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Pelvic Floor Weakness is Not a Normal Part of Aging.

By: Kathy Hubbard

When you heard, “I laughed so hard, tears ran down my leg,” you probably laughed, and if you’re like the 71 percent of women over 83, tears ran down your legs. However, today, we will talk about how this is not a normal part of aging. As a matter of fact, 37 percent of women ages 20 to 29 experience urinary incontinence regularly.

Although men experience pelvic floor issues, today, we’re focusing on women. Because of space limitations, we’ll circle around to the guys in another article soon.

At Bonner General Health’s Performance Therapy Services, we are privileged to have two physical therapists who not only treat patients with urinary incontinence but also perform treatment for those who suffer painful intercourse, pre- and post-partum chronic pelvic pain, bowel issues such as diarrhea and constipation, and coccyx pain.

Mary Rogers, PT, MS (physical therapist, Master of Science in health education) and Kristina Gonzales-Rahrig, PT, DPT, CLT (physical therapist, Doctor of Physical Therapy, certified lymphedema therapist) took time to answer some pertinent questions about treating pelvic floor problems.

Before we turn to them, let’s look at the pelvic floor. Mayo Clinic explains that the “pelvic floor is a group of 26 muscles that make up the bottom of the pelvic region. These muscles function together like a hammock across the pelvis and attach from the pubic bone in the front to the tailbone in the back.”

The pelvic floor has four primary functions: to support pelvic organs, including the bladder, uterus, and rectum; to stabilize the pelvis and spine; to assist with sexual function; and to support bowel and bladder control.

“Incontinence is largely due to weakness in the muscles of the pelvic floor and may be caused by weight gain during pregnancy, obesity, excessive coughing from asthma or allergies and jobs involving heavy lifting,” Rogers said.

There are two types of incontinence: stress incontinence and urge incontinence. Stress is the kind that happens when you laugh, and a bit of urine seeps out. “Urge incontinence occurs when your body sends a signal to your brain that you must void immediately, and this signal cannot be suppressed,” she explained.

She added, “Pelvic floor muscle weakness can also lead to a feeling of heaviness in the lower abdomen or pelvic organ prolapse (organs descending through the vagina) later in life.”

It’s critical to get treatment before symptoms worsen and before the only option is surgery. “Pelvic floor PTs are skilled in treating urinary incontinence,” Rogers said. “Like any other muscle in the body, the strength of the pelvic floor muscles are assessed and the patient is instructed in exercises for strengthening. Research shows that muscles can be strengthened at any age!

Gonzales-Rahrig said that “most patients are understandably nervous and anxious when they first see a pelvic floor therapist, but I tell them that I still work on muscles and alignment of bones and joints in the body, except in this case it’s a different part of the body.”

She said that others come to her after they’ve tried every other remedy out there without any improvement, and they think this is their last hope for relief. She also said that most of the patients she sees tell her how life-changing pelvic floor therapy is.

What to do? Ask your primary care provider for a referral. I know, you might think it’s embarrassing to talk about issues “down there,” but get over it. Then call 208-255-3676 for an appointment. This PT is handled at the Ridley Village location.

Just like PT for any other reason, your physical therapist will start with an assessment. This involves answering a lot of questions about your bladder, bowels, pregnancies and delivery, menopause, diet, and sexual health.

“Patient education is a big priority on the first day. Pelvic PTs will also do an internal pelvic floor examination to determine if they are contracting their pelvic floor muscles correctly and strongly or conversely if they need to relax it more. We also assess their hips, low back, SI (sacroiliac) joints, and other muscles and joints of the body depending on our findings,” Gonzales-Rahrig said.

If you are experiencing any of the described pelvic floor issues, wouldn’t it be nice to put them behind you? Make that call.

Kathy Hubbard is a member of the Bonner General Health Foundation Advisory Council. She can be reached at kathyleehubbard@yahoo.com. If there’s a topic you’d like me to tackle, please send me an email. This article was written for publication in the Bonner County Daily Bee on March 6, 2024.

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