The hidden secret to your lady issues

Alright, I know that most ladies are not talking about their “lady issues” or what to do about them with other people other than their gynecologist.  But I’m going to talk about the things that you don’t want to because more and more women are coming into my office with these complaints and they have never been told that there could be a solution for them (other than taking some form of medication).  Some of the most common lady issues are incontinence, painful intercourse, and frequent urination.  The hidden secret to resolve these issues lies in your pelvic floor, literally.  Read on to learn more about these issues and how to resolve them.

Incontinence.  Urinary incontinence is defined as any amount of leakage of urine during any type of activity.  So no, it’s not okay that you just avoid jumping jacks at the gym or running up the stairs.  Your pelvic floor muscles are a really big factor here because when they are working optimally, you should not have any type of incontinence.  It’s not necessarily that the muscles are weak and require strengthening because there are instances where the muscles are in spasm and cannot work because they are already contracted too much.  The muscles should also be capable of several things, contracting strongly, maintaining a contraction for several seconds, making quick contractions and working reflexively to contract prior to coughing or sneezing.  If you are experiencing incontinence, you should think about working with a pelvic floor physical therapist that is specially trained in this area and can address your specific cause for the incontinence.  I would not recommend “just doing kegels” without having it evaluated first because if the muscles are in spasm, kegels will make things worse.

Painful intercourse.  If the pain feels more superficial, you could need more lubrication for sexual intercourse.  Vaginal dryness is a side effect of decreased estrogen so as women age, their estrogen levels decrease, and can result in dryness.  If you are experiencing deeper pain during intercourse, it’s likely that you could have trigger points within the pelvic floor muscles.  When something is putting pressure on those trigger points, it will elicit pain.  This is especially common after having a baby due to the trauma that the pelvic floor muscles underwent during pregnancy and birth.  The best way to resolve this issue is to work with a pelvic floor physical therapist that will be able to manually release these trigger points and eliminate the pain.

Frequent urination.  Do you find yourself running to the bathroom often even if you just went a few minutes before?  Or perhaps you feel like you aren’t fully voiding therefore you have to go again soon after?  Or maybe you get worried about needing to go so you have begun to just go to the bathroom before you leave a place “just in case.”  Sound like you at all?  These symptoms indicate urge incontinence where you get a very strong urge to urinate and may or may not have issues with leakage.  If this is a new issue that just popped up out of nowhere, you should see your primary doctor as it may be a bladder infection or urinary tract infection.  But if this issue has been going on for quite some time, it’s time to have it addressed.  What happens during urge incontinence is that the bladder begins to be trained to not fill fully so you begin to get signals from the bladder that you need to void even though it is not filled all the way.   This begins to form a habit and before you know it, you will be running to the bathroom all the time.  For women with this issue that come into the office, we typically have them start recording when they are going to the bathroom so we can begin to retrain the bladder and increase the time between bathroom trips little by little.  Find a pelvic floor physical therapist that can help you with this so you don’t have to be afraid to go on long car trips or on long shopping sprees! 

If you have been experiencing any of these issues, it’s time to get them addressed.  Women do not need to deal with these issues throughout life and you should be able to enjoy things such as sexual intercourse without having pain or jumping on the trampoline without wetting your pants.  The issues aren’t as simple as “doing kegels” like so many other articles you may have read so see a specialist that can address all the factors and get you living an active life again!  Check out our website or email me with your questions at Brenda@revitalize-pt.com

How to have a healthy pelvic floor during pregnancy

I know some of you are probably thinking “ya right, there’s no hope for my pelvic floor.”  Well, I’m here to tell you that there is and there are things you can do during your pregnancy to help your pelvic floor and even set you up for better success after delivery.  The pelvic floor is so important in giving you stability and with all of the changes that occur during pregnancy, the pelvic floor undergoes a lot of stress.  Here are my top 4 tips on how you can keep your pelvic floor happy! 🙂

