Women’s Health

Pelvic Floor Pain Shouldn’t Be Ignored

Pelvic Floor Pain and urinary leakage

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 and urinary leakageWhat 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 and urinary leakage

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 and urinary leakage

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.

Meg’s Goal is 50 Marathons in 50 States

Running a marathon in all 50 states is an incredible accomplishment and something that was high on Meg’s bucket list. She was well on her way, having completed a race in 16 different states when pain set in and had her wondering if she’d ever run a marathon again, let alone 34 more.

Meg’s pain developed in her pubic bone while she was training for the Missoula Marathon. She started stretching prior to each run, but the only thing that eased the pain was to walk, not run. As race time approached Meg could only run one mile before the pain took it’s toll. She considered skipping the race all together but her family had already made plans to make the trek to Montana with her and she didn’t want to let them down. Meg continued her training, knowing she would have to walk quite a bit, and this wouldn’t be her best marathon, but at least she’d be able to cross one more state off her list.

On July 10, 2016 Meg completed the Missoula Marathon, but it was the most painful race she’d ever experienced and she did more walking and thinking in that 26.2 miles than she ever had before. It crossed her mind that this might be the last marathon she’d ever run. The pain didn’t go away after the race like it had while training. In fact, the pain was so severe that she had to lift her leg up with her hands just to get into the car. Feeling down, Meg took a month off from running, thinking maybe the pain would subside with some rest. That first run back proved to be equally as painful after only 100 yards.

meg_welch4Meg’s daughter is her biggest supporter

At this point Meg came to Northern to see if physical therapy could help with her pubic pain. She combined her physical therapy treatments with a visit to a sports doctor who conducted an MRI. Ultimately she discovered she was suffering from inflammation of her pubic area, tendonitis of the groin, and she had a small hernia forming. She had a cortisone shot to relieve her pubic bone pain and took a boot camp classes to strengthen her core. In addition, Meg had a gait analysis done by one of our therapists where she learned to adjust her stride when running. All these parts of the puzzle combined to reduce Meg’s pain and teach her how to potentially avoid a flare up in the future.

While Meg is still in the healing process, she’s pretty confident that she will be able to continue her goal of running a marathon in each state. Because it may take her some time to get there, she’s set her sights on a more achievable goal for the near future – to be fit and fabulous at the age of 50 (which she turned this spring), and able to run 4-5 miles pain free.

meg_welch2Meg’s family came to Montana to cheer her on

At the end of the day it was Meg’s positive attitude that got her through this process. Her ultimate goal still remains getting back to running marathons, but it could take a good year before she can train the way she needs to again. She’s set goals for herself to get stronger and fitter without worrying about the running, and that’s paid off. She can feel a difference in the little bit of running that she is doing because of her improved strength and gait.

Running a marathon is difficult. We’re so happy that Meg didn’t let the pain stop her. She understood there was an underlying problem and through physical therapy, a fitness program, and help from her sports doctor she began the process of healing. When Meg crosses the finish line of her 17th marathon (which we know she will), we’re going to be her #1 supporters, cheering her on the entire way!

Pelvic Dysfunction & Physical Therapy on WZZM

One in four women suffer from pelvic floor dysfunction, and it’s not just the elderly. As early as the teen years, people may feel unexplained pain in the hips or low back, urinary leakage, or pain in the pelvic region. Often misdiagnosed, the pain can go on for years, but there is a way to treat these conditions and that’s with a pelvic health specialist. We were delighted to have the opportunity to visit the studios of WZZM’s My West Michigan and talk to Catherine Behrendt about this topic, with the hopes of reaching people who are struggling with these issues.

Gina Otterbein and Melissa VanKampen, both based in our Coopersville clinic, are two of our pelvic health specialists.

Melissa spoke briefly about our upcoming Healthy Pelvic series, which features three different events focusing on nutrition and a healthy pelvis, childbearing years, and menopause. The first of these three events takes place on Saturday, April 30. You can get more details on our events page.

View the entire segment below.

Check out our previous segments on My West Michigan where we talked about weight lossusing an exercise ball, the 3 minute exercise routine, concussions in student athletes and senior health.