Ehlers-Danlos Syndrome and Bladder Problems. What’s Going On?

Author| Dr. Maureen O’Keefe, DPT pelvic health, back pain, neck pain and TMJ disorder specialist physical therapist.  Experienced with treating people who have Ehlers-Danlos Syndrome & bladder problems or pelvic floor dysfunction.

Can Ehlers-Danlos Syndrome Contribute to Bladder Problems or Pelvic Floor Dysfunction?

If you have Ehlers-Danlos Syndrome and also are experiencing some bladder problems and pelvic floor dysfunction symptoms, you may be wondering if the two issues are associated.  As an experienced pelvic health physical therapist for 25 years, I have treated people who have EDS and also have bladder problems and pelvic floor dysfunction, prolapse, pelvic congestion syndrome, bladder control problems, lower back and neck pain and hip problems (such as hip labral tears, hip pain, gluteal tendinopathy).  There has been research, that we will show here, that people who have Ehlers-Danlos Syndrome experience higher rates of urinary problems and pelvic pain.  Fortunately, our physical therapists specialize in helping people who have EDS to gain urinary control and reduce back, hip and pelvic pain.  If you have Ehlers-Danlos Syndrome and are experiencing bladder problems or pain, seeing a highly qualified pelvic physical therapist can help restore bladder function and reduce pain.  We provide treatment that is customized to your needs and abilities and is safe and effective for people who have EDS.  For more information about our in-person physical therapy at Purple Mountain PT in Grand Rapids, Michigan or remote consultations, call 616-516-4334 to speak with one of our staff members or contact us here. 

All of our licensed physical therapists here at Purple Mountain PT have experience helping people who have Ehlers-Danlos Syndrome and also have pelvic or lower back pain, bladder problems, neck or TMJ pain.

Because bladder problems and pelvic pain are common with individuals who have Ehlers-Danlos Syndrome, our pelvic PTs have training and experience in designing effective treatment programs to help optimize bladder function and reduce pelvic, back, neck, jaw and hip pains that are common with the hypermobility and other connective tissue issues with people with EDS.  Below I detail some of the bladder and pelvic floor issues that research has found for people who have EDS.  I also will review some of the methods that our licensed physical therapists use.  If you have Ehlers-Danlos Syndrome and are experiencing pelvic, back, hip, neck or TMJ issues and would like more information about our in-person treatment or remote consultations, call 616-516-4334 to speak with one of our staff members or contact us here. 

Do you feel like with your Ehlers-Danlos Syndrome you are the only one dealing with bladder problems?  You are not alone!  EDS can contribute to pelvic floor dysfunction and bladder problems. 

We know that people with Ehlers-Danlos Syndrome have been found to have many bladder and pelvic symptoms, including chronic pelvic pain, bladder control problems and pelvic floor dysfunction.

Research published this year (2022) asked more than 1300 people who have EDS if they experience pelvic prolapse, pain, bladder problems or sexual issues.  The respondents reported the following genitourinary problems:

  • 60% report stress urinary incontinence

  • 54% urinary urgency incontinence

  • 24% fecal incontinence

  • 21% pelvic organ prolapse.

  • 71% pelvic pain, especially dysmenorrhea, back pain and muscle and joint pain.

  • Nearly 50% have sexual dysfunction with 36% reporting painful sex (dyspareunia)

Kciuk O, Li Q, Huszti E, McDermott CD. Pelvic floor symptoms in cisgender women with Ehlers-Danlos syndrome: an international survey study. Int Urogynecol J. 2022 Jun 25. doi: 10.1007/s00192-022-05273-8. Epub ahead of print. PMID: 35751670.

Our licensed physical therapists treat all of the bladder problems, prolapse and sexual-related difficulties noted in this Ehlers-Danlos Syndrome study and many others, actually.  

We are fully experienced in the specialty fields of pelvic health (for men, women and children) and TMJ disorder physical therapy (also women, men & children).  Our PTs are also experienced orthopedic physical therapists who have treated every “common” ortho condition you can imagine anywhere in the body, including the feet, knees, shoulders, elbows.  When a person who has EDS comes to us for treatment for their pelvic condition, back, neck or jaw, we include treatment to these other areas, if needed, to help your primary issues. If you are experiencing pelvic, back, hip, neck or TMJ issues and would like more information about the in-person treatment or remote consultations, call 616-516-4334 to speak with one of our staff members or contact us here. 

