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You’ve seen the claims. A stronger pelvic floor! Fewer Leaks! Better Sex! The kegel craze is hot right now and for good reason. Kegels can do all of these things and we’re a big proponent of doing them for maintaining good bladder health and a healthy pelvic floor. But before you jump on the kegel bandwagon, read this post. Because while kegels can be super effective for all the reasons listed above, they can sometimes cause problems in women who have certain conditions.
Many women suffer from a weakened pelvic floor, the series of muscles and tissues that form a hammock at the bottom of your pelvis, and are responsible for holding many of your organs (including your bladder) in place. A weakened pelvic floor can be caused by many factors, but pregnancy, childbirth, and aging are all high on the list. This laxity in the pelvic floor can lead to things like incontinence, or even pelvic organ prolapse if not treated properly. And a great way to treat it (most of the time) is with kegels.
But not everyone has a weak pelvic floor – some women experience pelvic floor tension, which prevents the pelvic floor muscles from contracting or relaxing at a normal rate, again making them weak, but in a different way. This can lead to things like constipation, painful intercourse, or the inability to empty your bladder completely.
People with pelvic floor tension are advised NOT to do kegels, and if you think about it, it makes sense. Trying to tighten something that is already too tight can make your problems worse.
So, how do you know if you should be doing kegels or not? Our best advice is to see a physical therapist specialized in women’s health. A trained PT can give you a thorough evaluation and can determine if you have a pelvic floor that’s too tight or too loose.
An added bonus is that if your PT finds you’re a good candidate for kegels, they’ll be able to show you exactly how to do one – something that is actually somewhat difficult for many women. And, if you’re advised NOT to do a kegel, they’ll be able to help you learn how to relax your pelvic floor and will show you exercises to help with that as well.
It’s also worth noting that while kegels are great for many people, they also aren’t the end all be all move for your pelvic floor. Your muscles are all connected, after all, so concentrating just on kegels won’t be as effective as if you worked your entire core, glutes and thighs.
Want to find a PT in your area? Try our Specialist Locator!
Nocturia is defined as needing to get up to use the restroom two or more times at night. It is often a symptom of other medical conditions and becomes more common as we age. Having to get up and use the restroom that often in the middle of the night can be an especially challenging condition for a caregiver to deal with, as it disrupts not only their loved one’s sleep, but theirs as well.
Here are a few tips to help manage the symptoms:
- Just before going to bed, urinate and then double-void, relaxing so as to empty your bladder as much as possible
- Restrict fluid intake: No fluids the last three hours before retiring to bed
- Eliminate alcohol and caffeine, especially the last three hours before retiring to bed
- Take a late afternoon rest, lying down for an hour and elevating your legs on a pillow so that heels are higher than your chest, at least two hours before retiring
- If there is any swelling, or edema, in your feet or ankles, wear compression stockings during the day
- During the day, consume fruits and vegetables that have natural diuretic properties. A good example is lemon fruit, believed due to its high vitamin C content, according to Purdue University. Others are watermelon, cantaloupe, pears and peaches
The combination of afternoon naps, elevation of legs and compression stockings may reduce fluid build and help alleviate nocturia. In some individuals one of these three options is sufficient in reducing the needed to get up and use the restroom every evening.
As always, consult your physician and understand what treatment options are available. And let us know you’re thoughts in the comments. Nocturia is incredibly common—maybe you have other tips we should consider!
What is Reflexology?
Reflexology is a therapy that focuses on the small areas of your foot or hands that correspond to different areas of the body. In reflexology, it is believed that by massaging these specific areas, you may be able to alleviate certain ailments.
What Can I Expect when I see a Reflexologist?
Reflexology is a new concept for many people so don’t be scared to ask lots of questions! Your practitioner will likely conduct a thorough health history to make sure that reflexology is for you, and also to determine what issues you may be having so that he or she knows where to focus. Likely, the focus will be on the feet, hands, or ears, or some combination of the three.
The reflexologist may ask you to lie down, and may start by gently washing or soaking your feet in warm water. If you are seeing the reflexologist for a specific condition, he or she may focus on that area, but will also work all points of the foot or hands, as this is thought to allow the all areas of the body to relax and promote greater healing.
