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Listen Up Ladies!

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With posting the Cross Fit info recently, I had a few friends mention they read up on it.  They also said “I really did not realize what you do” and followed it with ” I mean I leak sometimes too when I jump or run”.    GIRLS!!!!!  I can help you with that, was my emphatic reply.  I have realized that despite me talking about what I do, even some of my good friends thought it would need to be severe leakage to need therapy, or maybe just thought a little was no big deal?  These are young women, mid to late 30’s who have multiple children, are very active and athletic.  And yes, while our lovely children are clearly to blame for the leaks, we do not have to sit back and deal with it. Do not just assume it comes with being a mother and certainly stop being a martyr and take care of you!  If you leak at all with exercise, laughing, coughing sneezing or strong urges to go YOU HAVE PELVIC FLOOR  DYSFUNCTION, and I can help you make it better.  Now, let’s talk about how…

Your pelvic floor has many functions beyond accomodating childbirth and sexual intercourse.  It provides stability to the pelvis and lumbar spine by working with the abdominal and deep spinal muscles.  It controls abdominal pressures through coordination with the diaphragm.  It helps with pelvic circulation and lymphatic flow. And it controls bladder and bowel function.  When any piece of this amazing machine is weak, the entire system can become dysfunctional.  Pelvic PT’s are trained to examine these functions and structures involved and determine where your problem lies. We can then develop a program specific to your problem to address the cause.

Your bladder function is affected greatly by any weakness or tightness in the pelvic floor, abdominal or deep spinal muscles.  The bladder and pelvic floor muscles communicate to one another. As the bladder fills and stretches, a signal is sent to the brain that it needs to be emptied. The pelvic floor muscles contract to signal the bladder to relax, they have things under control.  If your pelvic floor are weak, or too tight they cannot provide a good line of communication to the bladder, and it panics, and you leak.  This is called urge incontinence.  If you have weak pelvic floor and/or weak abdominal muscles and you cough or sneeze this creates an increase in abdominal pressure.  The pressure is too great for the pelvic floor muscles and you leak.  Strengthening these muscles, the pelvic floor, abdominal and deep spinal muscles, is essential to stopping the leaking.  It is also essential that you learn to coordinate them together, and use the diaphragm too so that abdominal pressure is well controlled.  A pelvic PT is specially trained to do just that!

Habits can be an important piece to the puzzle too.  Do you drink a lot of bladder irritants?  Examples would be Coffee (caffeine), Sodas (carbonation, artificial sweetener), citrus and tomato products and Alcohol.  Cutting back or eliminating some of these can be very helpful.  How frequently are you going to the bathroom?  If you are going too frequently you are training your bladder it cannot wait. You should go to the bathroom every 2-3 hours during the day, and young women (under 65) should not get up at night to void.  Are you pushing or straining to empty or start the flow?  You should never do this.  It creates significant problems for the pelvic muscles, and can actually create or worsen prolapse. You should be able to relax and pee without any effort on your part.  Do you go “just in case”?  Well, don’t;  this too can train your bladder it needs to be emptied more frequently than it does. The big deal is you do this and when the bladder gets even just a quarter full it flips out, sending crazy signals to your body to empty it.  Your pelvic floor is weak and oops, you are leaking again.  A pelvic PT can teach you strategies and tips to retrain your bladder to make this better.

So…if you are experiencing even just a little leakage with exercise OR any activity, seek help! It’s out there.  Surgery or medications are not the only option.  In fact conservative treatment by a pelvic physical therapist is one of the best options with a very high success rate (check out this article).  A pelvic PT can help you to know if you are in fact engaging the pelvic floor correctly, and teach you how to coordinate them with your abdominal and spinal muscles. We can help you with strengthening for your sport, or exercise regimen so that you don’t perform the exercise incorrectly and cause leakage.  You can perform high level exercise without leaking and I can help you do that.   We examine so much more than just those pelvic floor muscles. We look at everything from head to toe to determine where the dysfunction lies. We consider bowel function and bladder function. We take into consideration surgical history, childbirth history and your level of stress and emotional concerns.

Why am I so passionate about this?  I hate to see women suffer with, or ignore symptoms that are a huge impact to quality of life when there are answers. I hate to see women seek out surgery when they don’t need it.  I hate to see women limit their activity level for something that can be fixed.  I recently received a call from a patient who was scheduled for bladder sling surgery in the near future.  She was unsure if coming to see me was worth it or not, as she was going to have surgery soon.  She decided to give it a try. I spent one hour with her at her evaluation, educating her on everything I just shared above, but based on her individual findings.  We met on a Friday.  On Monday morning I opened my email to read this:

“You may recall I’ve been having 2-3 accidents per day for about 6 months now.  Since employing the trick you gave to me on Friday, I haven’t had even 1 tiny leak.  I am so grateful, Sarah.  Thank you.”

This is why I am passionate. This is why I LOVE my job. This is why you, yes YOU!  Should not let this go.  Get in to see me, or a pelvic PT near you.

Sarah Dominguez, PT, MSPT, CLT

This blog is here for your help. It is the opinion of a Licensed Physical Therapist. If you experience the symptoms addressed you should seek the help of a medical professional who can diagnose and develop a treatment plan that is individualized for you.  If you enjoyed this blog, check out our website at foundationalconcepts.net for more blog entries and to learn more about our specialty PT practice, Foundational Concepts.  Follow us on Twitter @SarahpelvicPT or @Jenn_pelvic_PT and like us on Facebook at Foundational Concepts for updates.


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