Tag: pelvis

Is it Normal to Pee When You Sneeze?

Is it Normal to Pee When You Sneeze?

Posted on by Monica
pee when you sneeze after babt
pee when you cough postpartum

So you had a baby… congrats! Isn’t it amazing what your body was able to do? You grew a child! You literally grew a few tiny cells to a full blown 6, 7, 8… maybe even 10lb sweet baby. How beautiful. But perhaps now you are experiencing some things that aren’t so beautiful? Maybe your friend says something hilarious; or your hay fever has you sneezing; or you cough after taking a sip of water and…oops…a little pee comes out. Yikes. But that’s normal after having a baby, right? FALSE! Peeing when you sneeze, cough or laugh is common, but it is NOT normal.

What is the pelvic floor?

So let’s start with a little anatomy lesson. Your pelvic floor is a group of muscles that hold the bladder and rectum in place. Think of your pelvic floor as a hammock. It lies on the bottom of your core supporting all your internal organs, and perhaps, a growing baby. The pelvic floor is made up of muscles, and therefore it can be stretched and/or strengthened.

Pelvic floor during pregnancy and postpartum

So now let’s think about pregnancy. For months you grow a baby in your uterus that sits on the pelvic floor. And the combined weight of the baby, the placenta, and extra fluid places quiet a bit of extra weight on these pelvic floor muscles. This causes the pelvic floor to stretch out and the muscles that close the urethra (where the pee comes out) to become weak.

What is normal?

As previously mentioned the pelvic floor is a group of muscles that supports our bladder and rectum. When they are strong and functioning properly we are able to contract and relax them in order to control when we go to the bathroom. Normal pelvic floor function means you should be able to run, jump, etc. without unexpected urine leakage.

What is not normal?

Urinary leakage in women (especially postpartum) is common, but not normal. You shouldn’t leak urine just like you shouldn’t need glasses for “normal” function. When we cough, laugh, sneeze, run, or jump there is increased pressure inside the core and excessive stress is placed on the pelvic floor. This can cause an involuntary leakage of urine and is referred to as stress incontinence.

Stress incontinence

Stress incontinence occurs when the muscles and connective tissue that surround the urethra become weak, which is common after pregnancy. When extra stress is placed upon the pelvic floor these muscles are unable to appropriately contract in order to keep the urethra closed. If left untreated the muscles can continue to get weaker making leakage more common.

Aging and weakness

New moms are not the only women to suffer from pelvic floor weakness and stress urinary incontinence. As we age our muscles and connective tissue can also get progressively weak. Again this can lead to unexpected urine leakage during times when the pelvic floor is unable to withstand extra pressure placed upon on it. Other signs of pelvic floor weakness or dysfunction include trouble having a bowl movement, low back pain, and pain with sex.

How can we fix it?

So what can be done if you believe you have pelvic floor problems? Start with talking to your doctor. Every pregnancy is different and every woman is different so you should always speak with the appropriate medical professional regarding your unique case.

Exercise:

Just like with any muscle, the best way to make it function properly is to make it strength and length. And one of the most common exercises for specifically strengthening the pelvic floor is a kegel. A kegel is a contraction of your pelvic floor muscles. Many describe a kegel as stopping the flow of urine while peeing. Personally my favorite cue for performing a kegel is to imagine drinking through a straw with your vagina. Go ahead and laugh but I bet you’re doing it right now.

But pelvic floor is not just about kegels. The body is a chain and the pelvic floor does not function solo. There are many other muscle groups that need to be considered if you are suffering from incontinence (refer to my “Pop- Can” core post). Some of these muscle groups include your core and your pelvic stabilizers.

Physical Therapy:

If you are peeing when you cough, sneeze, laugh etc. the best thing you can do is seek a referral for women’s health physical therapy. Depending on where you live in the U.S. you may need an script (order) from your doctor.

Physical therapists who specialize in the pelvic floor are are able to evaluate and treat your unique symptoms. No two pregnancies and no two women are the exact same. The muscles that are weak or too tight will not be the same for every woman.

