pelvic floor physical therapy Archives - Revitalize Physical Therapy

You’re convinced you have a UTI. You constantly need to pee, yet not a lot comes out. You’re having pelvic pain. And, worst of all, having sex hurts.

You finally go to the doctor’s office. Only you don’t get the answer you were expecting. Your doctor tells you that you have interstitial cystitis, which can closely mimic but is not a urinary tract infection.

Interstitial cystitis? You’ve never heard the term before. You wonder what that even means.

What Is Interstitial Cystitis?

While IC shares a lot of symptoms with a UTI, it is not the same condition. According to the Mayo Clinic, it’s a chronic condition causing bladder pressure, bladder pain and sometimes pelvic pain. Up to 8 million people have it. Most of those are women or those assigned female at birth.

Anyone who has gone through a UTI knows it can be uncomfortable. But knowing the pain will soon ease via antibiotics makes it at least somewhat bearable. Those with IC have it much harder. They have to manage their discomfort indefinitely.

What Causes Interstitial Cystitis?

According to Healthline, IC is caused by a damaged bladder lining. Many things, including bacterial infections, might cause that damage. In fact, painful bladder syndrome is another name for IC. There is also a theory that IC has a genetic component.

How Is Interstitial Cystitis Diagnosed?

Your evaluation for IC can involve ruling out similar conditions, according to the Mayo Clinic. A urine test is performed to determine whether or not there is a UTI. A biopsy and urine cytology, a sample of urine, can test for cancer.

Doctors often ask patients to keep a diary of how many times they are going to the bathroom. This is part of the diagnosis process. You may need to have a cystoscopy, a procedure that fills the bladder with water to see why you have bladder pain.

Interstitial Cystitis Treatment Options

IC treatment can be natural, over-the-counter or involve surgery. Your medical team will create a plan for you after diagnosis. But it can be helpful to know what to expect.

One of the treatments is physical therapy for the pelvic pain. Your physical therapist will work on releasing muscle tightness.

Your doctor may treat your IC with Advil, stress reduction techniques and dietary changes. Wearing looser fitting, less constricting clothing can help too.

Drinking more water (always a good idea) and quitting smoking (also a great idea) may noticeably improve IC. Elmiron is an FDA approved medicine for IC your doctor may recommend.

Surgery, which can enlarge the bladder and resolve bladder ulcers, is infrequently recommended.

Getting Your Life Back

Those first steps, getting a diagnosis and a treatment plan, are vital to managing this condition. They are how you ultimately get your life back. IC can be a very tricky condition. But once you uncover and expose your bladder’s great pretender, it loses so much of its power. And you restore yours.

If your doctor believes you should have physical therapy as part of your IC treatment, please don’t hesitate to reach out to me if you are near any of my locations. I offer free consultations, and we can talk about how I can help you treat your IC.

If you’ve never had pelvic floor physical therapy, I know it can seem overwhelming, scary and even embarrassing. But it can make a huge difference. It would be an honor and a pleasure to help you feel like yourself again.

The Key to Kegels

What are Kegels? Put simply, Kegels are to the pelvic floor what yoga is to the body, mind and spirit. They are an accessible form of low-impact exercise that has the potential to dramatically improve your life.

To get even more granular, “Kegel pelvic floor exercises are used to strengthen the muscles that support your uterus, bladder, bowel, and rectum,” according to WebMD. Kegels have enjoyed some publicity as of late, being touted as a way to treat erectile dysfunction and achieve pelvic floors of steel.

So how do you do them?

Many of us are not aware of where our pelvic floor muscles even are, so engaging them can be a challenge.

There are several ways, per Healthline. One is to simply replicate the experience of holding in gas. If you attempt that and then feel it in your vagina or back end, you’re doing it right! You can also locate these muscles by stopping urine while on the seat or putting a finger inside yourself while doing the exercise to feel the pull. Although please do not get in the habit of doing this routinely, as it sends mixed messages to your pelvic floor! You get one shot at it, for educational purposes only!

If you are of a certain age, think back to those claw arcade machines you played with as a child. The Cleveland Clinic compares the motion of a Kegel to the claw opening and closing around a prize.

You then will tighten your muscles for a count of five, and relax for the same count. For optimal help, perform these endurance contractions 20x, three times per week. You can also perform Quick Flicks, or “fast exhale squeeze, fast inhale release” 50x, three times per week.

Your physical therapy appointment is another great time to check your Kegel form. You shouldn’t be embarrassed or feel like you are bothering your therapist. That’s what they are there for!

Now, let’s take a closer look at what they’re for.

Pelvic Organ Prolapse

As I explain in my book The Inside Story, “POP is associated with the excessive descent of one or more of the pelvic organs or the vaginal wall.” It can happen after childbirth, and there are several different types of prolapse. These include uterine or cervix prolapse, cystocele/anterior prolapse, rectocele/posterior prolapse, and rectal prolapse. I also talk about prolapse in this blog post – well worth the read! Pelvic organ prolapse has a number of treatments, ranging from a pessary to surgery, but Kegels can make pelvic floor muscles stronger and those are the muscles that keep those organs stable.

Incontinence

Pelvic floor muscles affect how much control we have over our urination and defecation, which is why it may be recommended to strengthen them to treat urinary, urge and fecal incontinence.

Better Sex

Now I’ve got your attention! Yes, Kegels can even help in this department. According to WebMD, there is scientific evidence that Kegels can “enhance female sexual arousal by relaxing the vagina, improving lubrication and allowing more blood flow to the genitals.” In men, they may heighten the pleasure of orgasm and provide “greater control over ejaculation.” (Pelvic floor muscles really are the center to so much that goes on in our bodies!)

Who Shouldn’t Do Kegels

Kegels can be a problem for people with a hypertonic pelvic floor. This means the pelvic floor muscles are unable to fully relax. Nebraska Medicine states, “While these exercises may benefit both men and women, performing too many ─ or performing them incorrectly ─ may increase muscle tension and pain, or worsen your symptoms.” One journalist received a hypertonic pelvic floor diagnosis simply from doing Kegels alone, so you have to be careful. They also provide very limited benefit for overflow incontinence.

As usual, it is best to speak with a healthcare provider.

Also, have patience: Don’t expect overnight success as they can take up to a few months to work. Try adding Kegels to your Google calendar or doing them first thing in the morning. You can even pair them with your favorite podcast to help make the habit automatic. And the result is not only a stronger pelvic floor but stronger relationships, less embarrassment, less pain, more pleasure – overall, a pretty big impact for such a really tiny movement!

Tag: pelvic floor physical therapy

Interstitial Cystitis: Your Bladder’s Great Pretender