Tag Archives: Incontinence

Prevent Pelvic Organ Prolapse (POP) with Better Birthing Techniques.

Pelvic_floor_side_view_larger_fontBy Marianne Ryan PT, OCS
Clinical Director MRPT Physical Therapy

A very common side effect of childbirth is Pelvic Organ Prolapse, POP, some studies show up to 25% of women will develop it at sometime in their life.

What is Pelvic Organ Prolapse?

POP occurs when organs such as the uterus or bowels slip down from their normal positions inside of the pelvis.

There are different degrees of how much the organs slip, in severe instances organs can protrude outside of the vagina, especially when performing activities that require abdominal bracing such as heavy lifting, sit-up exercises and even passing a bowel movement.
POP can lead to several complications such as incontinence, pelvic and back pain and sexual dysfunctions.

Prevent Pelvic Organ Prolapse With Better Birthing Techniques:

Did you know that certain childbirth techniques could reduce the risk of developing pelvic organ prolapse (POP)?
The more strain placed on the pelvic floor during childbirth, the more a woman is at risk of developing POP. Choosing better positions, breathing techniques, and timing can benefit both mom and baby.

To read more about this in an article I wrote for the Association for Pelvic Organ Prolapse, “Reduce the Risk of Developing Pelvic Organ Prolapse: Birth Techniques For Less Strain on Pelvic Floor Muscles”, click here.

Did You Know Physical Therapy Treatment Can Reverse or Reduce the Severity of POP?

In an earlier post I discussed a study that shows that  1/3 of the surgeries performed to reverse Pelvic Organ Prolapse fails within 7 years. That is a really bad statistic! click here
What most people do not realize is that physical therapy treatment has been proven to reverse or lower the severity of the amount of slippage, and therefore may be used in the treatment of incontinence, pelvic and back pain and sexual dysfunctions.

Painless Parenting the Radio Show

Move Forward Radio Marianne Ryan PT, OCS is interviewed by Move Forward Radio on the subject of Painless Parenting.

“Parenting provides challenges but it doesn’t have to be a pain. In this episode, Marianne Ryan PT, OCS discusses how to help parents avoid the minor aches and pains – and even significant injuries – that sometimes occur during pregnancy and after childbirth”.

Tell me what you think?

Click below to listen to the show:

Listen to Move Forward Radio’s segment about Painless Parenting or dowload the podcast on Itunes.

One Third of Childbirth Repair Surgery Fails?….Why?

shutterstock_55118254By Marianne Ryan PT, OCS
Clinical Director MRPT Physical Therapy

Did you know that “a common surgery often performed to repair damage caused by childbirth fails one-third of patients within seven years, a new study shows”?

Yup, it is the surgery women have done to cure incontinence and other problems caused by pelvic organ prolapse (POP), which often occurs as a result of childbirth.

An article written by Liz Szabo, for USA Today, goes on to explain:

1. “In nearly one-third of cases, surgical repair failed or women saw symptoms return”

2. “About 225,000 women undergo some kind of pelvic organ prolapse surgery each year”

3. “Some surgeries can be prevented; pelvic physical therapy can cure many milder cases”

Szabo also mentioned “about one in four women suffer either prolapse or incontinence at some point, and studies show that 11% to 19% of women undergo surgery for it.”

Let me repeat: 25% of all women develop incontinence or pelvic organ prolapse. That is one out of four of your female friends!

Cheryl Iglesia of the Georgetown University School of Medicine was quoted in Szabo’s article as saying, vaginal deliveries increase the risk of developing pelvic organ prolapse (POP), and in the future doctors will need to perform C-sections rather then vaginal deliveries for women at high risk for prolapse.

Yikes! Iglesia’s answer to the problem is more surgery and more C-sections?

What about more physical therapy?

The article does mention that studies show that “pelvic physical therapy, which includes Kegel exercises that strengthen pelvic floor muscles, can reverse many mild cases of prolapse”, but there is no mention on how pelvic physical therapy can prevent POP. There are also studies that show pelvic physical therapy can reduce the level of prolapse, for example reduce a grade 3 to a grade 2, etc.

If pelvic physical therapy can reverse pelvic organ prolapse, why aren’t women knocking down my door to get physical therapy treatment? 

Why? Because I don’t think we take postpartum recovery seriously in our country. Women traditionally receive excellent prenatal and obstetric care during delivery, but postpartum care is lacking. 6 Weeks after delivery, women are usually given a pat on the back and told “good job done” and that they can resume sexual activity. What about postpartum rehabilitation? In our country women are left to fend on their own after delivery.

In other countries, such as France, they take postnatal care seriously. Did you know all French women receive free physical therapy after they give birth. I have been told by some of my patients that postpartum physical therapy is “mandatory” in France and they go for about 20 visits focusing on rehabilitating the pelvic floor and abdominal muscles after every baby they deliver. 
In a light hearted article written by Claire Lundberg, “The French Government Wants to Tone My Vagina”, for Slate Magazine, Lundberg discusses the positive experience she had with the French postpartum rehabilitation program called la rééducation périnéale and how she was glad “a medical professional was paying attention to what happened down there.”

What about more physical therapy after one of these surgeries?

Did you know that after having surgery for pelvic organ prolapse most women do not receive pelvic physical therapy?

