Physical Therapy News

Pelvic Floor Pain Shouldn’t Be Ignored

Pelvic Floor Pain Shouldn’t Be Ignored

Do you feel like you’re always running to the bathroom, leak a little when you laugh, cough or sneeze, or avoid intercourse because it hurts?

These are embarrassing problems that most people don’t talk about – bladder problems, frequent urination, and pelvic floor pain. If you’re feeling this way, you’re not alone. Approximately one in four women experience some form of pelvic floor dysfunction, ranging from chronic pain to constipation to stress and urge incontinence. Men can also experience urinary incontinence, especially after prostate cancer.

Oftentimes, people suffer in silence due to embarrassment and shame, or they think what they’re experiencing is normal, and there’s no help available. While certain illnesses and lifestyle factors can contribute to incontinence, the truth is, loss of bladder control is not a natural part of aging. And the good news is many pelvic floor disorders can be treated through physical therapy and lifestyle changes. Luckily, you’re not destined to a life of pads or pills. Working with a specially trained physical therapist can alleviate pain, restore normal bladder control, and help improve your quality of life.Pelvic Floor Pain Shouldn’t Be IgnoredWhat is the pelvic floor?
The pelvic floor acts like a hammock and supports the pelvic organs, primarily the bladder, uterus/prostate, and rectum. These muscles also help to control functions of the bowel and bladder. The female pelvic floor includes the openings of the urethra, for urination; the vagina, for intercourse and childbirth; and the anus, for fecal elimination.

The pelvic floor consists of pliable muscles that wrap around these openings in a figure-eight shape. There are a lot of organs in a tiny space and they can drop or shift due to childbirth, obesity, a hysterectomy, and age. Pelvic floor muscles also can become weak, tight or spastic as a result of disuse, surgery or trauma.

Pelvic Floor Pain Shouldn’t Be Ignored

Men have pelvic floors too
Men experience incontinence as well and can usually be treated in a similar manner. For more complex male pelvic pain and dysfunction, there are therapists who specialize in the treatment of male pelvic floor dysfunction.

Signs of pelvic floor dysfunction
There are a variety of symptoms associated with pelvic floor dysfunction, including urinary or fecal incontinence, a frequent or urgent need to urinate, or pain in the pelvic region.

  • Pain in the abdominals, buttocks, pelvic floor, tailbone, vagina, rectum, penis or testicles
  • Urinary urgency or painful urination
  • Constipation or strained bowel movements
  • Lower back pain
  • Painful sex or inability to have penetrative sex for women
  • Pressure in the pelvic region or rectum
  • Pelvic prolapse
  • Muscle spasm in the pelvis or pelvic floor
  • Vaginismus or endometriosis
  • Vulvodynia (pain of vulva) and genital skin conditions
  • Pregnancy and postpartum recovery
  • Painful or premature ejaculation for men

Two most common symptoms
Most patients complain of pain or issues with bladder or bowel controlUrinary incontinence can present itself in many different ways, including frequent urination and a strong urge to urinate. Leakage is often, but not always, associated with incontinence. Other symptoms include painful urination and stop and go urination.

Stress incontinence occurs with activities such as coughing, laughing, sneezing, jumping, lifting and running. If the pelvic floor muscles are weak, they have trouble holding back urine during times of increased pressure on the bladder.

Urge incontinence is related to an overwhelming urge to urinate, sometimes so strong that you can’t hold back the flow of urine. You can have urinary urgency without leaking. Certain things can “trigger” an urge sensation like getting close to a bathroom, being near water or the cold. Urge incontinence can develop from an overactive bladder muscle, due to neurologic damage or from irritation to the bladder itself – like drinking tons of coffee.

Mixed incontinence is a combination of the two and most common in older women.

Pelvic pain can be experienced in the pelvic floor, abdomen, or low back. The pain is often chronic and severe. Some may experience discomfort in the way of heaviness or bulging in the pelvic floor. This pain and/or discomfort can interfere with daily activities and impede sexual function.