Why do women in the U.S. think it is normal?

So why do so many women think it’s normal to pee after having a baby? The answer is because there is a significant lack of knowledge and discussion about pelvic floor function. Did you know in France women are required to go to a pelvic floor therapist at 6 weeks postpartum and each woman has on average 10 pelvic floor therapy appointments? In the U.S. we have one postpartum visit with our OB, and pelvic floor function is not readily discussed. Hopefully, that can change.

What’s next?

This post just scratches the surface about pelvic floor function and dysfunction. And while this might be longest post I have written to date I wanted to try and keep it fairly short and sweet for now. We could dive much deeper into pelvic floor function, treatment, and prevention but I will save that for another day. Feel free to leave a comment or send me a message with any questions you might have about pelvic floor therapy. Let’s open up about pelvic floor function! 

–Monica

Sciatica: A real pain in the butt (what causes it & why)

Sciatica: A real pain in the butt (what causes it & why)

Posted on by Monica

We all know being a mom can be a real pain in the butt. But what about when you actually have pain in your butt? Now that is just not fair! If you are having aching, numbness, or sharp pain from your butt down the back of your leg you may be experiencing sciatica. Sciatica is a word that gets tossed around a lot but what actually is sciatica and why do some women get it?

What actually is sciatica?

Moms with sciatica

Sciatica is an irritation or compression of the sciatic nerve. The sciatic nerve is the largest nerve in the body and starts at the base of your spine, runs through your pelvis/gluteal region and down your leg to innervate most of your lower leg. Sciatica can feel like a burning, aching, or shooting pain and is most often felt only on one leg. It follows the path of the sciatic nerve (through the butt, down the back of the leg and into the foot). Sciatic nerve irritation can cause numbness, weakness, or pins and needles sensation in your leg. Sometimes it can even feel like an electric shock sensation down your leg. All of these symptoms can lead to pain and discomfort with walking, standing or sitting.

Ok, so what causes sciatica?

What is sciatica First, it’s important to note that sciatica is a symptom, not a condition. There is usually some condition in your body that is causing the sciatica to occur. Most often sciatica is caused by a herniated disc or spinal narrowing which can occur from prolonged stress or an acute injury to the lumbar spine. Sciatica can also be caused by tightness of the muscles around the gluteal/pelvis region. One of the most common muscles to irritate the sciatic nerve is the piriformis muscle. The sciatic nerve travels over, through, or under this muscle so adhesions or tightness of the piriformis can result in compression and irritation of the nerve. Thirdly, instability and laxity of the ligaments and muscles of the pelvis can cause certain areas through which the sciatic nerve travels to have excessive pressure and therefore, irritation. This is often the case in pregnant women.

How common is sciatica & who gets it?

Pregnancy sciaticaThose who have physically demanding jobs that involve a lot of bending, lifting, or standing typically tend to put more pressure on their spine which can result in disc herniation or degeneration of the spine. This places them at increased risk of developing sciatica. Similarly, but on the opposite end of the spectrum those who work jobs the involve a lot of desk work and prolonged sitting are also at risk. Most people do not have good posture during prolonged sitting which will irritate your spinal posture muscles and potentially compress your discs in your spine. Furthermore, inactivity and prolonged sitting causes your muscles to become shortened and tight especially around the hips and pelvis.

And as previously mentioned, pregnant women are more susceptible to developing sciatica. A gradually changing posture; the hormone relaxin coursing through the body which causes the ligaments of the pelvis to become unstable; and the increased pressure on the uterus and pelvic muscles creates a perfect storm for sciatic nerve irritation.

How do we fix sciatica?

Treating sciaticaYou should always speak with the appropriate health care provider if you are experiencing prolonged or unusual back or leg pain. But if you are looking to avoid or relieve some of the nagging pain sciatica can bring try out some of these tips to get some relief.

