Incontinence is not a disease.  It is a symptom of pelvic floor and/or bladder dysfunction.  The root of this dysfunction may be poor muscle strength or endurance of the pelvic floor.  It may also be altered or blocked transmission of the nerves that communicate with the bladder or pelvic floor muscles.

There are many risk factors that can cause the altered nerve communication or poor pelvic floor muscle function.  They include:  smoking, obesity, pregnancy and childbirth, pelvic/abdominal surgery, neurogenic disease, chronic cough, repetitive heavy lifting, hormone changes, and more.

Researchers continue to discover new risk factors as they study incontinence and prolapse … Continue Reading

I am 6 weeks post-partum and I feel this heaviness in my vaginal area but no bulge.  I want to start running but don’t know if I am ready.  Is this similar to what you felt?

 My prolapse sounds like a bit more than yours, with a grade III cystocele. When I stood in a half-squat position in front of the mirror, I could see the anterior wall of my vagina, about 1/2 fist in size, bulging out. So my pelvic floor had completely shut down. After my first delivery I had my eye on the 6-week mark to begin running … Continue Reading

I want to share a couple of tips that many of my patients have found helpful in their journey through pelvic floor rehabilitation and return to activity: triathalon shorts and a high fiber diet. The high fiber diet seems logical to reduce any added strain on our pelvic floor, but the triathalon shorts…pretty random right? I agree, but so many women have shared these tips with me that I must pass them on.

Let’s start with the tri short. The benefit of the tri short is two-fold. Number one, they hug tight to your hips … Continue Reading

I have a pregnancy class that I teach and I am unsure which position I should teach the pelvic floor lift and holds?

I would recommend your clients perform the pelvic floor lift and holds and quick flicks in a seated position. Coach them to find their “tripod” first and then perform the exercise. This is easiest on a Swiss ball but can be performed sitting anywhere once they master it. The sitting and standing positions are far more functional, as well as being more advanced. Teach the supine version to help them feel the muscles they are drawing up and … Continue Reading

I have been told to exaggerate the curve of my lumbar spine, is this your neutral spine?

No. Neutral spine is a happy medium between the two extremes of the lumbar spine. It is a position that requires muscular control because we are not relying on bone-on-bone compression. Not to mention that if we exaggerate the lumbosacral curve, our spine has to balance out the curves which this leads to an exaggerated thoracic and/or cervical curve. To a physical therapist, this means that the shoulders are forward and there is decreased room for chest/lung expansion (this is bad … Continue Reading