Shari Berthold, DPT
Physical Medicine and Rehabilitation, UPMC
Are you nervous to sneeze or laugh too hard? Have you stopped running, jumping, or other certain physical movements because you fear leaking? You are not alone. Urinary incontinence affects about 50% of adult women and up to 10% of adult men, with percentages increasing with age. Other symptoms of pelvic floor disorders including bladder issues, bowel problems, sexual dysfunction, and pain. Although a few of these symptoms may be common, they should not be considered normal.
What’s the Pelvic Floor?
The pelvic floor is a group of muscles that spans from the pelvic bone to the tailbone and acts like a sling or hammock to support the pelvic organs, including the bladder, uterus or prostate, and bowels. These muscles stabilize the spine, support the internal organs, control bladder and bowel storage and emptying, and contribute to sexual function. Problems with the pelvic floor can affect women and men of all ages. Issues arise when the pelvic floor is either too weak, too tight, or not contracting at the right time. Risk factors for developing problems can include pregnancy, childbirth, changes in estrogen, muscle trauma, aging, surgery, or chronic straining with lifting or constipation.
Physical therapists who are trained in pelvic floor rehabilitation evaluate and treat a variety of conditions including, urinary incontinence, urgency and frequency of urination, bladder pain and urinary retention, pelvic girdle and muscle pain, painful intercourse, constipation, fecal incontinence, pelvic organ prolapse (cystocele/rectocele), as well as post-cancer treatment. Interventions for pelvic floor dysfunction assist patients in becoming more aware of their muscles and how they are used and encompass much more than just Kegels (strengthening exercise).
What To Expect at Pelvic Floor Therapy
During the first visit, patients discuss their medical history, symptoms, and goals for physical therapy with a trained therapist. A physical therapist can examine posture, range of motion, strength of muscles of the hip and pelvis, bony alignment and assess muscle tissue for scars, tension, and tenderness. Based on the information gathered, the physical therapist designs a home program. The first visit takes about an hour and is typically followed by a three-month course of treatment with four to eight follow-up visits.
Patients are evaluated and treated in private treatment rooms to maintain privacy and comfort. Treatment options are tailored to the patient and can include manual therapy, electrical stimulation, education in bladder and bowel strategies, fluid intake and dietary influences and bladder training techniques. Another therapy option called biofeedback uses real time ultrasound to visualize the muscle as they are contracting and relaxing.
Knowing what is and isn’t normal is helpful. Although leaking urine throughout the day or running to the restroom due to an overactive bladder are common conditions, they are not normal and can often be improved with just a few weeks of physical therapy. If you are experiencing pelvic discomfort or noticing changes in bladder or bowel function, talk to your primary care physician about a referral to a pelvic floor physical therapist.
Shari Berthold, DPT, is a physical therapist with UPMC Physical Medicine and Rehabilitation at UPMC Williamsport, Divine Providence Campus, 1705 Warren Avenue. For more information, visit UPMC.com/RehabNCPA.