Women’s Health Physical Therapy (WHPT), a topic not known to many, is a specialized section of PT that addresses issues of pelvic pain, dysfunction and incontinence. Many orthopedic patients with persistent lower back and pelvic pain or sacroiliac can benefit from a Women’s Health approach. WHPT is often the missing link that, once addressed, gets patients whose healing has stalled, over the plateau. For this blog, I am providing a general overview of urinary incontinence and pelvic pain for an initial introduction, then I will go into more depth in future blogs.

The American National Association for Continence reports that urinary incontinence impacts 25 million adults. Additionally, Twenty six percent of women between the ages of 18-56 have involuntary leakage. This is a staggering number of women suffering with the daily management of urinary incontinence, when through education and WHPT, their symptoms can be greatly reduced. I would like to start by defining the two primary forms of urinary incontinence: Urge and Stress Incontinence.

Urge Urinary Incontinence is the involuntary loss of urine accompanied by or immediately proceeded by the sensation of urgency. There are many triggers and behavioral patterns that can lead to an Urge Incontinence episode. A few of the more common provoking factors are cold temperatures, running water, and “key in the door” syndrome (an intense urgency when you get home and have a difficult time making it to the bathroom). There are many behavioral therapy strategies and bladder training skills that can be learned to address Urge Incontinence.

Stress Incontinence is the loss of urine with physical exertion, such as, coughing, sneezing, or exercise. It typically occurs when changing positions, like getting in and out of bed or getting up from a chair. Therapy for Stress Incontinence typically includes pelvic floor strengthening exercises and bladder retraining. Stress Incontinence is more consistently a muscle weakness issue rather than a behavioral/psychological response. In some cases, patients have a combination of both Urge and Stress Incontinence, which involve both the behavioral component, as well as, muscle weakness.

Pelvic Pain is a general diagnosis that can encompass multiple areas of pain including the lower abdoman, vulva/lvagina, perineum, low back, and pelvic ring. Many women do not think anything can be done for the pain they experience and live with daily, however, therapy has been shown to be successful in many cases. Common precursors of pelvic pain are: prior pelvic surgery/scar tissue, childbirth, low back pain, sexual injury, pelvic infection, pelvic inflammation, posture dysfunction, stress/tension, depression, and muscle guarding. WHPT treatment for pelvic pain includes biofeedback, pelvic floor strength and/or relaxation education, and manual therapy (scar tissue mobilization, soft tissue mobilization, lumbar spine/pelvic joint mobilization).

If you have experienced any level of urinary incontinence and/or pelvic pain, I encourage you to discuss this with your doctor and consider Women’s Health Physical Therapy for treatment. Endurance Physical Therapy has one Women’s Health therapist, Megan Starr, DPT, that has the specialized training/education to meet your therapy needs. You do not need to live in persistent pain or with incontinence. You do not need to know where every bathroom is in town, stop at every rest stop on the way to Portland, or leak while you are running!

Please call with any questions or for information and Megan will be happy to speak with you.

Heal to Live!
Megan and Diane