I recently asked a urogynocologist, who refers patients to my practice, why she did not refer her patients to physical therapy after preforming these types of surgeries. The answer was that she did not think it was necessary, and was not convinced that physical therapy would help the patient recover. 
It is common practice to go for physical therapy treatment after surgery on other body parts, like the shoulder or knee; why isn’t is considered part of the rehabilitation process with pelvic surgeries? 
If surgeons started sending their patients for physical therapy treatment after prolapse surgery; doesn’t it follow logic that it would help them reach better outcomes? Maybe physical therapy treatment could prevent surgical failures? 
(Just in case you didn’t know, you can go directly to a physical therapist without a doctor’s referral in most states.)

More surgery is not the answer. More physical therapy is the key to solving pelvic organ prolapse. 

References:

http://www.usatoday.com/story/news/nation/2013/05/22/common-pelvic-surgery/2325055/

http://www.slate.com/articles/life/family/2012/02/postnatal_care_in_france_vagina_exercises_and_video_games.html

 

Moms Want to Run Again? Read This.

This is a great video by one of my colleagues, Julie Wiebe PT … she teaches ladies how to get that “running grove” back on:

Are you trying to get back into running? Do you have a little problem “down there”, like incontinence or pelvic organ prolapse? Are you a mom and anxious to get your baby body back in shape? Watch this video for tips on how to safely return to running.

Learn how to lean into the hill or down the hill when you run.

If you are a city dweller like me, don’t worry if you use a treadmill, just increase the incline slightly and you will be working out your “Core Muscles”.

“Hip-hop mogul , Sean “Diddy” Combs reveals…he was a bed wetter from drinking too much Koolaid.”

Puff Daddy DiddyBy Marianne Ryan PT, OCS
Clinical Director MRPT Physical Therapy

Learn why “Diddy” Wet His Bed as a Kid. He reveals this to Ellen DeGeneres and he blames it on Koolaid.” (huffingtonpost.com)

“I grew up as a Kool-Aid kid. I never drank water. I used to pour a half a pound of sugar into the Kool-Aid. Besides it having me bouncing off the walls, I used to be a bed wetter…So I went on this quest to stop wetting the bed… when I stopped drinking sugary-chemical filled drinks, like Koolaid, I didn’t wet the bed… it was, like, one of the greatest days of my life.” 

Surprised?

Believe it or not, urinary incontinence can be cured by some very simple steps like avoiding foods and drinks that can act as irritants to your bladder or staying well hydrated.

Consuming foods or drinks that cause the walls of the bladder to become irritated may cause uncontrollable bladder contractions leading to urinary leakage. Some of the beverages to avoid are drinks that have chemicals in it, caffeine, carbonated beverages, alcohol and acidic juices, such as orange juice and cranberry juice. Foods that are best to cut down on are chocolate, tomatoes, spicy foods and fruits high in acid like strawberries, pineapples and grapefruits. More often then not, urine leakage is more related to diet than a full bladder.

Staying well hydrated will keep your urine diluted and decrease the concentration of irritants in your bladder. So don’t skip fluids to prevent leakage. While there’s is no exact formula for how much water you should drink, drink enough to quench your thirst. When you are healthy and hydrated, your bladder will naturally fill and signal that is should be emptied every 2.5 to 3 hours during the day. You may find it helpful to cut back on drinking fluids a few hours before bed for an uninterrupted night of sleep.

There are several other causes of urinary incontinence, such as weak pelvic floor muscles and a good Pelvic Physical Therapist will be able to help you restore those muscles. If you have any questions about our Incontinence Physical Therapy Treatment Program, do not hesitate to call and make an appointment.

On The Radio…Women’s Health

Marianne Radio 1By Marianne Ryan PT, OCS
Clinical Director MRPT Physical Therapy

Earlier this week both Lila Abbate and I were guests on Karen Litzy’s weekly radio show “Healthy, Wealthy and Smart” on the Talking Alternatives network.

We spent about 1 hour discussing our “niche specializations” within Women’s Health Physical Therapy.

You can listen to the interview here 
I discussed physical therapy treatment for Prenatal / Postpartum issues and Lila told us how she uses physical therapy to treat GI / Bowel dysfunctions.

We both had a blast and enjoyed spreading the word on how physical therapists are the “go-to” medical professionals for musculoskeletal problems.
A recording of the show is also available on the Talking Alternatives website and is also available as a Podcast on iTunes.
Click here to listen to the broadcast. Or click here to get the iTunes Podcast

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New Moms Need Physical Therapy: Bet You Didn’t Know That!

Posted by Marianne Ryan PT, OCS
Clinical Director MRPT Physical Therapy

Massage Low Back Pain
Here is an excellent article written by Ginger Garner and published in Modernmom.com:

“Pregnancy and childbirth…is exhausting and at the same time…it is transforming and beautiful…BUT when a mother does not get the physical and emotional support she needs, the effects can be devastating.

Physical Therapy after childbirth can make a women…stand strong, fit …and successfully complete her birthing experience so that she feels…wholly healed.

One of the many fields of specialization in physical therapy is women’s health.

I bet you didn’t know that.

That’s okay. Most doctors don’t either. Doctors are educated very little, if at all, about PT services in medical school.

Here are 4 reasons why new mom’s need physical therapy: 1. Managing Urinary and Fecal Continence, 2. Prevent Scar Tissue Adhesions & Pelvic Pain, 3. Manage Low Back Pain, 4. Wellness for Future Pregnancies and Daily Life

The sad fact is that “most new mothers will never get the Physical Therapy they desperately need after giving birth. ”  To read more of Ginger Garner’s article click here