URGE URINARY INCONTINENCE (Otherwise known as “The gotta go’s, oops I went”)

• Frequent strong, sudden urge to urinate
• Regularly going to the bathroom 8 or more times in a 24 hour period
• Getting up 2 or more times during the night to go to the bathroom
• Leaking all of a sudden for no good reason
• Knowing where all the good bathrooms in town are and how long it takes to get there, because you never know when you will have to go “just in case”
• Limiting the amount of fluid you drink so there is less urine to leak
• Once you pull in the driveway or put the key in the lock it is a mad dash to get to the bathroom

Even if you do not leak in these situations, but you still experience them, you may have overactive bladder.

STRESS URINARY INCONTINENCE (Otherwise known as “pee pee when you hee hee”)

• Losing urine with physical activities such as lifting or exercising
• Losing urine when you cough, laugh, or sneeze
• Losing urine when you stand up or sit down

MIXED INCONTINENCE

• Experiencing most or all of the symptoms of overactive bladder and stress urinary incontinence

“I have a 7 month old baby whom I breast-feed and also carry frequently on one side or the other throughout the day. By nighttime, I have pain and burning in my mid-back area. What can I do?”

The scenario described above is very common among new mothers. There are several possible reasons for the symptoms. The position of breast-feeding tends to place the mother in a slumped forward posture with the added weight of holding the baby. To maintain the normal curve of your spine while stabilizing your hips make sure your feet are supported. To avoid a slumped posture, use a pillow under the baby to support your baby’s weight and under your elbows and forearms during nursing. Placing another pillow behind your back can assist in maintaining good posture so that breast-feeding can be an enjoyable experience, not a painful one.

Carrying and lifting a baby frequently throughout the day can cause burning and aching in the mid to low back area. When a baby is held on one side, it forces the hip to hike upward on that side and the spine to slump forward and sideways. This causes the spine to be held in an awkward strained position. When the weight of the body leans away from the vertical position, the muscles must work overtime to hold the body up and the joints are loaded in an imbalanced way. Obviously, a mother will need to lift and hold her baby frequently, but there are techniques that can minimize the stress placed on the back.

• The spine functions best when it is kept in good postural alignment (vertical).

• When holding the baby, maintain a balanced posture by keeping your abdominals tightened.

• Even while indoors, wear comfortable shoes with good arch supports to improve shock absorption through the spine and promote alignment.

• Learn and practice correct lifting techniques, like bending from your knees, not your back, when picking up the baby.

• If standing for a prolonged period of time in one position, prop one foot up on a footstool to help maintain a proper curve of the spine.

• Keeping your body fit with a walking or exercise program while help your body withstand the strain of carrying your baby.

If your pain persists you should contact your physical therapist for help.

Pelvic Floor Muscle Location

Exercises that strengthen the pelvic floor muscles can help hold urine inside the bladder, preventing leakage. These are commonly called “Kegel” or pelvic floor muscle exercises, named after the doctor who developed them. Personally, I like to refer to them as pelvic floor muscle contractions.

There are several ways to find your pelvic floor muscle. When contracting the muscle, women will feel a slight pulling in the rectum and vagina. Men will feel a pulling in of the anus and movement of the penis. Every person is unique, and different techniques work for different people. Below I have outlined 2 techniques to help you find and isolate those muscles.

Technique #1

Everyone, at one time or another, has been in a crowded room and felt as if he or she were going to pass gas or “wind.” Imagine that this is happening to you. Most of us will try to squeeze the muscles of our anus to prevent the passing of gas. These muscles being squeezed are your pelvic floor muscles. If you feel a “pulling” sensation at the anus, you are using the right muscles.

Technique #2

For women, lie down and insert a finger into your vagina. Try to squeeze around your finger with your vaginal muscles. You should be able to feel the sensation in your vagina, and you may also be able to feel the pressure on your finger. If you can, then you are using the right muscles. If you cannot detect any movement with one finger, try two fingers.