In addition to focused pelvic treatment that may include manual therapy & exercises to the abdomen, pelvis, low back and hips, patients who have EDS benefit from comprehensive, whole-body treatment.

By addressing posture, overall strength, movement patterns, muscle imbalances, stability, balance, pelvic floor dysfunction, SI joint alignment and other things, we customize a treatment plan for each patient who has Ehlers-Danlos Syndrome.  With Ehlers-Danlos Syndrome, your movement patterns and weakness contribute to incontinence, pelvic pain, overactive bladder, prolapse or other pelvic symptoms;  it is our hope to personalize the treatment for you to get you functioning as well as possible, within the context of your EDS.  Our goal is to address the many contributions to your pain, prolapse, pelvic floor dysfunction, incontinence or other issues so you can function at a higher level, experience better bladder function and learn how to protect your muscles, pelvic floor, pelvic organs and joints in the process.  If you have questions about our physical therapy for pelvic floor dysfunction, Ehlers-Danlos Syndrome or other conditions, call us at 616-516-4334 to speak with a knowledgeable staff member or submit your questions here. 

Many of our patients have already tried other therapies, medical interventions, alternative treatments or personal efforts and still struggle with bladder issues or pelvic pain.  Because we specialize in helping people who have Ehlers-Danlos Syndrome and bladder or pain problems, we are able to provide care that is effective, comprehensive and different than other approaches.

It is our goal to get you relief from pain and bothersome bladder problems by providing comprehensive physical therapy treatment that differs from what you have tried.  Our treatment plan for people who have Ehlers-Danlos related bladder and pain problems includes a variety of whole body interventions that are customized to each person’s needs.  To effectively address pelvic floor dysfunction, pelvic or back pain or bladder problems, we partner with you to create a treatment plan that includes manual therapy, corrective exercise, postural training, body mechanics instruction, bladder control therapies, balance exercises, pelvic floor exercises or any other methods you may need.  For individuals who have Ehlers-Danlos Syndrome we often find a high amount of muscular trigger points causing pain.  Our manual therapy techniques or dry needling can be effective approaches to helping ease trigger points and their pain.

Our pelvic physical therapy program for people who have Ehlers-Danlos Syndrome takes into consideration the special accommodations or needs that a person who has EDS may require in a physical therapy program.

We provide postural support and use methods to ensure your joints are not strained during therapy.  Our PTs also recognize that you may experience more fatigue with exercise and are able to create movement retraining programs that are better tolerated for your body.  Some of our patients who have Ehlers-Danlos Syndrome also have POTS (positional orthostatic tachycardia syndrome) and our PTs will modify and customize your treatment program to a level that your orthostatic intolerance can tolerate.  If you have Ehlers-Danlos Syndrome and are looking for a solution to your pelvic condition and would like to work with a physical therapist who is knowledgeable and experienced both with working with people who have EDS and who have pelvic floor dysfunction (bladder, prolapse, pain, fecal issues), we offer in-person treatment or remote consultations.  Call 616-516-4334 to speak with one of our staff members or contact us here and get your questions answered.

71% of people who have Ehlers-Danlos Syndrome reported pelvic pain

This study specifically found a high rate of back pain, joint pain, muscle pain and menstrual cramps for people who have Ehlers-Danlos Syndrome.  Chronic pelvic pain is one thing that our PTs specialize in treating, including in people with hypermobility, pelvic floor laxity, pelvic organ prolapse and chronic back and hip pain.  We treat all of the pain conditions mentioned in the research and many others, such as endometriosis related pain, persistent genital arousal disorder, chronic SIJ pain, tailbone pain, Pudendal neuralgia, vaginismus, vulvodynia, chronic c-section scar pain and others.  For some patients the pain is related to pelvic organ prolapse, which is also common amongst people who have Ehlers-Danlos.  Our treatment is designed to improve your pain, prolapse, pelvic floor muscular support, posture and other issues. To ask us a question about our physical therapy for pelvic floor dysfunction, Ehlers-Danlos Syndrome or other conditions, call us at 616-516-4334 to speak with a knowledgeable staff member or submit your questions here.

Common areas of pain that we treat for people who have Ehlers-Danlos Syndrome include chronic low back pain, chronic pelvic pain, SI joint pain, tailbone pain, hip pain, neck and TMJ pain. 