Exercise it.  Your pelvic floor is working so hard because your body has gained roughly 30 pounds of weight very quickly over the course of your pregnancy.  And all of that weight rests on the pelvic floor.  So you can imagine why it seems to be common during (and after) pregnancy to experience incontinence.  If you had to hold 30 pounds all day long you would probably be tired too.  To help with this, it’s important to do specific pelvic floor exercises, ie: kegels.  Now, I’m going to put a disclaimer in here and tell you that this is not for everyone because sometimes women have an overactive pelvic floor and kegels will make this worse.  And I’m also going to tell you that the advice you read on the internet that tells you to do like 50 kegels is absolutely ridiculous since most women struggle to do 10.  It’s best to work with a pelvic floor physical therapist to do what is right for you but if you can’t find one close to you, it’s important to only do an appropriate amount of kegels.  Try doing several in a row and count how many you can do before you feel as if you are not getting a full contraction.  This might only be 4-5 reps (or less).  But this will be your starting point for reps during the day.  Squats are also a great exercise for the pelvic floor.

Take it easy with all the jumping.  Since your pelvic floor is working really hard to give you support, jumping makes it work even harder!  Simply put, high intensity exercises such as running and jumping puts a lot more stress on the pelvic floor and can make it fatigue quicker.  It can also create the issue where the pelvic floor is overactive, ie = spasm, because the muscles are really tense trying to work really hard.  This will make your delivery much more difficult and long since the muscles have difficulty relaxing.  If you enjoy doing these types of exercises, work with a pelvic floor physical therapist to make sure your pelvic floor is functioning properly so you can have a quicker and easier delivery.

Stay hydrated.  Consuming an adequate amount of water is important to stay hydrated and minimize the risk for incontinence.  It may seem counter-intuitive to drink more water to stop leaking urine but the rationale behind this is because when you are dehydrated, your urine becomes very concentrated.  This irritates the bladder and makes incontinence more likely because the bladder will be trying to expel the irritating contents within it.  Hydrated muscle tissue also allows it to work properly so if you’re well hydrated, your pelvic floor muscles will be able to get everything it needs to function.

Practice good breathing techniques.  Have you heard of diaphragmatic breathing?  You’ve most likely read something about it at some point or another.  Well, it’s important for SOOO many reasons.  When you breathe correctly, meaning the belly expands out rather than the chest and shoulders rising upward, this helps the pelvic floor to relax properly.  If you are breathing with your upper chest more, like so many of us do, it causes the pelvic floor muscles to tense up more and become overactive (like we talked about above).  The diaphragm also completes the cylinder along with the pelvic floor, ab muscles and back muscles.  All four need to be strong and work properly in order to give you the support you need.  When one (or more) is not, there are issues such as pain, incontinence, or instability.  And as you move along in your pregnancy, there will be less room for your diaphragm to expand so practicing these breathing techniques will help keep everything healthy.

If you ever have questions about anything we talked (or didn’t talk about), please feel free to reach out to me at Brenda@Revitalize-PT.com and I would be more than happy to talk with you.  Did you also know that we offer the Revitalize Bump Package and Revitalize Body After Baby Package that addresses some of the things we talked about today?  Check them out on our website and please pass it along to any friends that you have that are pregnant.

 

4 ways your body changes during menopause (and what you can do!)

Menopause is such a downer hey?  It seems like that should be the time in your life that you are living it up and doing everything you enjoy.  And most of you still are!  But there are these pesty things that always seem to get in the way (you know I’m talking about those darn hot flashes)!

We just recently held our first “Your body without estrogen” talk last week where we covered these topics in much greater detail and gave solutions for these issues.  It was a great group of women and they all learned a ton at the talk.  If you are in the greater milwaukee area, franklin, greenfield, muskego, hales corners, or mukwonago area and are interested in learning more, come check out our next talk on October 4th at 7:00 PM.

So as many of you maybe already know some of the changes that occur with menopause, we are going to talk alittle more in depth about them.  During menopause, estrogen levels drop and is the main culprit for these symptoms.  While having hormone replacement therapy is one solution, we will be focusing on more natural ways of alleviating symptoms.  Keep reading to learn how!