Pelvic Floor Pain Shouldn’t Be Ignored

Why see a pelvic floor therapist?
Before costly and invasive surgery, it’s worth a visit to a urogynecologist, urologist, specialty bladder clinic or pelvic floor therapist. Many pelvic floor conditions can be treated and managed through a combination of therapies, including pelvic floor rehab.

Pelvic floor therapists specialize in rehabilitation of the pelvic floor and resolving dysfunctions in the pelvis that contribute to bowel, bladder, sexual health, and pain complaints. They can help you understand your symptoms and lifestyle factors that may aggravate them. They will work with you to create a personalized program to minimize or manage pelvic discomfort or pain, along with retraining and strengthening your muscles, and maintaining lifelong pelvic health.

Your physical therapist may recommend:

  • Education: Nutrition and behavioral strategies including reducing bladder irritants and retraining your bladder to go less often
  • Pelvic floor exercises: Working with a therapist to learn to do Kegel exercises correctly at home with or without a biofeedback tool (egg or wand)
  • Manual therapy: Hands-on trigger point massage to release muscle tension, improve posture, blood circulation, and mobility
  • Therapeutic exercise: Stretching, yoga, and core stabilization exercises
  • Self-care: Mindfulness, breathing techniques, and other pain management methods
  • Pelvic floor biofeedback: This technique helps patients “see” how the pelvic floor muscles are working by doing Kegels and watching the results on a computer screen.
  • Electrical stimulation: Using a probe inserted into the vagina or anus, a low-voltage electrical current helps exercise muscles, reduce spasms, and teach patients how to coordinate muscle contractions.

Tips for a healthy bladder

  • Aim to go every 3-4 hours
  • Avoid “just in case” (JIC) urination
  • Take time to relax and sit on the toilet. Don’t hover or rush through urination
  • No straining or “bearing down” on your pelvic floor
  • No nighttime just in case peeing; avoid fluids a few hours before bed
  • Avoid constipation with plenty of water and high-fiber foods
  • Drink enough water (at least half your body weight in ounces, or try our 100 ounce challenge)
  • Limit bladder irritants including coffee, soda, and sugary drinks
  • Do regular Kegels and pelvic floor exercises

Don’t ignore your pelvic floor

When your pelvic floor is not functioning correctly, it can impact your life on many levels. Don’t be embarrassed to discuss these issues and find treatment – it’s more common than you might think. Frequent urination, pelvic pain, and urinary leakage can be very personal and difficult to address. Treatment through physical therapy is very private and each patient is treated with respect and understanding.

Contact a Northern Physical Therapy clinic today and free yourself from pelvic pain, pads and revolving your life around bathrooms. We offer free consultations so you can meet with a pelvic floor expert and find out the treatment method that’s best for you.

 

Pelvic floor therapy is now being offered in our Caledonia clinic! Set up a free consultation to get your questions answered and see if pelvic floor therapy is right for you.

Treatment for Pediatric Constipation, Bed Wetting, & Leakage

Treatment for Pediatric Constipation, Bed Wetting, & Leakage

I never imagined that bowel movements and urination would become a daily topic of conversation. Then I had kids. It instantly became the norm to pay attention to whether the baby went poop each day, what it looked like, how many times, etc. As my child got a few years older the questions changed, but the topic stayed the same – do you have to go potty, does your stomach hurt, when was the last time you went, etc…

When your child is having issues with constipation or bed wetting, it can be difficult to properly diagnose. As a parent, you can’t help but wonder if this is just a normal part of growing up, or if you should be concerned.

By six years old, most children should have full control of their bowel and bladder function. Yet, it is estimated that up to 20% of pediatric healthcare visits revolve around bladder and bowel problems. And, up to 25% of children visiting a pediatric gastroenterologist experience bouts of constipation or encopresis (bowel leakage or soiled undies).

These issues can be frustrating for both parents and children. But, help is available through pediatric pelvic floor physical therapy – a safe and effective treatment options for infants, toddlers, and children.