Reflexology is relaxing to most people and can be a great stress reliever.
Does reflexology help with bladder control?
More research needs to be done on reflexology and bladder control, but some people believe that by focusing on the areas of the foot and hands that are associated with the bladder, you may be able to reduce bladder spasms which often cause an urgent and frequent need to use the restroom (also known as overactive bladder, or OAB).
Can I try Reflexology on my own?
While reflexology may be most effective when performed by a practitioner, you may be able to feel the benefits on your own, or with a partner. Check out the pressure points on the foot in this chart, and learn some great techniques to perform the practice at home.
If you're reading this article, you, or someone you know, have likely dealt with some form of incontinence before. It's a common occurrence (more common than most think!), and can be a source of daily annoyance, shame and fear in our lives.
For those living with Multiple Sclerosis (MS), bladder dysfunction is often present and can greatly affect the quality of one's life. Symptoms such as hesitation, interrupted or weak flow, incomplete emptying, incontinence, frequency, and pain are reported by many who suffer from MS. However, there is hope. Many treatments are available to those living with this condition. Watch the videos below to see how Amy, an MS sufferer, bravely describes her struggles with neurogenic bladder, and her amazing transformation after she started treating it with Botox.
Amy's Before Video
Amy's After Video
Those who struggle with bowel control issues know full well the impact it can have. From fecal incontinence (also known as accidental bowel leakage), to constipation, not being regular can be be a huge nuisance, and can cause embarrassment, shame and frustration.
One way to manage bowel control is with bowel retraining, which literally means to “teach” your bowel how to function properly again. By stimulating the bowel at regular intervals, you can train it to empty regularly, and with a normal consistency.
Some tips before you begin:
- Keep a Bowel Diary. Knowing how often and when you empty your bowel now will help you later on as you begin the retraining process. Keep a bowel diary for at least 4 days to get a good idea of both your voiding schedule, and what you’re eating and drinking.
- Manage Your Diet. Speaking of eating and drinking, what you consume can have a huge effect on your bowels. To maintain a good bowel consistency, be sure to consume high fiber foods, like vegetables, beans and whole grain foods. If you suffer from loose stools, using a bulking agent, such as psyllium, which can be found at health food stores, can help. And don’t forget to drink plenty of water, which is vital when trying to maintain a healthy bowel.
- Be Consistent. Select a time of day that works for you to perform this exercise and stick with it. This will ensure that you are training your bowel not only to function properly, but at the same time each day as well.
How to perform bowel retraining:
- Insert a lubricated finger into the anus and make a circular motion until the sphincter relaxes. This may take a few minutes.
- After you have done the stimulation, sit in a normal posture for a bowel movement. If you are able to walk, sit on the toilet or bedside commode. If you are confined to the bed, use a bedpan. Get into as close to a sitting position as possible, or use a left side lying position if you are unable to sit.
- Try to get as much privacy as possible. Some people find that reading while sitting on the toilet helps them relax enough to have a bowel movement.
- If digital stimulation does not produce a bowel movement within 20 minutes, repeat the procedure.
- Try to contract the muscles of the abdomen and bear down while releasing the stool. Some people find it helpful to bend forward while bearing down. This increases the abdominal pressure and helps empty the bowel.
- Perform digital stimulation every day until you establish a pattern of regular bowel movements.
- You can also stimulate bowel movements by using a suppository (glycerin or bisacodyl) or a small enema. Some people drink warm prune juice or fruit nectar to stimulate bowel movements.
The most important thing to remember when practicing bowel retraining is to be consistent, and to not get frustrated if you don’t see results right away. This process usually takes a few weeks to develop a normal routine. If you find that you are still having problems after several weeks of bowel retraining, or if you have additional questions, be sure to consult your physician.
Prostate cancer is one of the leading cancer causes of death in men in the US. The American Cancer Society estimates that approximately 1 in 7 men will be diagnosed with prostate cancer in his lifetime. But, while this is a widespread condition, and treatment is sometimes warranted, the medical industry has begun to see a shift in the prostate cancer treatment, choosing to actively monitor patients over time instead of choosing to perform surgery or conduct radiation immediately. This treatment path is called “watchful waiting”, and is becoming more and more common for men with prostate cancer.
