be caused by a blockage in the urinary system, other medical conditions, or dysfunction of your pelvic floor muscles.   

Functional Incontinence involves the sensation of needing to urinate but being unable to get to the bathroom in a timely manner due to factors such as muscle weakness, poor balance and coordination, dysfunctional movement patterns, or even a cluttered household.  

Life’s too short; there’s no time to worry about leakage or urgency. 

So much can be done in pelvic health physical therapy to address these issues. 

Contact us to schedule an appointment with a trained pelvic health physical therapist!

To schedule an appointment with Dr. Madeline at our Neenah clinic on Commercial St., call (920) 215-6225.

We also have therapists specializing in pelvic health at our Appleton North clinic on Enterprise Dr.

Pelvic Health and You

May is Pelvic Health Month and here at Advanced, we are all about changing the narrative around symptoms/conditions that may be caused by pelvic floor dysfunction.

Did you know that 1 in every 3 women will develop a pelvic floor dysfunction in her lifetime and 1 in every 8 men* will develop a pelvic floor dysfunction in his lifetime?

While very common, it’s certainly not normal.

Pelvic floor issues may be embarrassing to admit to and even harder to talk about, but they affect the quality of your life. We understand that you may have questions; that’s why we are here.

Not all physical therapy practices have a therapist who specializes in pelvic pain/dysfunction, but Advanced PT’s Autumn Pawlowski is a physical therapist with training and experience in the management of a wide range of issues (for both women and men) that occur with compromised pelvic floor muscles.

When you are ready, please call the Appleton North clinic (920.991.2561) to request an appointment with Autumn.

In the meantime, here are a few facts that just might be the inspiration for you to take action and get back to living the life you want. 

What are pelvic floor muscles?

●     Group of muscles in your pelvis that is kind of like a hammock between your sit bones

●      Support pelvic organs

●       Maintain continence

●      Role in sexual function

What happens if there is dysfunction in the pelvic floor muscles?

●     Urinary incontinence

●     Urinary frequency and/or urgency

●     Pelvic pain

●     Heaviness/fullness feeling

●     Low back or hip pain

Are there other conditions that a pelvic health physical therapist could help out with?

●     After a prostatectomy

●     Prenatal and postpartum

●   Post-cesarean delivery care

What should I expect during my first pelvic health physical therapy visit?

Your pelvic health physical therapist has gone through extensive training in order to treat individuals who have pelvic floor dysfunction.

The first visit will allow you to discuss your concerns with the pelvic health physical therapist and they will ask you follow-up questions.

Then the provider will complete an assessment to help determine the root cause of your symptoms. The assessment may include an orthopedic screen (looking at your back/hips) to see if there are any significant findings that may be contributing to your symptoms.

If the pelvic health physical therapist feels like an internal pelvic floor assessment would be appropriate, they will explain what that would entail. The internal pelvic floor assessment would only be completed if you provide consent. Based on the findings, the pelvic health physical therapist will develop a treatment plan for you.

Treatment may include modifying bathroom habits, modifying diet/fluid intake, strengthening exercises, stretching exercises, breathing techniques, and discussing how the nervous system has a role in your symptoms.

How do I set up an appointment with a pelvic health physical therapist?

You are not alone with your symptoms.

We know how difficult it may be to pick up the phone and call to schedule an appointment, but we promise you you’ll be glad you did. The pelvic health physical therapist will be able to answer a lot of your questions during the first visit. 

Call our Appleton North clinic at 920.991.2561 to request an appointment with Autumn Pawlowski PT, DPT.

*Data is limited for our populations that do not align with the above genders; however, we recognize that every population has unique pelvic floor needs and implications.*

---

References:

https://www.uclahealth.org/medical-services/womens-pelvic-health/patient-education/pelvic-floor-disorders#:~:text=One%20in%20three%20women%20will,problems%2C%20or%20bowel%20control%20problems.

https://theconversation.com/men-have-pelvic-floors-too-and-can-benefit-when-they-exercise-them-regularly-184451#:~:text=Though%20pelvic%20floor%20problems%20are,pelvic%20floor%2C%20bladder%20or%20bowel.

Back Pain during Pregnancy and Postpartum

Amanda Uting, PT, DPT

Back pain is common during pregnancy, with the prevalence of low back pain during pregnancy estimated to be between 50-75%. Back pain during pregnancy increases the risk of pain after delivery; more than one-third of women that have back pain during pregnancy still having back pain at 18 months postpartum. Back pain can decrease your ability to do normal activities at work and around the house, limit your exercise, and impair your sleep.

