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Femina Physical Therapy blogThe Staff of Femina Physical Therapy Blogs About Vaginismus, Pregnancy and Postpartum Best Practices, Treatments for Incontinence, and More

Don’t let your New Year's workout make you leaky!

Happy New Year!
With new year’s resolutions, a lot of us will be starting new workout routines to shape up. While exercise is a cornerstone of physical health, a little talked about side effect of increased athletic training, particularly for those with female anatomy, is urinary incontinence. A comprehensive literature review published March 2018 in International Urogynecology Journal found that female athletes have an increased the risk for urinary incontinence.

What exercises cause more leakage?

In generally higher impact sports, such as basketball, volleyball, and tennis have a higher prevalence of urinary incontinence vs. lower impact sports such as swimming and pilates (de Mattos Lourenco, et al., 2018).

The following list outlines more:

High impact activities- 58% Prevalence of UI
Basketball
Football
Gymnastics
Tennis

Medium impact activities-
30.46% Prevalence of UI
Hockey
Judo
Running
Softball

Low impact activities- 12.64% Prevalence of UI
Bodybuilding
Cycling
Hiking
Pilates
Swimming

Why would exercise make you leak?

One leading hypothesis for this is an increase in abdominal pressure. As we’ve talked before in our blog series about pelvic organ prolapse, when the pressure in the tummy is stronger than the supporting muscles, tissues and tendons, things tend to travel south. If you are doing high-intensity activities like sprinting, jumping, lifting, and crossfit, you may be increasing your abdominal pressure without enough pelvic floor support to help your organs from shifting.

What You Can Do

Participate in lower impact activities if you are leaking
Low impact activities have less prevalence of urinary incontinence. Activities like weighlifting, cycling, hiking, pilates, yoga, and swimming are examples of low impact activities. If you are in an aerobics class that requires a lot of jumping, modify the movement to stay stationary on the ground: an example would be instead of jumping jacks, you could do squats or alternate bringing one leg out at a time.

Strengthen Your Pelvic Floor
Are you doing low impact activities and still leaking? You might need to strengthen your pelvic floor. Don't know how? Check out the Femina blog for articles about kegels.
Still confused? Come see us! The pelvic floor therapists at Femina PT are ready to help, make an appointment today. 

Exhale with Movement
One common cause of incontinence and increased intra-abdominal pressure is holding your breath. Breathe when you move!

Try exhaling with the following activities:

  • Exhale with exertion during exercise. Examples: when you bring a hand weight up into a bicep curl, exhale. When you push up from a squat, exhale.      
  • Exhale while lifting (weights, baby, groceries)
  • Exhale while pushing anything (luggage, strollers, trash can, shoveling)
  • Exhale while you are bending over during exercise (stretching)
  • Exhale while reaching overhead (pull-ups, weight lifting)

Steady Breath While you Exercise
Practice a steady breath throughout your entire exercise session. This will help regulate your abdominal pressure and the pressure placed on your bladder.

Some Tips:

  • Relax shoulders and upper chest
  • Breathe in slowly to fill the lungs fully
  • Breathe out slowly through the mouth or nose
  • If you are feeling winded, bring your heart rate back down until you can breathe easily again

See A Pelvic Floor Therapist

Pelvic floor therapists are trained to fully assess what is going on in your body in order to fully understand what is contributing to any urinary incontinence. Check out our post on what to expect on your first visit for more info. 

Resources
De Mattos Lourenco, Matsuok, Baracat, Haddad. 2018. Urinary incontinence in female athletes: a systematic review. International Urogynecology Journal 29(12):1757-1763.

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Urinary Incontinence is common, Pelvic Floor Therapy can help

Urinary incontinence is the loss of bladder control. Urinary incontinence affects up to 1 in 3 women. The two most common types of urinary incontinence that affect women are stress incontinence and urge incontinence (also called overactive bladder, or OAB). Incontinence affects twice as many women as men. This may be because pregnancy, childbirth, and menopause are contributing factors to urinary incontinence. Urinary incontinence should not be considered a normal part of aging, and it can be treated.

A new article published in September, 2018 by Lamerton, Torquati, & Brown found that being overweight (BMI 25-30) increased risk of urinary incontinence for young and middle aged by 35% and obesity (BMI ≥30) almost doubles the risk at 95%.

The findings of this study are important because those with urinary incontinence when young and middle aged adults are more likely to have worse symptoms when they are older. Another reason why the study is important is that weight, relative to factors like genetics, is a risk factor that can be controlled with diet and exercise.

Read more: Obesity and Overweight...

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A 101 on the credentials, training, and skills of pelvic floor therapists

Two recently published articles, in the International Urogynecology Journal and in Neurourology and Urodynamics talk about the positive outcomes of treatment with trained pelvic floor therapists. Today is a basic rundown of what kinds of credentials, training, and skills pelvic floor therapists have to offer you.

Credentials

Pelvic floor therapists are often physical therapists (PT) or occupational therapists (OT). Both of these disciplines require academically rigorous coursework that covers topics from anatomy and kinesiology, to neuroscience, and the evaluation, treatment, and management of common diagnoses. They are also trained in a medical system, and are aware of "red flags" in signs and symptoms that patients may present with. These "red flags" will typically require additional medical referral to rule in or out (i.e. suspected masses, infection, etc).

You will often find a jumble of letters after your pelvic floor therapist’s name. Here is a breakdown of what those letters mean:

PT, MPT, MSPT, or DPT: These letters represent the degree that your physical therapist earned. For many years, physical therapists earned a bachelor's degree prior to becoming licensed. Later, schools transitioned to master's degree programs. The letters MPT or MSPT indicates a master's degree in physical therapy. Most programs today now train therapists for a DPT degree, which stands for doctorate of physical therapy.

Read more: Why see a pelvic floor...

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Menopause is a period of life transition for many of us. Today we will review what menopause is and how symptoms can negatively affect pelvic health, including bowel, bladder and sexual function.

What Happens During Menopause?

Menopause is an important life transition for those with female anatomy, marking the end of the regular menstrual cycle and the transition to life beyond the reproductive period.

Babies born with female anatomy have a set number of eggs which are stored in their ovaries. The ovaries make the hormones estrogen and progesterone, which control monthly periods and ovulation. Menopause happens when ovaries no longer regularly release an egg every month and menstruation stops.

The age menopause starts can vary, but usually it is after the age of 40. Some people can go through menopause early, usually after a hysterectomy, damage to the ovaries, and sometimes from chemotherapy.

Read more: Menopause and Pelvic Health

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Painful periods are common.

According to the American College of Obstetricians and Gynecologists, more than half of those who have periods suffer from “dysmenorrhea” (pain associated with their cycles) 1-2 days each month.

What causes the pain?

There are two main causes of the pain associated with menstruation:

  • Primary dysmenorrhea is pain caused by the related to menstruation and starts shortly before or after bleeding begins
  • Secondary dysmenorrhea is period pain that is tied to another condition, usually endometriosis or fibroids

Although period pain is a commonly shared experience, your pain shouldn’t be keeping you from doing things like resting comfortably, going to school, going to work, or being active.

Read more: Painful Periods: Treatment...

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Tightly Wound recently released on Iris!

Tightly Wound has been released, watch it today and share it with your loved ones and anyone else who may need more education on vaginismus and pain with sex.

Tightly Wound is a 15-minute animated short by Shelby Hadden. Our very own Heather Jeffcoat, DPT is one of the producers of film. Check out the video here.

Read more: Watch Tightly Wound!

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