Ester Marsh column: Performing physical therapy for the bladder
Yes, there is physical therapy for the bladder!
Whoever knows me understands that I don’t have any trouble talking about any “pink elephants” in the room. One of those subjects is incontinence. I did not have too much trouble with incontinence until my son was born. He was 9 pounds and 4 ounces and face up. They turned him three times with forceps (no anesthesia) and I truly believe that had a lot to do with my incontinence that started shortly after.
As an aerobics instructor, we jump around a lot. I was doing OK until I would do jumping jacks or jump rope with two feet together. What? I was too young for this!
Some myths go with the territory:
• age does not mean you won’t have incontinence
• I birthed children so it’s “normal” to have incontinence afterwards
• incontinence does not just happen to women
Off and on for almost 21 years, I have dealt with some sort of incontinence. I am very open about it. When we were doing jumping jacks in class, I would tell them to do it like I was doing if they didn’t want to pee their pants (more side to side versus out and in). My gynecologist and very dear friend Dr. Jesse Blumenthal always checks up on me about this. One option she mentioned five or six years ago was physical therapy for incontinence. I am all for PT for any body part so I was all for it.
I had my appointment set, but I messed my neck up, so Dr. Roy had to fix that problem first. Somehow, I never rescheduled because like many of us, I was thinking that incontinence is a normal part of childbirth, getting older or being a woman. I was able to continue with a poise pad while jumping around and doing Kegel exercises. Slowly, the problem was getting worse and when Dr. Blumenthal and I talked about incontinence on my past annual checkup in January, physical therapy for incontinence was mentioned again. She said that Novant has an amazing physical therapist specialized in pelvic physical therapy. Her name is Lauren Sides and she practices at the therapy facility off Julian Road. She takes you in a private room so you are not in the main part on one of the big physical therapy tables.
I am so happy I started physical therapy, and it has made a world of difference! My issue was that I have a slight prolapsed bladder, weak floor muscles (that was a shock to me) and a lazy bladder. Because of having incontinence, I would go to the bathroom any chance I had, thinking it would help, but it actually made things worse. Then the Kegels I was doing were performed incorrectly. Lauren explained everything so clearly with visuals and biofeedback that I have made a huge improvement already. To be able to perform jumping jacks for 20 seconds (about 10) and not pee my pants was invigorating and the class heard about it! In time, continuing with a few more sessions and continuing my exercises, my pelvic floor should get stronger and be able to better support my bladder. I have had to learn how to “pelvic brace” when straining such as coughing, lifting or laughing. For homework, I will give you the following: I would highly recommend making your own appointment because your story might be different from mine.
Urge drills — I would go as soon as I felt I thought I needed to pee, but ended up with just a dribble (sound familiar?). Instead of going every 30 minutes, she had me add 15 minutes each time. This one was huge for me, and I saw positive changes very soon. I have been exercising regularly, but my bladder has been “sitting on the couch” the entire time! One example Lauren gave me I truly love. Compare a sensitive, urgent bladder to a kid screaming in a candy store. Give the child the candy (pee at the first sign of urge) and the child will just scream again louder and sooner. Delay urination and allow bladder filling to achieve normal voiding (peeing) intervals of 2-4 hours.
Practice pelvic floor contractions in coordination with breathing. Inhale and pelvic floor drops, exhale and pelvic floor rises. Having a pelvic floor physical therapy specialist help you perform this correctly is essential. I started with five times holding it for five seconds each (a full breath in between to proper relax floor muscles) five times per day. And you know what the great part is? You can do this anywhere — sitting, standing, in bed or in the car. I have moved up to 10 times for 10 seconds each, 10 times per day (including my pelvic bracing while doing jumping jacks). I truly am stoked because I now feel with the correct exercises and making it part of my daily exercise routines, my bladder will finally stop being a couch potato. And men, if you are dealing with the same problem, there is as much help for you with physical therapy as there is for women.
Talk to your doctor and schedule your appointment to fight your incontinence soon.
Ester H. Marsh is health and fitness director of the JF Hurley Family YMCA.
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