What may contribute to increase pain during pregnancy?

· Weight gain and postural changes: Women with a normal BMI are encouraged to gain 25-35 lbs during pregnancy. This weight gain, along with postural changes related to a growing uterus and baby, puts more stress on your joints.

· Joint laxity

· Fluid retention: results in increased pressure on soft tissues

How can physical therapy help you during pregnancy and after delivery?

As musculoskeletal experts, physical therapist have an important role in decreasing pain and improving function during pregnancy and during the postpartum period. Working with a physical therapist may include the following:

• Patient education

○ Exercise and safe return to exercise postpartum

○ Posture and breastfeeding positioning

○ Healthy bladder habits

○ Scar mobilization for Cesarean deliveries

• Safe manual therapy techniques.

• Home exercises.

Below are some exercises that may be beneficial for you to relieve back pain and increase strength for the physical demands of motherhood.  During pregnancy, please check with your healthcare provider before starting any home exercises.

○ Shoulder blade squeezes: Squeeze your shoulder blades down and back and hold for 2-3 seconds. Perform 10-20 reps. This is a great exercise during or after feeding your baby to counteract a forward shoulders posture.

○ Chest stretch: Stand in an open doorway and rest your palms on the doorframe with your elbows at shoulder height. Lean forward to feel a gentle stretch in the front of your shoulder and chest. Hold 30 seconds and repeat 1-2 times.

○ Cat/cow: On your hands and knees, gently relax your stomach towards the floor and then arch your back up towards the ceiling. Perform 10-20 reps in each direction.                                    

○ Bird dog: From a hands and knees position, attempt to push your abdominals towards the floor, and look forward; then contract your abdominals and arch your back, as if you are trying to hug baby in with your ab muscles. Keep your back flat as you extend one arm. If this feels easy, extend one arm with the opposite leg. Hold for 1 second. Perform 10-20 reps on each side.

○ Child’s pose: From a hands and knees position, bring your big toes to touch and sit your hips back. Let your stomach relax between your knees and feel a stretch in your back as your arms stay extended forward.

In addition, pelvic health physical therapists with specialized training can help patients that experience:

· pelvic pain

· urinary frequency or incontinence

· disastasis recti (abdominal separation)

If you are interested in the benefits of physical therapy during pregnancy or after giving birth, please get in touch with Advanced Physical Therapy & Sports Medicine at (920) 991-2561.

References:

Katonis P, A Kampouroglou, A Aggelopoulos, K Kakavelakis, S Lykoudis, A Makrigiannakis, K Alpantaki Pregnancy-related low back pain. Hippokratia. 2011 Jul-Sep; 15(3): 205–210.

Kanakaris Nikolas, Roberts Craig S, Giannoudis Peter V. Pregnancy-related pelvic girdle pain: an update  BMC Medicine 2011. 9(15)

Sabino J, Grauer JN. Pregnancy and low back pain. Curr Rev Musculoskelet Med. 2008;1(2):137–141.

Ostgaard H, et al. Back pain in relation to pregnancy: A 6 year follow-up. Spine. 1997; 22:2945-50.

Larsen EC, et al. Symptom-giving pelvic girdle relaxation in pregnancy. Prevalence and risk factors. Acta Obstet Gynecol Scand. 1999; 78: 105-110.

Kesikburun, S., Güzelküçük, Ü., Fidan, U., Demir, Y., Ergün, A., & Tan, A. K. (2018). Musculoskeletal pain and symptoms in pregnancy: a descriptive study. Therapeutic advances in musculoskeletal disease, 10(12), 229–234. doi:10.1177/1759720X18812449

“Exercise during Pregnancy” https://www.acog.org/Patients/FAQs/Exercise-During-Pregnancy

“Exercise during Pregnancy” http://americanpregnancy.org/pregnancy-health/exercise-during-pregnancy/

“ACOG Committee Opinion” https://www.acog.org/Clinical-Guidance-and-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Optimizing-Postpartum-Care

“Pregnancy and Low Back Pain: Physical Therapy Can Reduce Back and Pelvic Pain During and After Pregnancy”J Orthop Sports Phys Ther 2014;44(7):474. doi:10.2519/jospt.2014.0505