To understand why watchful waiting is becoming a more popular trend, let’s back up a bit and explain a little more about the diagnosis of prostate cancer. The average age of men diagnosed with prostate cancer is 66 years old. Common treatment options for prostate cancer have included medication, surgery to remove the prostate, chemotherapy, radiation, and even hormone therapy. And while these treatments have become more and more effective over the years, they cause unwanted side effects (such as incontinence and impotence) and pose serious risks (like blood clots in the legs and lungs, heart attack, pneumonia, and infections.)
There has been much debate around whether or not the benefits of treatment outweigh the added side effects and risks that are introduced when one undergoes these types of therapies. Additionally, it is not clear if these treatment options will completely eliminate the cancer. For those patients who are low risk, the benefit of aggressive treatment compared to the potential side effects may just not be worth it.
What types of patients may be good candidates for watchful waiting? Those who are not seeing any symptoms from the cancer, those whose cancer is small, and located only in the prostate, and those whose cancer is expected to grow slowly all may benefit from this type of treatment.
Additionally, older men who have a life expectancy of less than 10 years may not benefit from the added years that surgery can offer, making them a better candidate for watchful waiting.
However, if the cancer is growing steadily, or spreading beyond the prostate, more aggressive treatment is usually recommended. Men who are diagnosed young may also benefit from more aggressive treatment, as there is a greater chance that the cancer may grow worse over a longer span of time.
Whatever stage you are at, only you and your doctor can decide what is best for you. Be sure to talk with him or her about the risks and benefits associated with each treatment path prior to making a final decision.
Thinking about trying to treat your overactive bladder with an herbal concoction? Many think that an herbal treatment may be more natural than medication, but be careful – herbal remedies do not go through the same rigorous testing and approval process with the Food and Drug Administration (the FDA) as approved medications do. This means that while some herbs may be effective, they can also be dangerous, and many have side effects that could counteract your efforts.
Read this roundup of 5 popular herbs used to treat overactive bladder, and talk with your doctor before starting any treatment.
A guest blog post from Michelle Herbst
Fitness is defined as the condition of being physically fit. There are many parameters to assess one’s fitness level.
Patients often focus on how fast, how far and how long an activity can be completed, while physical therapists (PTs) focus on the mechanics of a body’s ability.
Because physical therapists are intimately aware of musculoskeletal anatomy and comprehend how the individual joints, muscles and nerves work together synergistically, physical therapy compliments general fitness by designing an individual home care and exercise plan allowing you to go faster, farther and longer.
Because PT’s tend to think beyond the fitness concerns of a patient, many questions are asked about the onset of the injury or current limitation a patient is experiencing. All of these questions help PT’s get to the root of the information that help them formulate an individualized plan.
Some questions patients often here are: How did the injury happen? When and where? What did you do after the injury? Have you seen your primary care provider? Are you on any medication to treat the injury? How is this effecting your daily activities?
When a particular task, such as walking, has been negatively impacted by injury or illness the physical therapist may measure how fast, how far and how long the patient can complete the activity before symptoms worsen or force the patient to stop. The information gathered is used to develop an individual treatment plan.
At the end of the day, a PT’s job is to get the patient’s body mechanically fit to complete fitness activities and excel at regular, day-to-day movements that are necessary for an active life.
Have you finally made that appointment with a PT to discuss incontinence issues? Kudos to you for seeking out physical therapy for your incontinence problems. As you prepare for your first visit questions may be circling through your mind. That is OK and is normal. Do not feel imitated by asking your physical therapist questions.
Physical therapists love patients who are engaged and choose to participate in their treatment plan. A fully engaged patient will have better compliance resulting in an improved overall outcome. The end result may be a happier and healthier YOU!
Carefully chosen questions will allow you to get to know your physical therapist and why they treat patients with your condition. No question truly is a bad question. So, let’s fire away. Below are some questions that should be on your list for your first appointment.
How long have you been practicing physical therapy?
Go ahead and ask - this question will provide a brief history of your therapist. In order for your physical therapist to have obtained the skills necessary to properly evaluate and treat incontinence she will have been out of physical therapy school for a few years.
What additional training have you received to evaluate and treat my condition?