It takes some practice to get used to contracting the muscles, so don’t give up on it.

An old man walked up a shore littered with thousands of starfish, beached and dying after a storm. A young man was picking them up and flinging them back into the ocean. “Why do you bother?” the old man scoffed. “You’re not saving enough to make a difference.” The young man picked up another starfish and sent it spinning back to the water. “Made a difference to that one,” he said.

YOU MAKE A DIFFERENCE, EVERY DAY.

Adolescence is a great time in life to develop good exercise habits. When a girl’s body begins producing the hormone estrogen, which helps trigger sexual development, she may notice an increase in body fat. Getting exercise in 5-7 days of the week with an appropriate diet stocked full of fruits and vegetables is the healthy way for adolescent girls to maintain their weight.

Participation in athletics is a great way for adolescent girls to build self-esteem and stay healthy. Being a female athlete brings with it some specific health concerns. Athletes who train every day with rigorous regimens can lead to amenorrhea (cessation of menstruation). Also, because of their wider hips, females are often at a greater risk of developing knee injuries.

A physical therapist can be a helpful professional during this time of life. We can guide you in setting up an appropriate exercise program and can help if an injury develops.

INTRODUCTION:

Women are unique creatures. At our most fundamental level women’s bodies are structured to give birth and supply early nutrition to the next generation. Yet, whether or not we decide to have children, our reproductive system affects our body throughout our lifetime. Now I am not giving you free reign to blame hormones on everything, but they do play a huge roll!

We will be talking about various women’s health conditions from adolescence, menstrual pains, female athletes, childbearing years, and menopause. Please feel free to send me suggestions of information you are interested in learning about.

• Deep Breathing: Several times a day focus on your breathing. Take deep breaths in through your nose feeling your belly bulge out a little. Then exhale through your mouth and feel the belly relax back to its normal position.

These next suggestions are best performed in a quiet room with low lighting. Turn off the television, turn of the cell phone. Put on some of your favorite soothing music and light some candles. Don’t worry it is okay to pamper yourself.

• Close your eyes and take a deep breath.
• Feel yourself sinking into the bed or chair and letting your hands and legs get “heavy”.
• Think about blood flowing into your arms like molasses and warming them or think about an image of you lying in the warm sun.
• Daydream about places that have been peaceful for you: church, a meadow, lakes, mountains, beaches, etc.

Hopefully these suggestions can help you recharge a little during this hectic time of year. Happy holidays to all!

The cookie got me thinking about the importance of bone health as we age. There are several easy steps that we can do to help boost our bone health!

• Try to eat 3 servings of calcium a day. (Milk, yogurt, cheese, and broccoli are all good sources of calcium)
• Get enough Vitamin D. Your body creates Vitamin D when it is exposed to sunlight, but you can also get it from dairy products, fish, and eggs.
• Work out your bones. Try to get 30 minutes of moderate activity in on most days of the week. Walking or jogging is a great way to build up bone strength in the legs and spine. Pushups help build up arm bone strength.
• Modify your lifestyle. Moderate caffeine and alcohol use and eliminating smoking can improve bone health.

So I am going to take my own advice right now and put down my coffee and get a little exercise in before my next patient comes in!

We had a good turnout at our first health fair appearance. We had fun raffling off two Cardinals' tickets!

Our most recent booth was at the Des Peres Lodge Health Fair on 11/7/09.

We look forward to getting out and talking to the public more at future health fairs. Educating women how they can help themselves is truly a passion of mine. If you hear of any upcoming fairs or health events that you think we should participate in, please let me know!

Although I would like to take credit for this article, I cannot. It was written by Michele Wojciechowski and published in the Noveber 2009 issue of PT in Motion. I have included an excerpt of the article below and the link to get to the article online. I hope that you find the information helpful.

In the past, women’s health was most often thought of in terms of gynecological care. Even today, some physical therapists, hearing the words “women’s health,” first think of “pelvic floor dysfunction.” But that’s only one reason that women of all ages need and seek treatment.

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