Pelvic Health and Alignment

Urge and Stress Incontinence are quite different although they can often occur together. What is it? Urge Incontinence is a symptom of Overactive Bladder (OAB) which is the overly frequent contractions of the detrusor muscle which forms the muscular wall of the bladder. This occurs even when the bladder is not full and can be in response to certain triggers, for example warm water, getting home from an outing (key-in-the-door syndrome), and different foods.  It can also make you feel like you need to go to the washroom every 20 minutes but when you do, there's not a whole lot to empty.  OAB does not always cause leaking, however it can lead to urge incontinence if you are unable to make it to the washroom on time. Particularly if you do not have adequate pelvic floor muscle strength.  While it sounds annoying at the most, it can have a significant impact on your lifestyle as you are constantly worried about where the closest bathroom is. When it becomes more s...

Stress Urinary Incontinence (SUI) is the involuntary leaking of urine and one of the most common and easily cured reasons for urinary leaking.  What is it? In essence, it is due to physical stress or external pressure on the bladder with increased pressure in the abdomen. For example, laughing, coughing, sneezing and lifting all involve strong abdominal contractions that place significant pressure on the bladder. Running, changing directions quickly and jumping all involve higher impact and displacement of the bladder with similar results. Leaking occurs when the muscles of the pelvic floor are not able to react appropriately to close off the urethra and thus allows urine to escape.  What are the causes? Most often it is caused by dysfunction of the pelvic floor muscles which can be from any of the risk factors discussed in this post "Everyday things that can put your pelvic floor at risk" :  Most notably:  Excessive straining with bowel movements or on...

Now that we've had a look at some easy changes you can make to protect your pelvic health, lets look at some of the conditions you will be preventing. For those who are experiencing some of these conditions, I will provide some reliable information on what it actually is, reasons why these problems may be occurring, as well as options for treatment. I'm starting with urinary incontinence because it is very, very common. Increasingly so in a younger population, often after childbirth but not necessarily. It is one of the leading causes for admission of older people (not just women) into nursing homes and can cost a small fortune to manage using pads. And while I am glad that awareness of adult incontinence is increasing thanks to television advertisements for adult diapers, I do not agree with their message that leaking is just something to put up with.  If you only take away one message from this post, let it be this: Urinary incontinence, regardless of whether ...

So in a previous post we looked at things you can change to help decrease your risk of pelvic floor dysfunction. Here are a few achievable ways to get more movement into your day! 1. Pomodoro Technique Now, I know a lot of people have jobs that require them to be sitting for 8 or more hours a day, obviously not ideal for the human body. Recently I was introduced to the Pomodoro technique by a friend (Pomodoro meaning tomato in Italian). It is based on the idea that frequent breaks during your work day, a 3-5 minute break every 25 minutes, can help improve productivity and efficiency. I love this idea, not only because it gives your brain a rest, but also your body. You can also use this time to give your muscles a break. Stand up, stretch and wake up all your postural muscles, including your pelvic floor! Check it out!  2. Change up your work space If possible, see if you arrange your work set up to be standing instead of sitting (or alternate between the two).  Another ...

I am going to start by letting you know that pretty much everyone is nervous before their first Pelvic Health Physio visit. However , most people leave saying "Well, that wasn't nearly as bad as I expected!" As we are physiotherapists first and foremost, the structure of the visit is similar to an orthopaedic or musculoskeletal visit with the main difference being that it is in a private room.  The visit begins with taking a detailed history of your current symptoms and past history of injury or pregnancies, your pain and/or bladder and bowel habits. This is then followed by a biomechanical assessment of your lower back, pelvic and hip movements.  As the patient, you are in control of the entire treatment and do not have to give any more information or undergo any assessment unless you are comfortable with it. Both of these parts are important as they help to give us clues about the possible underlying causes of your symptoms. It also allows you to become more co...

As Pelvic Health Physiotherapists, we are specially trained to assess and treat conditions relating to... you guessed it, the Pelvis! This includes the pelvic floor muscles and surrounds, the pelvic joints (pubic symphysis, SIJ, lower back, hips), bowel and bladder problems, pregnancy and sexual dysfunction. A literature review published in 2010 showed that women with stress urinary incontinence had the most benefit from a pelvic floor exercise program when they consulted a pelvic health physiotherapist or continence nurse compared to learning the exercises from a pamphlet (2). Without proper instruction, it is sometimes hard to tell if you are doing the exercises correctly and some women are actually doing more harm than good. If you are experiencing any of the following symptoms, it might be wise to seek out a good Pelvic Health Physiotherapist near you (see the Find A Physio tab).  What to look out for:  Bladder Leaking of urine with any occasion (cough, s...

In physio we talk a lot about modifiable and non-modifiable risk factors. In pelvic health terms, the non-modifiable factors or things that you cannot change include:  Gender - Females tend to be more at risk than Males Genetics - There does seem to be a genetic disposition for conditions such as prolapse (thought to be due to composition of connective tissue within the body) Age - unfortunately the risk increases as we get older, particularly after menopause and our estrogen levels decrease  However, the good news is that there are a lot of things that you can change! Starting right now.  This is how I used to sit, e specially as a student! Improve your alignment while  sitting and standing  Decrease total sitting time during the day Switch out your positive-heeled shoes for flats/barefoot/negative heeled shoes  Avoid any breath holding when lifting or doing any heavy work Decrease and manage straining on the toilet / consti...

While there are many great things about being female, our anatomy combined with our upright, two-legged posture puts us at a significant disadvantage when it comes to pelvic floor dysfunction (PFD) compared to men. Even before becoming pregnant and giving birth!  For example, our higher incidence of urinary incontinence can be somewhat attributed to the much shorter distance from the bladder to the outside world (via the urethra). The female pelvis is also wider and therefore has more space for our organs to descend eg. prolapse (Thanks a lot gravity). Unfortunately I do not have any statistics for Canada and Australia, however recent literature has shown that within the USA alone, the incidence of pelvic floor dysfunction is going to rise from 28.1 million WOMEN in 2010, to 43.8 million in 2050 (1). Firstly that is a huge number in 2010 (roughly around 18% of the female population) and the predicted increase is even more troublesome. While I'd probably never be out of a job, I...