It is ok to ask this question – this is your health and you want to be seen by a qualified provider. Here is the reason why. The skill set necessary to treat incontinence is an advanced skill set that isn’t developed in physical therapy school. Your physical therapist will have taken at least one advanced course past physical therapy school in order to properly evaluate and treat pelvic floor conditions.
How long have you been seeing patients with my problem?
Asking this questions will establish your therapist’s experience with your condition. Please do not be put off if you are one of her first patients. Often times, when a therapist is ‘new’ to a condition – that patient is her primary focus and challenge.
What can I do outside of my physical therapy appointments to help in my treatment?
Ka-ching! Great question to ask. Physical therapists love patients that want to work hard. Your therapist will LOVE providing you practical and progressive home program to complement your clinic treatments.
Do you have or know of any resources that help me understand my condition?
Again, a great question. The therapist will likely have printed materials to give you but will also have recommendations for valid and reliable online resources.
Treatment options for pelvic floor pain and weakness run the gamut from kegels, squats, physical therapy to biofeedback. One of our favorite (and most undervalued) options for people needing to tighten the ‘basket of muscles’ is the power of massage.
When your muscles are tight, pushed too far, or are pinched when they should be relaxed, massages can help alleviate the tension.
We made a list of some of our favorite articles on the topic, below. Take a read, then talk to your physical therapist-- or find a physical therapist-- and get a plan in motion.
Biofeedback is a treatment option for individuals needing assistance understanding where and how to activate their pelvic floor.
Biofeedback treatment is primarily composed of two types of sensors that are placed on the body to measure muscle activity by detecting and recording electrical activity. Patients work with biofeedback therapists to flex and relax muscles to gauge muscle strength, and also help the patient become aware of activating these specific muscles. By better identifying these muscles and learning how to activate them, patients learn how to more easily control their incontinence.
Two types of sensors can be used in biofeedback therapy and both are effective in measuring muscle activity. Either small tampon-like sensors are placed in the vagina or an external “stick-on” type of sensor can be placed just outside the anal opening. The most common error that some individuals make in performing pelvic floor muscle exercises is using their abdominal muscles instead of the pelvic floor muscles.
While this whole thing may sound a bit intrusive, improvement in symptoms may be seen in as little as three sessions. With biofeedback, you can learn to stop using the wrong muscles and start using the correct ones.
If this treatment interests you or you’d like to talk to a specialist about this treatment option, click here to find a NAFC-approved specialist.
And if you’re still a little uncomfortable discussing the subject for your own treatment but want to learn more, click here to ask people in our community who have been there before.
Multiple Sclerosis (MS) is the most common autoimmune disease presently affecting approximately 2 million people worldwide.
MS is a disease of the central nervous system. The central nervous system is the hub for the autonomic nervous system and the somatic nervous system. These systems regulate many parts of your body’s mechanics. Most notably: blood pressure, heart rate, bowel activity, sexual arousal, skin sensation, and muscle control.
In patients with MS the immune system attacks the material that insulates nerve fibers. Without insulation the nerves of the central nervous system cannot communicate with the rest of the body. This faulty communication between the brain and spinal cord often results in muscle weakness, abnormal sensation, psychiatric problems, and difficulty regulating breathing, blood pressure, and temperature. Loss of bladder or bowel control can be a result of muscle weakness; almost half of MS patients report bladder and or bowel complaints as the first symptoms of multiple sclerosis.
Sixty-eight percent of individuals with MS experience symptoms of one or more Pelvic Floor Disorders (PFD). PDFs are a loss or lack of bladder or bowel control and can include urinary incontinence, urinary frequency and urgency, bowel incontinence, sexual dysfunction, pelvic organ prolapse, and pelvic pain related to a “spastic” pelvic floor.
Among MS patients with PFDs the most common diagnosis are overactive bladder (69%), voiding problems (41%), Sexual dysfunction (42%), and fecal incontinence (30%)[i]. These symptoms represent major detriments to quality of life.
The good news is that patients with MS can benefit from the same behavior modifications as anyone else with a pelvic floor disorder. Pelvic floor neuromuscular rehabilitation, often referred to as “pelvic floor therapy”, is a behavior modification practice of retraining the pelvic floor muscles using techniques like pelvic floor muscle training, biofeedback therapy and electrical stimulation.