Common pediatric pelvic floor issues include:

Pediatric bed wetting & daytime incontinence – Most children begin to stay dry the entire night between the ages 3 and 5. The primary reason for nighttime leakage is constipation, followed by not fully emptying during the day. Our bodies are designed to hold urine and children should not have to get up to urinate at night.

Pediatric Constipation – Constipation is one of the most common gastrointestinal complaints among children, but can also be a contributor to urinary leakage or the urgency to go. Pediatric bladder and bowel dysfunction can continue well into adulthood so it’s important to get this taken care of early on. Contributing factors to constipation can include diet, emotional issues, and sometimes busy children simply ignoring the signs that they have to go.

Diastasis Recti – A common issue in infants, especially those born prematurely, diastasis recti is a separation between the left and right side of the rectus abdominis muscle, which is the muscle that covers the front surface of the belly. This can also lead to poor trunk control, which can affect the bowels as well.

Other diagnosis that affect the pelvic floor in children – voiding dysfunction (when your child’s bladder is not emptying, or they are not urinating normally or fully), urinary urgency and frequency, vesicoureteral reflux (backflow of urine into the kidney), and pelvic pain.

Treatment for pediatric pelvic floor issues

Physical therapy can be a safe and effective way to help a child gain control of his or her bladder. By focusing on a group of muscles and soft tissue, called the pelvic floor, which support the pelvic organs and help control bladder function. When these muscles are too tight, too weak, or in spasm it can cause problems in children because the pelvic floor muscles aren’t working well with the bladder.

Children who are experiencing issues with bladder and bowel control may be more prone to bladder infections, constipation, difficulty sensing when the bladder is full, or other problems resulting from not completely emptying the bladder. This can also lead to urinary or bowel leakage and wetting during the day or night.

Pediatric pelvic floor treatment techniques may include:

  • Biofeedback – Helping children learn to strengthen or relax their pelvic floor muscles in order to improve bowel or bladder function and decrease pelvic floor pain
  • Behavorial and diet modification
  • Soft tissue mobilization – Using hands-on techniques on muscles, ligaments and fascia with the goal of  optimizing muscle function
  • Stretching and strengthening of pelvic floor and surrounding muscles
  • Relaxation techniques

Treatment for Pediatric Constipation, Bed Wetting, & Leakage

 

As a mother of two children, I’m passionate about pediatric pelvic floor issues and eliminating the stigma surrounding them. There’s a level of stress and embarrassment associated with these conditions, for both parents and children. It’s important to understand that pediatric pelvic floor issues aren’t normal, but they are treatable with the right help. If a child had ankle problems, you would address those problems with a specialist. The same should go for bowel and bladder issues – these are real problems that should be talked about openly so children can get the help they need.

Melissa VanKampen
Pelvic Floor Expert & Physical Therapist Assistant

Physical therapy may help if:

  • Child is 5 years or older and still wears pull-ups
  • Medication is needed for bladder or bowel control
  • Urinary incontinence or leakage
  • Bed wetting (nocturnal enuresis)
  • Laughing causes urine leakage
  • Frequent urination or overactive bladder
  • Infrequent urination or underactive bladder
  • Constipation/diarrhea, painful bowel movements, over/underactive bowels

With a parent present, a physical therapist with specific training in pediatric pelvic floor therapy will examine the muscles of the abdomen, pelvis, and pelvic floor area. Consultation and treatment often consists of muscle retraining, biofeedback, patient and family education, behavior and diet modification, soft tissue massage, stretching and strengthening of the pelvic floor and surrounding muscles, and a home exercise program. We have expert physical therapists on site who are specifically trained to work with this population.

If you feel your child may be suffering from any form of pelvic floor dysfunction, call our Coopersville office at 616.997.6172 or schedule a free consultation with Melissa VanKampen, physical therapist assistant and our lead expert in pediatric pelvic floor treatment. Melissa has taken numerous continued education courses in pediatric pelvic floor issues related to constipation and bed wetting.

 

Get more information about pediatric incontinence and pelvic floor dysfunction from Herman & Wallace, the pelvic rehabilitation institute.