1.Hot flashes and insomnia: How annoying, hey?!?  Both of these are caused primarily by the drop in estrogen that occurs in the body.  Although there isn’t a great solution, exercise can help alleviate both hot flashes and insomnia.  Hot flashes can also be controlled by diet to some degree so avoiding triggers such as alcohol and coffee.  Insomnia can also be influenced by stress in your life so trying to manage stress and unwind before bed can also help you get some extra ZZZ’s.

2.  Dryness:  Experiencing vaginal dryness is common as women age but it can lead to other issues such as painful intercourse and incontinence.  It’s caused by the loss of estrogen which ultimately slows down mucous production in those areas creating the dryness.  Using a topical estrogen cream can help this by giving you just alittle bit of the hormone to that specific location.

3.  Weight gain:  As estrogen levels drop, it can contribute to increasing body fat and decreasing muscle and bone mass.  A lot of women that come into our clinic want help to build up muscle again because of this.  When you lose muscle mass, it slows your metabolism down which can make it much harder to keep excess weight off.  Exercising will help increase your muscle mass and burn more fat.  It will also keep your bones strong depending on the type of exercise you do which is important for long term health.

4.  Incontinence:  Nobody likes having to run to the bathroom, wear a pad, or worse, having to bring a change of clothes along in case of incontinence.  We tend to see women coming into the office with this issue as they are hitting menopause but it is not due entirely to the decrease in estrogen.  Often times it is multi-factorial and festers for many, many years.  Having dryness can exacerbate the incontinence as well so trying to resolve that can make incontinence alittle better.  Since it is often times complex, it is best to see a pelvic physical therapist that specializes in it to make sure you can fully resolve the incontinence.  If you are near Hales Corners and have questions, feel free to reach out to me otherwise I can also help you find one in your area.

Having a steady routine with exercise and a healthy diet will help you navigate the waters through menopause and if you want extra help, don’t be afraid to ask for it.  Life is too short to suffer on a daily basis!  Have a great week everyone!

 

3 ways to get through your workout without running to the bathroom

Do you ever have that issue where you are in the middle of a great workout and as soon as you do a jumping jack, you get a strong sudden urge to go to the bathroom?  You definitely aren’t alone!!  1 in 3 women have issues with incontinence and it occurs commonly during any type of exercise that involves quick movements, jumping, or running.  Not only is it not a “normal” thing to happen (how many times have you been told that because you’ve had kids or maybe you’re getting alittle bit older?) but there are things you can do to stop it.

Perform 3-5 kegels when you feel the urge to run to the bathroom.  If you are doing a jumping task and suddenly get a strong urge to go, don’t rush off to the bathroom immediately.  Sometimes that rushing can cause you to leak.  Instead, take a second and pause, do 3-5 kegels then slowly walk to the bathroom.  There has been research that has shown that most women do kegels incorrectly so it would be best to see a physical therapist to learn the proper way.  In order to do a kegel correctly, think of picking up a blueberry “down there”.  You should be pulling up and in but not holding your breath or squeezing every other muscle.

Incorporate core exercises into your workout.  In addition to having weakness in the pelvic floor, often times the core is weak as well.  And most importantly, the two do not work together as they should.  Strengthening your core muscles will help you avoid any episodes of leaking.  Try doing a plank to strengthen all of the core muscles at once.  Don’t allow the lower back to sag and keep you your hips level.

Drink water.  Okay, you might think I am totally nuts but trust me on this one!  Most women think that if they drink less water, there is less likelihood of having to run to the bathroom and leaking urine.  Totally logical…but in fact, it makes incontinence worse.  The more dehydrated you are, the more concentrated your urine gets and that is a bladder irritant which makes it much more likely to have a sudden urge to go to the bathroom or leak.