Modern methods of pelvic floor rehabilitation such as The Pfilates Method™ and The VESy Lab™ utilize movement taken from Pilates and Yoga to provide greater pelvic floor response. The key to success with pelvic floor rehabilitation is establishing a practice that continues for a lifetime. Working with a specially trained Physical Therapist provides excellent results and should be considered an element of any care plan for MS patients with bothersome pelvic floor symptoms.
[i] Int J MS Care. 2014 Spring;16(1):20-5. doi: 10.7224/1537-2073.2012-052.
Traditional Chinese medicine (TCM) has been treating urinary symptoms such as overactive bladder for more than 2,000 years. Acupuncture and Chinese medicinal herbs potentially offer an alternative to the treatment of not only the symptoms of overactive bladder, but possibly the root cause as well. Rather than looking at the body to find the particular tissue, muscle, or organ that is unhealthy or diseased, Chinese medicine sees the body as a whole and promotes the idea that a symptom can come from an imbalance in the interaction between the tissue, muscle, and organ systems. Once the imbalance is corrected, the root of the problem is improved, and the body can work to heal itself.
In TCM, there are 12 major meridians that correspond to the organ systems. These meridians are lung, large intestine, stomach, spleen, heart, small intestine, bladder, kidney, pericardium, triple burner, gallbladder, and liver. Keep in mind that while the organ names and some functions are similar, if not the same, in both TCM and Western medicine, an imbalance of the TCM organ does not necessarily translate to a disease in the Western medicine organ.
Overactive bladder has quite a few translations in TCM. The root of these imbalances can stem from the lungs, heart, spleen, bladder, kidneys, or liver and, more often than not, from a combination of two or more of these organ systems.
In TCM the kidneys "govern water", meaning that the kidneys are in charge of the metabolism of water and urination, and the kidneys also filter urine, which is the same in Western medicine. Different from Western medicine, the kidneys’ energy, or “qi” (pronounced "chee"), plays a role in holding the urine in the bladder. Subsequently, a deficiency of kidney qi could be the root cause of an overactive bladder. If the lung and spleen qi are deficient, signs that may be related to overactive bladder include a feeling of bearing down, incontinence, labored breathing, slight abdominal distention after eating, and loose stool.
Other functions of the organs can be described with the Chinese concepts of “yin” and “yang”. The bladder’s ability to hold urine is a yin function. When there is deficient kidney yin, the bladder will not be able to hold the urine, leading to symptoms such as frequent and sudden urination or urgency incontinence. Deficient kidney yin can also be linked to stress incontinence, where there is a leakage of urine while laughing, coughing, or sneezing. In TCM, these common symptoms of incontinence that are related to insufficient kidney yin can be accompanied by night sweats, dizziness, poor memory, nighttime urination, and dry mouth. Kidney yang deficiency symptoms of overactive bladder can be associated with nighttime urination, abundant pale urination, lower backache, a feeling of coldness throughout the body, impotence, and decreased libido.
The liver "governs the muscles and sinews" in Chinese medicine, which means that the general function and health of the muscles are affected by the energetics of the liver. Since muscles are involved with the ability to hold urine, an imbalance in the liver can be a root cause of overactive bladder. Other signs of the livers' involvement are when the condition is worse with stress or anger.
Acupuncture and Chinese medicinal herbs focus on correcting the root of the body's imbalance rather that just treating the symptoms. A well-trained acupuncturist will use specific points on the body to stimulate kidney yin, kidney yang, qi deficiency, and overall balance between the organ systems. The treatments are usually once or twice per week for 10-12 sessions. Treatment may result in an increase in the ability to hold urine, a decrease in the number of nighttime urinations, a decrease of urgency, and a creation of a smoother flow of urine. Of course, it is not limited to just these benefits.
A trained Chinese herbologist may also give an herbal formula to enhance these functions and aid in the acupuncture treatments. Side effects come from Chinese herbs, the most common of which is an upset stomach, which can often be remedied by taking the herbs with food.
Acupuncture and Chinese medicinal herbs are an alternative and holistic approach to treating an overactive bladder. If you are interested in learning more about how acupuncture can help your overactive bladder, please contact a licensed practitioner in your area.