| Greetings!
I hope you are enjoying your summer. Did you take my advice and get your body moving? Let me know if you did any of the suggested hikes or activitites. It is such a great time of year to enjoy nature. I am savoring the lettuce, beans and zucchini that we have been harvesting from the garden. In the next month the tomatoes should be ready. Is there anything better than a warm deep red home-grown tomato? My mouth waters just thinking about it!
Have you seen the abundance of commercials on TV for women who "gotta go" or have "faulty plumbing"? It's not surprising there are so many commercials since urinary incontinence (UI) is such a common problem. Unfortunately, many women (and their providers) may think that drugs are the only answer. The commercials make it look like drugs are a panacea but there are a number of different treatment approaches to take. From an integrative perspective, it is always best to try to get to the root of the problem whenever possible. That's why in this month's newsletter, Margaret Yen-Chuang Matthews, MPT, a physical therapist at UCSF will discuss physical therapy as a treatment option for urinary incontinence.
Sincerely,
Priscilla Abercrombie, RN, NP, PhD
Women's Health & Healing
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Urinary Incontinence:
Physical Therapy Can Help
The involuntary loss of urine called urinary incontinence (UI) is experienced by millions of women. UI can be associated with activities such as laughing, coughing or running. This is called stress UI. Other women experience UI because they have the urge to urinate but they can't hold it. This is called urge UI. Some women have both types of symptoms and this is called mixed UI. Symptom severity can range from an occasional dribble of urine to complete emptying of the bladder. Women experience UI at least twice as often as men probably because of the way their urinary tract is structured and how it is influenced by hormones and childbearing.
There are many misconceptions about UI. Some women believe that they are the only ones living with these symptoms or that leaking urine is a normal part of aging. Many women are embarrassed about their symptoms so they are reluctant to talk about it with their health care providers. In fact, many women live with UI for years before asking for help.
Another misconception is that surgery, diapers/pads, or medications are the only treatment options. The truth is there are many different treatments available. Most women find improvement in their symptoms without surgery.
Incontinence occurs because of poorly functioning pelvic floor muscles and nerves. The muscles may be too weak to provide adequate support for pelvic organs. Weak, strained, or overly tight pelvic floor muscles may lack the strength for continence and bladder control. Unfortunately, 40% of patients are unable to perform a proper pelvic floor muscle contraction with verbal instructions alone (Bump 1991) so they need a physical therapist to help them. Bladder symptoms frequently improve with proper instruction and performance of strengthening activities (like Kegel exercises) and re-education of pelvic floor muscles. Patients with UI also need significant education in bladder habits and activity modification. For instance, a woman may be asked to keep a bladder diary and learn to retrain her bladder so that she doesn't go to the bathroom as often. There are many other interventions that physical therapists can use such as bio-feedback, electrical stimulation, vaginal weight, supportive devices or manual work to help lessen or eliminate UI.
When to consider seeing a physical therapist:
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Loss of urine with cough, sneeze or exertion
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Inability to make it to the toilet before leaking after feeling the urge to urinate
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Frequent trips to the bathroom during the day or night
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Adjusting daily activities or social outings because of the problem
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Other weaknesses or pain including low back, abdominals, and/or hips
Who are women's health physical therapists?
Women's health physical therapists (PTs) are specialists who have advanced training and experience in assessing and treating specialized conditions including pelvic pain, pain and dysfunction in pregnancy, incontinence, urinary urgency/frequency, etc. This training is obtained through post-graduate continuing education in these specific areas. PTs are unique in their ability to analyze movement and understand principles of training and muscle physiology. They are the experts in addressing movement impairments and provide system-level neuromuscular retraining.
Margaret Yen-Chuang Matthews, MPT is a women's health and orthopedic physical therapist working at UCSF Medical Center.
Materials sourced from APTA Women's Health Section.
Resources
The Mayo Clinic has more information about Kegel exercises that strengthen the pelvic floor muscles. To find a PT in your area go to the American Physical Therapy Association website and look for a PT that specializes in women's health or women's incontinence. See the video on the UCSF Women's Continence Center website and more information about what they have to offer.
Thany thanks to Margaret for this helpful information! |
WHH believes that women want to receive health care that is always healing oriented and engages the body's natural and innate ability to heal itself whenever possible.
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| WHH News | |
Is it time for your annual gyn exam? I have appointments available at the UCSF Osher Center for Integrative Medicine. We take insurance. We also have terrific TCM providers, massage therapists, and a yoga instructor. Give us a call at 415-353-7700.
We are recruiting for our dysmenorrhea study. Women ages 18-25 with menstrual cramps who are interested in receiving an injection of Vitamin K into an acupuncture site should call Steff at 415-353-7356. Help us recruit- pass this information on to the young women in your lives! |
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