Monthly Archives: July 2013

Gotta Go, Gotta Go, Gotta Go….. RIGHT NOW (or else)

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Have you ever been sitting at your computer, watching TV, or doing WHATEVER when all of a sudden you have a StRoNg urge to urinate? Have you ever felt that if you didn’t race to the bathroom you would pee all over yourself? If so… you are NOT alone. The good news is, there is something you can do to regain control of your bladder!

First of all, stay calm and take a few deep breaths! Often times, when we feel those strong urges, our anxiety increases and our bladder is already ready to empty.

Secondly, perform 5-10 quick Kegels. DO NOT squeeze your pelvic floor muscles (see our previous post So What Exactly Is The Pelvic Floor) as hard and for as long as you can. This will only fatigue your muscles and make it harder to get to the bathroom without an accident. These contractions should be light, quick contractions with an emphasis on full relaxation between each squeeze.

Third, try to distract yourself. Count backwards from 25, sing the chorus to your favorite song, balance your check book (if you aren’t using online banking yet 😉 ), anything you can do to take your mind off of your bladder!

To your surprise, you may have just suppressed the urge to urinate. If so, CONGRATULATIONS! If not, try those 3 steps again. If the urge persists, go ahead and make your way to the restroom. The most imperative part about this though is DO NOT UNDRESS ON YOUR WAY. The minute that zipper comes down, your bladder is ready to empty. Trust me. I’ve been there, and ALL of my patients have too!

Good Luck!

Written by: Jenna Sires PT, DPT

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Re-blog from Pelvic Health & Rehab

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Check out this amazing post from Stephanie and Liz at the PHRC in California on the patients’ role during pelvic PT…

What is the patient’s role during pelvic floor PT?

App of The Week

We all experience accidents…. So check out the First Aid app by the American Red Cross:

First Aid App

The official American Red Cross First Aid app puts expert advice for everyday emergencies in your hand. Get the app and be prepared for what life brings. With videos, interactive quizzes and simple step-by-step advice it’s never been easier to know first aid.

So… What Exactly is The Pelvic Floor?

The pelvis is a complicated and fascinating structure in the body. From a musculoskeletal perspective, it is the central component of your body. A well-functioning pelvis is necessary to walk, bend forward, stand up, and roll over. In addition, the organs of the pelvis work in coordination with the muscles, ligaments, tendons and connective tissues to ensure healthy urinary, bowel, sexual and reproductive functions. Basically, the pelvis rules. It’s crucial. It’s a beautiful part of the body. And, it’s often forgotten, misunderstood, and unappreciated until something goes wrong.

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Really, think about it. How often have you thought about your pelvis? Men, how many times to do you stand in front of the toilet and feel thankful that your muscles are relaxing right as your bladder contracts to empty? Ladies, how many times do you have sex and thank your muscles for stretching and contracting to help sex feel good for you? How many times do you walk up stairs and recognize that your muscles are perfectly supporting all of your joints around your pelvis to help you take those steps without pain? Unless you have a problem with your pelvis, you probably have answered “never.” Don’t feel bad. You’re not alone. Most people don’t recognize the fascinating complex structures within their pelvis until they have problems with it. And at that point, it can feel like a dark hole—complicated and unknown. That’s where we come in!

First and foremost, you must understand the role of the pelvis and the muscles at the base of our core.

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These beautiful muscles (clearly, a pelvic PT bias 😉 ) serve many roles including sphincteric control, supporting the pelvic organs, stabilizing the pelvis as part of the core, and improving sexual function.

Most of the patients we treat are familiar with the role of the pelvic floor in maintaining continence (not leaking). These muscles wrap around the urethra, rectum, and vagina (in females), and in order to maintain continence of urine and feces, they must contract. Conversely, in order to completely empty our bowels and bladder they MUST fully relax. When the muscles do not function properly–whether they aren’t contracting well or aren’t relaxing well– we see problems in both urinary and/or bowel function. A pelvic floor therapist can help you to coordinate these actions to facilitate complete emptying and achieve continence if necessary.

Secondly, the muscles of the pelvic floor support the bladder, rectum, and in females, the uterus. When these muscles are weak, patients are at increased risk for pelvic organ prolapse (POP). POP occurs when the fascia, ligaments and muscles of the pelvic floor no longer support the pelvic organs resulting in the drop (prolapse) of the pelvic organs from their normal position (FDA). People can develop prolapse of the uterus, bladder, rectum or small intestines. According to Varma et al. “Women aged 50 and older are 6 times as likely as men to present with rectal prolapse. Although it is commonly thought that rectal prolapse is a consequence of multiparity, approximately one-third of female patients with rectal prolapse are nulliparous. The peak age of incidence is the seventh decade in women, whereas the relatively few men who have this problem may develop prolapse at the age of 40 or less”. Some risk factors for POP include childbirth, the aging process, genetic predisposition, connective tissue disorders, obesity and frequent constipation.

In regards to stabilization, the pelvic floor muscles are essential. This muscle group sits at the base of the pelvis and works in harmony with the diaphragm (breathing muscle), transverse abdominus (deep core stabilizer), and multifidus to provide stability prior to and during movement. This combination of muscles work sort of like a soda can to maintain a pressurized pelvis and core to allow for stability of the lumbopelvis. We wrote more about this role of the pelvis in our post, here.

Core

Lastly, the muscles of the pelvic floor play a crucial role in sexual function. We will post more about this at a later time, but for now, know that the pelvic floor is important in women to stretch and allow for penetration and also to contract to provide pleasure and orgasm. In men, the pelvic floor contracts to assist in erection and relaxes to allow for ejaculation.

There you have it! We hope this blog post helps you to better understand how these muscles function.

Written by: Jenna Sires PT, DPT and Jessica Powley PT, DPT, WCS

App of The Week

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We emphasize the muscles of the pelvic floor ALOT around here, but keeping your pelvic floor healthy involves keeping all of the muscles that attach to the pelvis working optimally. Check out the free app, Butt Workout, to strengthen your glutes. This muscle group balances out the anterior (or forward) pull that the pelvic floor has on the sacrum.

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