An Athlete with Spina Bifida Uses Physical Therapy to Keep Her Game in Check

An Athlete with Spina Bifida Uses Physical Therapy to Keep Her Game in Check

Susie Kluting has used a wheelchair or crutches to get around her entire life, but one could argue that she’s equally comfortable on the ice. Despite being born with spina bifida, 26 year old Coopersville resident Susie has never let that get in her way. Susie has tried wheelchair tennis, wheelchair basketball, swimming, fencing, water skiing, and rock climbing. While she’s always enjoyed being active, she longed for a sport that would really speak to her – that’s where sled hockey came in.

An Athlete with Spina Bifida Uses Physical Therapy to Keep Her Game in CheckSpina bifida left Susie with limited use of her legs, but she never let her “different ability” get her down. The second youngest of six children, Susie grew up on a farm and inherited a love for animals and cheering on her siblings at their various sporting events. While she loved the years she spent showing rabbits through 4-H, riding four-wheelers with her brothers, and farm life in general, she wanted to find something new that she could do with people who were “more like her.”

At a young age Susie began trying a variety of different clinics and playing sports through Mary Free Bed. Although she tried many different sports and continued to attend sports camp every summer until she was 18, Sled Hockey is the one she excels in.

Sled hockey was invented in the early 1960s by a group of Swedes at a rehabilitation center who, despite their physical disabilities, wanted to continue playing hockey. Sled hockey follows most standard ice hockey rules, except players sit in specially designed sleds that sit on top of two hockey skate blades. Each player has two sticks which are used to hit the puck and to propel themselves.

An Athlete with Spina Bifida Uses Physical Therapy to Keep Her Game in Check

Northern Physical Therapy has been a big part of my recovery from all sports injuries, and they’ve helped tremendously in allowing me to maintain my ability for the past 8 years. I love the team at Northern! They’re so helpful, friendly and always happy to answer any questions I have. Northern PT has helped my independence as a young adult and made it possible for me to do daily tasks at home, take care of myself, enjoy activities with my family, and compete in team sports – for this I am so grateful. – Susie Kluting, physical therapy patient living with spina bifida

For the last six years Susie has been the Assistant Captain for the adult Grand Rapids Sled Wings, which was formed because of the high level of interest from players who were over 18, which is the age limit for the junior league. She has also been a part of the U.S.A women’s sled hockey team. Susie can even thank sled hockey for introducing her to her boyfriend Connor. They met in 2010 at a sled hockey camp in Rochester, N.Y. and have been dating since 2017.

An Athlete with Spina Bifida Uses Physical Therapy to Keep Her Game in CheckBecause Susie is living a majority of her life in a wheelchair, and is also someone who is very active, she understands that injury is always a possibility. To keep her game in check, and to maintain her level of daily activity, Susie regularly receives physical therapy treatments, even during her off season.

An Athlete with Spina Bifida Uses Physical Therapy to Keep Her Game in CheckHow can physical therapy help With spina bifida?
Physical therapy plays an important role in helping children and adults with spina bifida gain and maintain mobility, and function at their best throughout all stages of life. Spina bifida is a birth defect involving the spine that occurs when a baby’s “neural tube,” or fetal spinal cord, does not completely close in the early stages of development during the first month of a mother’s pregnancy.

Spina bifida may cause both physical and intellectual disabilities that range from mild to severe, depending on the size and location of the opening in the spine, and the extent to which the spinal cord and nerves are affected. Babies born with spina bifida often cannot move their legs due to weakness or paralysis resulting from spinal cord and nerve damage.

People living with spina bifida can experience partial or complete paralysis and may need assistive devices like braces, wheelchairs, or crutches. These people work with physical therapists to learn specific muscle strengthening exercises.

We can help
A spina bifida diagnosis can leave parents with many questions and concerns. If you’ve wondered how physical therapy can help you or your child, schedule a free consultation with one of our therapists. We’ll conduct an evaluation and talk about the different treatment opportunities available.