Activity Modification:

If you have a physical job try to sit briefly or stretch to avoid prolonged pressure on the low back or pelvis. Avoid prolonged standing in one position by placing one foot up on a small step or raised surface to reduce pressure on the lumbar spine. If you have a sedentary job make sure to get up and move around several times throughout the day.

Stretch:

Below are some stretches particularly for the gluteal or piriformis muscles; the most common muscles that compress or irritate the sciatic nerve. Learn more about back pain and helpful stretches for low back pain in motherhood here. 

  • Stretch for sciaticaStretch to treat sciaticaChild’s pose – Sit your bottom back towards your heels and stretch your arms forward. Hold for 30 seconds. Repeat x 3

 

 

 

  • Stretch to treat sciaticaSeated piriformis stretch– Cross the affected leg over the thigh of your other leg. Gently press your knee downwards and lean forward over your leg while maintaining a straight low back. Hold for 30 seconds. Repeat x 2

 

 

  • Stretch to treat sciaticaSupine piriformis stretch– Cross the affected leg over the thigh of your other leg. Reach and grab your unaffected leg and bring it towards your chest. Hold for 30 seconds. Repeat x 2. Can also be performed in a seated position on the floor.

Massage:

Massage for sciaticaMassage is another great way to reduce muscle spasm or tightness which may be contributing to sciatic nerve irritation. If you don’t have access to a masseuse (or your husband can’t massage to save his life) you can use a tennis ball to self massage. Simply place the tennis ball under your painful side while sitting; move over the top of the tennis ball using your body weight to press into any tender or painful regions around your hip/buttocks. If you find a particularly tender area hang out there to encourage the muscle to release.

Strengthen:

Exercise for sciaticaI will never be done stressing how important it is to have strong and stable muscles. Stability prevents the body from moving in bad ways that can cause pain and discomfort. You can start with the 6 pelvic stability exercises you should be doing. And check out my next blog post this week for more booty work to keep you movin and groovin with less pain.

What’s next?

Again you should always speak with the appropriate medical professional as no two people or their symptoms are the same. If something does not feel good or seems to make the pain worse, stop. There are many possible contributors to sciatica . Lumbar degeneration, core weakness, muscle imbalances/tightness and excessive pressure on the pelvic muscles are common contributors to sciatica pain. Later this week I will post some more exercises that focus on your glutes to help stabilize your pelvis.  So be sure to come back and check it out.

–Monica 

Exercises to Decrease Pelvic Pain (A Pelvic Reset)

Exercises to Decrease Pelvic Pain (A Pelvic Reset)

Posted on by Monica

Pelvic pain is unfortunately fairly common in women, especially pregnant or recently pregnant women. But pelvic pain does not discriminate. Men and non-pregnant women can also suffer from pain in the pelvis or sacroiliac (S.I.) joint. There are many possible causes for pelvic pain, but S.I. pain in the non pregnant population is often due to a misalignment of the pelvic joint. This can be caused by muscle imbalances, ligamentous laxity (such as during pregnancy), improper positioning and movement patterns, acute injury or ligamentous sprains. Luckily, there is an easy exercise progression you can do at home to try and “reset” your pelvic alignment. Doing these exercises may help decrease your pelvic pain. 

A misalignment of the pelvis is one of the most common musculoskeletal causes of sacroiliac joint (S.I. joint) discomfort. It can be experienced at the front or back of the pelvic joints. Pelvic pain can be very painful and disruptive changing how you walk and move, which can affect more muscles and joints up and down the “chain”. So it is very important to correct a pelvic misalignment to decrease pelvic pain and to prevent further injury.

Exercises to Help Reset Your Pelvis & Decrease Pelvic PainExercises to help pelvic pain

These exercises below use your muscles to help pull your pelvis into a proper alignment. Most involve performing an isometric contraction which means squeezing your muscles without your body parts actually moving. Start with the first exercise and move through each one in the following order.

1. Isometric Hip Adduction: Exercise for pelvic pain

Place your hands on the outside of your knees. Press your knees outwards into your hands. Hold for a count of 6. Repeat 6 times.

