Emily Pace, Pelvic Health Program Director
Physical Therapy Can Help With What?
When people ask me what I do for a living, I generally say I’m a physical therapist, but sometimes I will divulge that I am a pelvic health physical therapist. This is usually met with lots of questions. Yes, I can treat neck pain, knee problems, general weakness, and all the usual things that you normally think a physical therapist can treat. However, I also have additional training that allows me to treat specific dysfunctions in the pelvic area like bowel and bladder incontinence, pelvic pain, and tailbone pain. These are often conditions that people think they need to just live with, but that is absolutely not true!!
I hear this statement all the time: “Sometimes I leak urine, but I’ve had kids so that’s normal right?”
No. Urinary incontinence is very common-ranging from 0.3-44% in the literature, but it is not normal even after having children. Urinary incontinence can occur in all ages and fitness levels. It can be the result of a strong urge from the bladder or it can be caused by cough, laugh, sneeze, or other movements that will increase the pressure in the abdominal area. Both types of leakage can be helped by a physical therapist with this additional training.
Everyone has a group of muscles that make up the bottom of their pelvis called the pelvic floor muscles. These muscles are key players in the ability to maintain bowel and bladder continence and just like any other muscle group, they can get weak over time. Most people have heard the term “Kegels” which is just another name for a pelvic floor muscle contraction.
Another statement I hear a lot is that “Well, I’ve tried Kegels in the past and they didn’t help!”
Only about 50% of people verbally cued to do a pelvic floor contraction are doing it correctly. So about half of the people who have tried to strengthen their pelvic floor on their own are not utilizing these muscles correctly. These muscles also have to have the correct dosage of exercise to be effective. If these muscles are overworked, urinary incontinence may get worse. If these muscles are underworked, the muscles never get stronger and these symptoms never improve. Maybe the muscles are strong enough, but the timing of the muscle contraction is not occurring when it is needed to prevent incontinence. Maybe these muscles are working too hard because another muscle in the hip or core is weak and the pelvic floor is trying to make up for that weakness.
Sometimes it is not as easy as doing Kegels at every red light to fix a problem like this. A physical therapist with training to assess this condition can help to figure out what is causing the muscles to work inefficiently. Spine and Sport is excited to be able to offer pelvic health services in our Oak Ridge by myself and West locations by Lauren MacGuire to help patients across the greater Knoxville area find solutions to their pelvic health problems.