Bladder issues such as urge incontinence (leaking when you have a strong urge to urinate), stress incontinence (leaking when extra pressure is placed on the bladder when coughing, sneezing, laughing, or straining), pelvic pain, constipation or bowel incontinence, and tailbone pain can be treated through pelvic floor physical therapy. Mixed incontinence is both stress and urge incontinence. It is very common for a person to have both.
Dr. Malerie Kurt, PT, DPT, is one of the two therapists at St. Clare Hospital that is trained in working with individuals with pelvic floor dysfunction.
"I think the best part about working with patients who struggle with controlling their bladder, is that most start getting better after just a couple visits," Kurt said.
To find the right treatment, Kurt highly recommends talking with your doctor to figure out what might be contributing to your symptoms. Not all incontinence issues are the same and there are usually multiple factors that can affect the bowel and bladder, including diabetes, obesity, medication interactions, and much more. Depending on your symptoms, your doctor can order pelvic health PT in addition to medication or referral to a specialist such as a gynecologist or urologist.
Dr. Georgia Corner, PT, DPT said she thinks it can be “amazingly helpful and totally worth going to an unexpected place to get some great benefit."
"Lots of people come in, sort of embarrassed or unsure of what to expect from pelvic floor therapy. I always tell them that the more details they can give me, the better I'll be able to help them. And don't worry, I can tell you that I've heard it all,” Kurt said.
What to expect on the first visit
Both Kurt and Corner said they spend a lot of time asking questions, listening, and educating patients about incontinence. Patients should prepare to talk about some personal details such as bladder habits, accidents, pain with specific activities such as exercise or intimacy, or anything that you struggle with.
Next steps would include basic examinations such as range of motion in the lumbar spine, flexibility of your hips and legs, and core strength testing. After those examinations, providers conduct an external and internal exam that lets the PT determine what muscles are weak or overactive in the pelvic floor. This is not required, however, it helps guide the plan of care. To put into context, physical therapists view pelvic floor PT as regular physical therapy, but all the muscles are inside a cave. After the exam we move right into treating what is found, so expect some homework from the first session.
Approximately 80 percent of people with urinary incontinence can improve their symptoms or be cured through a collaborative approach with pelvic health PTs, their primary care provider, and specialists like gynecologists and urologists.
