Going Public About Privates

By Jamie Justice, Physical Therapist at Creative Therapeutics

  • I leak when I cough and sneeze.
  • I have pain with intercourse.
  • I can’t always make it to the bathroom in time.
  • I can’t sit that long or wear tight jeans anymore because of pain.

Do any of these sound familiar to you? These are all very common complaints women have but don’t always bring it up to their doctor secondary to feeling embarrassed or not thinking there is any treatment available. A lot of women also think it is just part of life after having children. Common yes, but not normal. Pelvic floor dysfunction can be the reason you are having these problems and physical therapy is a treatment option that can help.

Pelvic Floor Dysfunction

This is a term you may or may not have heard before. It is a topic that everyone knows about. Either you laugh about it or you don’t talk about it. It’s time to shed some light on the issue so many women and men can get the help they need. It is actually a collective term for a wide variety of problems that can occur with your pelvic floor muscles. It can mean weakness, disuse, incoordination, pain or holding too much tension. When weakness is the problem, the normal support the pelvic floor provides to our pelvic organs is lax, making prolapse worse. Also, when these muscles are weak it can lead to urinary leakage not only when we cough, sneeze or laugh, but also with strong urgency or not being able to make it to the bathroom in time.

When muscles are tight, short, and weak, generally they do not relax all the way. This can cause pelvic pain and pain with sexual activity. Difficulty with urinating and constipation can also be related to this problem. Women with endometriosis, interstitial cystitis, vaginismus, vulvodynia and men with prostatitis often have very painful and tight pelvic floor muscles.

Physical Therapy Can Help

There are physical therapists who specialize in the treatment of pelvic floor dysfunction, generally called pelvic floor PT’s. This type of therapy is not well known or understood but can be very effective. Accurately evaluating the pelvic floor muscles allows the therapist to design a treatment plan which will individually address what type of dysfunction may be going on. Although, the location of the muscles makes this a much more sensitive problem to treat, these muscles can be treated as if any other muscle in the body.

One common misconception is that therapy is just going to tell you to do kegels (contracting the pelvic floor muscles as if you were going to shut off the flow of urine). Many people have been told to do kegels exercises, but have never been shown the correct way. You may have been doing them incorrectly all this time. Kegels are also not necessarily appropriate to do in every situation. At times, they can make the symptoms worse. Relying on the expertise of the therapist will ensure a better outcome.

Take Charge Today

These are symptoms that many of us suffer from in silence. Talk to your doctor today about pelvic floor dysfunction and the treatment options that are out there, including physical therapy. Having a healthy pelvic floor can lead to many things – normal bladder function and control, decreased back pain, improved abdominal strength, a healthy sex life and decreased pelvic pain. Talk to your doctor today!