March 31, 2013

Secrets between us

By Dr. Jessica Manely, PT, DPT
Performance Physical Therapy

It’s not just that you are getting older and don’t have the energy to go out, it’s that you, like 30 to 55 percent of all other women, feel embarrassed about an accident happening if you do go out. (1,2) Coughing and sneezing bring anywhere from tiny drips to massive leaks. Laughing too hard at a joke requires a trip to the restroom to do damage control, now that you feel you have wet yourself. Some women report needing to wear a pad in order to go out, to protect from leaking urine or, as it is referred to medically, incontinence.

You are not alone, and you are not just getting older. Several women have issues with incontinence, but it is not something that occurs in all older adults. Often, following childbirth, women will have a bout of leaking for two to six weeks. (3) However, for many women, the kids are grown
but the incontinence remains! Childbirth disrupts the normal function of the pelvic floor muscles – the muscles that are responsible for maintaining continence – or, in other words, the muscles that keep us from wetting our pants. In addition to childbirth, many women who have a history of back/hip pain, surgery, or a hard fall landing on your bottom can cause the start of incontinence. (4)

Maybe it only starts when you really have to go and can’t quite make it to the restroom. However, make sure that this does not become a recurring event. It can be a short term issue, but many women view it as normal, even when it has been going on for YEARS. There is help to be had! The pelvic floor muscles are just that – muscles, and they can be strengthened!

Have you ever heard of Kegels? Arnold Kegel, in 1948, coined the term for this muscle contraction when he first taught the exercise. Performing a Kegel is much like trying to stop the flow of urine or trying to not pass gas. Sit or lay on your back and attempt to perform a Kegel by “stopping the flow of urine” or “trying not to pass gas,” to see if you can feel the contraction of these important muscles. Normal strength of these muscles allows for 10 strong repetitions, with relaxation in between each repetition. Normal endurance, or sustained strength, of these muscles is being able to hold a Kegel for 20 to 30 seconds. It is also important that you are able to perform these exercises without anyone else being able to tell! This is the secret workout that you can do to prevent urine leakage!

If you have difficulty with these exercises, or if pain is associated with doing these exercises, with urination or with bowel movements, contact Performance Physical Therapy’s Womens Health Center to develop the skills you need to get your life back!

Dr. Jessica Manley, PT, DPT of Performance Physical Therapy provides a free, monthly Women’s Health Seminar called Leaking Secrets. Meetings are the first or second Thursday of the month. Each seminar reviews pelvic anatomy, to help familiarize you with your body, and a related, relevant topic that is of interest to the group. Past topics have included: healthy lifestyle choices, chronic pain, and the anti-inflammatory diet. Please join us for future meetings! The next seminar dates are April 4 and May 9 from 5:30 to 7 p.m, and will be highlighting the role of yoga in the treatment of chronic pain and/or chronic pelvic pain.

References:
1. Nitti, VW. The prevalence of urinary incontinence. Rev Urol. 2001;3(Suppl 1):S2-6.
2. Thom, D. Variation in estimates of urinary incontinence prevalence in the community: effects of differences in definition, population characteristics, and study type. J Am Geriatr Soc. 1998;46(4):473-480.
3. Urinary incontinence fact sheet. womenshealth.gov. U.S. Department of Health and Human Services Office on Women’s Health. 2010.
4. Kegel exercises: A how-to guide for women. Mayo Clinic Women’s Health. 2012.
http://www.mayoclinic.com/health/kegel-exercises/WO00119.

References for Further Information:

For more info on Kegel exercises:
http://www.mayoclinic.com/health/kegel-exercises/WO00119

For difficult bowel movements consider the Squatty Potty: http://www.youtube.com/watch?v=pYcv6odWfTM