2.Isometric Hip Abduction (pillow): Exercise for pelvic pain

Place a pillow between your knees when sitting or laying down with your knees bent. Squeeze your knees into the pillow. Hold for a count of 6 seconds. Repeat 6 times.

3. Isometric Hip Abduction (fist):Exercise for pelvic pain

Place a small ball or your fist between your knees. Again perform in a seated or laying down position. Squeeze the ball (or your fist). Hold for a count of 6. Repeat 6 times. You may hear or feel an audible “pop” or click with this exercise. This is a good thing because it means your bones are going back into alignment.

 

Stretches to Decrease Pelvic Pain

Stretching some of the muscles around your pelvis can also be helpful for reducing pain. Some of the commonly tight muscles are your hip adductors (the muscles on the inside of your thighs). Try these two stretches below for a good adductor stretch:

 

1. Butterfly stretch:

Exercise for Pelvic Pain- Moving Like a mother

Seated place your feet together with your knees flaring out. Hold 30 seconds and perform at least twice

 


2. Laying down butterfly stretch:

Same as above but lay down and perform it. Hold 30 seconds at least twice.

What next for pelvic pain?

The above exercises will aid in realigning your pelvis if you are suffering from misalignment and pelvic pain. There is also a muscle energy technique (MET) that can be used to aid in pulling your pelvis into a proper position but you would need to be appropriately evaluated by a physical therapist to determine the way in which your pelvis is rotated.

But ideally, these exercises will help to decrease your pelvic pain. However, the most important thing you can do to prevent pelvic pain or keep your pelvis from become misaligned again is to strengthen your pelvic stabilizers.

If you are looking for more higher intensity exercise moves to strengthen your inner thigh muscles to aid in pelvic stabilization be sure to try these 8 Moves For Your Inner Thighs. 

Activity modification and an S.I. belt can also aid in decreasing pelvic pain if you are suffering from pelvic instability. You can read much more on causes and treatment for pelvic pain on my post What causes pelvic pain.

If you have pelvic pain that doesn’t go away or you are pregnant you should always consult with the appropriate medical professionals. But give these exercises a try if you feel like your pelvis just needs a pause, a breath, and a reset.

–Monica

Exercises for Pelvic Pain

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What causes pelvic pain

What causes pelvic pain

Posted on by Monica

Pelvic pain is a common occurrence in women, especially women who are or have been pregnant. But it’s not only pregnant women that suffer from this pelvic discomfort. It can also occur in women who haven’t had children and even men. But what causes pelvic pain? Pain felt in the pelvis region is multi-factoral and there are several reasons you may be experiencing discomfort in this area. Lets chat about the who, what, why and when of pelvic pain.

What does pelvic pain feel like:pelvic pain

We usually categorize pain as pelvic pain when it is felt below the belly button and between the hips. Common areas of pain include near the groin, around the low back/ buttocks region, near the pubic bone, and even felt as pain or pressure in our nether regions. Pelvic pain can be felt as a dull ache, pressure, pulling, or sharp sudden pain.

When does pelvic pain occur:why does pelvic pain occur

Pelvic pain in women most often occurs during pregnancy. To think we can lug around a bowling ball for 9 months and it not effect our pelvis is wishful thinking. But women can have pain in their pelvis after pregnancy, even several years later. Pelvic pain occurs when there is extra stress, a misalignment, or some type of muscle imbalance in our pelvic girdle often during or after pregnancy. But it can also occur in non pregnancy related ways from everyday activities that put your pelvis in poor alignment. For example, when men sit on their wallet in their back pocket it can throw their pelvis out of alignment. Surprise, men can have pelvic pain too.

Why does pelvic pain occur

Ah, the million dollar question. Why does pelvic pain occur? There are several causes for pelvic pain related to musculoskeletal imbalances or a misalignment of the pelvis. However, there can also be other medical causes for pain felt around the pelvis and if you have pelvic pain that doesn’t go away you should always consult your doctor. But lets chat about the common muscle and alignment reasons.