Try these tips to avoid having any embarrassing runs to the bathroom during your next workout.  And if you suffer from this, please don’t feel like you have to suffer through.  Visit a women’s health physical therapist to resolve the issue and quit being afraid of running to the bathroom or having to wear a pad during exercise.  Check out our website to learn more about how we specialize in women’s health in the Hales Corners, Milwaukee, and Greenfield area.

 

Is your Diet Coke making you pee your pants?

Diet Coke making you pee your pants…crazy thought hey?  Well, if you have any issues with leakage or incontinence, then you need to read this!  It’s a topic that people don’t particularly talk about in conversation so this topic doesn’t always get the press that it should.  There are so many people out there that suffer from this but think that it’s normal or have been told by someone else that it’s normal because you had a baby, you’re getting older, etc etc, etc.  Well, let me tell you, it’s not “normal” and you don’t need to suffer from it or be embarrassed by it because you can stop it with the appropriate pelvic floor physical therapy.  Anyway, I digress.  Let’s talk about that Diet Coke!

So why is Diet Coke so bad for you?  It contains several bladder irritants that affect the bladder and make you more prone to leaking urine.  For example, if you are a coffee drinker you have probably noticed that after drinking a large coffee, you pee ALOT afterwards.  Caffeine is a bladder irritant.  However, Diet Coke has several bladder irritants such as caffeine, carbonation, artificial sweetener and high acidity.  Each bladder irritant works in a different way if you are interested in the scientific model but ultimately all have an effect on the bladder.

What can you do to minimize incontinence if you like to drink Diet Coke?  For starters, it is best to decrease the amount of Diet Coke that you drink (and soda isn’t great for you for several other health reasons other than incontinence).  But if you have to have your Diet Coke, try to drink water along with Diet Coke as it helps offset the concentration of these ingredients.  It’s also important that you get adequate water intake throughout the day which is approximately 6-8, 8oz glasses of water.  And most importantly, have it checked out by a physical therapist.  Make sure your physical therapist has taken additional training in this area so they can appropriately work with you.  Please comment or email me with any questions that you might have about incontinence and I would be more than happy to answer them!

The real truth about doing kegels

TGIF!  I just got back from a long weekend course in Iowa where I took several tests to become a Pelvic Floor Specialist.  I have two more levels to go in order to sit for the certification exam.  But it was a great class and I was able to learn so much in regards to treating women’s health patients.  I’m excited to implement some of the techniques I learned into my patient care.  So after being at this course for 3 days, I thought what better topic for this week’s post other than kegels!

I’m guessing you have probably heard about kegels a time or two in your life or perhaps you were told by your physician or other healthcare provider to “just do some kegels” after you had a baby.  While it is true that kegels help to strengthen the pelvic floor, it is not quite that simple however.  First, research has shown that over 60% of women are doing kegels incorrectly.  Second, the pelvic floor muscles are composed of both fast twitch and slow twitch fibers; essentially quick contraction fibers or endurance fibers.  Both types of fibers should be strong in order to prevent incontinence or prolapse.  And third, in order to strengthen the pelvic floor, it must be progressively overloaded similar to how you would increase weight at the gym while doing bicep curls.

Most people don’t realize that the pelvic floor consists of muscles similar to everywhere else in our body.  In order to strengthen those muscles, there has to be an appropriate exercise program for them.  If you could only do 5 bicep curls, you wouldn’t try to do 20 because there’s no way you could have good form for all 20 repetitions.  It’s also important to note that resolving incontinence is often times not quite as simple as just strengthening the pelvic floor.  It is often times mixed with some urge incontinence and can also be due to hyper active pelvic floor muscles.  In that case, kegels can make it much worse since the muscles are already working too much.  The best way to know what is best for you is to have it assessed by a Pelvic Floor Specialist Physical Therapist.  There are a lot of people out there that say they treat incontinence but have not taken additional classes for it (which is needed to treat it effectively).  If you have any questions about kegels or incontinence, please email me at FitandTonedWI@gmail.com.  Lastly, incontinence is not normal in any scenario (pregnancy, old age, etc) so if you suffer from this, book an appointment with me in the Greater Milwaukee area and we can get it resolved.