Pelvic pain explained:why pelvic pain occurs

Lets have a quick anatomy lesson. The pelvis is composed of two main bones, which you can think of as the “hip bones”. You have a one on the left and one on the right that are joined by the sacrum in the back and joined by your pubic symphysis in the front. Our pelvis is often referred to as the SI joint, or sacroiliac joint. A typical, healthy, pain free pelvis has symmetrical alignment where the two bones line up nicely and each rotate the appropriate amount as you bend over, flex your hip, or generally move about in life. However, sometimes the pelvis can become misaligned where one bone is rotated too far forward or backwards, or one is up too high. This is going to cause pain and pulling of the tissues, muscles, and ligaments that surround your pelvis.

Pregnancy and Pelvic Pain pregnancy and pelvic pain

Pregnancy is also a big contributor to pelvic pain. During pregnancy the hormone relaxin allows your ligaments and muscles to become more lax to allow room for the baby to grow. And as the baby grows it places extra stress and pressure on your pelvis and pelvic floor muscles. All of this together places your pelvis at increased risk for becoming misaligned.

Another cause of pelvic discomfort in pregnancy is pubic symphysis pain. Your two pelvic bones meet together in the middle and form a joint known as the pubic symphysis. It is located right in front of your bladder. I could write a whole additional blog post about pubic symphysis pain but just know that it can become very unstable, irritated, and contribute to pelvic pain during pregnancy.

Pelvic pain can also be related to problems with the muscles of your pelvic floor. Frequently after having a baby our pelvic floor muscles are too tight or too weak. If you feel you are having problems with your pelvic floor you should consult with your doctor and consider a referral for women’s health physical therapy for a complete assessment.

Pelvic pain vs. hip pain vs. back pain

An important fact to remember is the body is a chain. When one body part (or link) is not working properly another link up or down the chain will be effected. And our pelvis is part of our core which is the base of our body. Consequently, pelvic pain or misalignment can also cause pain in our hips and in our lower backs.

Treatment to help pelvic pain

Exercise:

Exercise for pelvic pain

Musculoskeletal imbalances, aka when the muscles surrounding a body part are not working in a balanced manner, is a common contributor to pelvic pain. Tightness of the hip adductors, tightness or weakness of the pelvic floor, weakness of the pelvic stabilizers, and core weakness are usually some of our first suspects when someone has pelvic pain. This can be rectified with strengthening and pelvic stabilization. Check out some quick and easy pelvic stabilization exercises here and basic core stabilization exercises here. Sometime a special muscle energy technique can be used to help “reset” our pelvis. Stay tuned for my next post this week that is all about exercises to help pelvic pain.

SI Belt:

As previously mentioned our pelvis is also referred to as our SI joint. And a very helpful product to provide external stability to our pelvis is an SI belt. An SI belt is useful when the muscles surrounding the pelvis are not yet strong enough and you are experiencing pelvic or back pain due to joint instability. They offer SI belts for both pregnant and non-pregnant people. I wore an SI belt for several weeks while I was pregnant with my son and it provided stability to allow a muscle strain in my lower back to heal.

Position or Activity Modification:

Sometimes pelvic pain is a result of an activity or position we are putting ourselves in everyday. For example activities that require you to stand on one leg (putting on pants, shoes, climbing into bed, etc) can increase your pelvic pain during pregnancy. Instead, try sitting down to put your pants on and off to reduce the stress place on your pelvis. 

wallet causing pelvic pain

As I previously mentioned, men often sit on their wallets which places their pelvis in a asymmetrical position. This will lead to tightness and pain in either their pelvis or low backs. Take note of where and how you are sitting and ensure that you are sitting with good symmetrical alignment in the car, on the couch, or in your desk chair.

So what’s next?

There are many possible contributors to musculoskeletal related pelvic pain. Pregnancy, muscle imbalances, and improper positioning are leading causes of pain. Later this week I will post some quick easy exercises to help “reset” your pelvis as well as stretches to aid in prevention of asymmetrical pulling. So be sure to come back and check it out.

-Monica