The spine, hips and pelvis undergo tremendous forces with daily activities.  For individuals who have Ehlers-Danlos Syndrome there is often excess strain occurring through these joints, nerves, connective tissue and muscles.   By treating your whole body, reducing muscular trigger points, enhancing deep core muscle stabilization and pelvic floor muscle function, optimizing your postural alignment to the best of your ability and retraining movement patters, our physical therapists develop treatment plans for individuals who have EDS that can reduce your pain and enhance your bladder and bowel function.  If you are interested in speaking with one of our knowledgeable staff members about our physical therapy for pelvic floor dysfunction, Ehlers-Danlos Syndrome or other conditions, call us at 616-516-4334 to speak with a knowledgeable staff member or submit your questions here.

Treatment may be directed to your head, TM joint (jaw), neck, rib cage, shoulders, the low back, hips, knees or feet.

Bladder problems and pain problems need treatment that goes well beyond simply treating the pelvic floor muscles.  To best improve the incontinence, urgency and frequency or pelvic pain that a person who has EDS is experiencing, we must include whole body treatment.  We use stability exercises and hands-on manual therapy to retrain your core muscles, including the pelvic floor muscles (that attach to the coccyx and influence tailbone, SIJ and lower back pain).  Often the SI joint is not aligned or functioning properly for our patients who have Ehlers-Danlos Syndrome; this SIJ dysfunction can contribute to bladder problems, including incontinence and overactive bladder (urinary frequency and urgency), which is why we always check and treat the SI joint for all of our patients who have EDS.   To ask us a question about our physical therapy for pelvic floor dysfunction, Ehlers-Danlos Syndrome or other conditions, call us at 616-516-4334 to speak with a knowledgeable staff member or submit your questions here.

For our patients with Ehlers-Danlos who have chronic pelvic pain, we have found benefit from a combined manual therapy approach with stabilization, strengthening and movement-based retraining.   

By combining therapeutic hands-on treatments (to your neck, back, abdomen, hips, thighs and other areas with muscle guarding and myofascial pain) with corrective therapeutic exercise care, we are able to help you alleviate your pelvic, back and other pains.  Because pelvic floor dysfunction is a special area of focus for us, we include treatment to the pelvic floor muscles, which has typically been overlooked by other treatment methods.  People who have back pain, hip pain, tailbone pain or SIJ pain also have pelvic floor dysfunction.  Research supports that people who have EDS typically also have weakness.  If someone has pelvic pain, we need to improve strength and also need to reduce trigger points, muscle guarding and imbalanced or hypermobile joints.  We do this with specific corrective exercises and hands-on manual therapy, adapted according to your tolerance if you have POTS.  The whole-body, comprehensive care we provide to pelvic pain patients who have EDS offers you a path forward.  Our PTs pledge to provide you personalized care that meets your needs and is customized to our findings for you.  If you have questions about our physical therapy for pelvic floor dysfunction, Ehlers-Danlos Syndrome or other conditions, call us at 616-516-4334 to speak with a knowledgeable staff member or if interested in scheduling an appointment, you can contact us here.  

60% of the people who have EDS reported stress urinary incontinence, a leakage of urine problem that benefits from pelvic PT.

Improving stress incontinence, which is the type of leakage that occurs when you laugh, cough or sneeze, can be frustrating, without the support of a pelvic PT who specializes in this. Many patients come to us and have tried solving this problem on their own, without success.  People who have Ehlers-Danlos Syndrome, hypermobility type, benefit from the personalized training and focus from our licensed physical therapists to learn how to more effectively control their bladder, stabilize their movements and manage the intra-abdominal pressure that is generated with their daily movements and exercises.   If you have Ehlers-Danlos Syndrome and are experiencing pelvic issues such as SIJ pain, lower back pain, pelvic pain, pelvic organ prolapse, urinary incontinence, frequency or other bladder issues, our PTs can help you.  If you are like many of our patients, you are tired of dealing with these problems and looking for a solution.  You have found a place that is devoted to helping people just like you.  To get your questions answered or speak with one of our knowledgeable staff,   call us at 616-516-4334 to speak with a knowledgeable staff member or contact us here.

When wondering if Ehlers-Danlos can cause bladder problems and pelvic floor dysfunction, 60% stress incontinence and 54% urinary urgency incontinence rates are higher than typical and indicate there can be an EDS component contributing to bladder problems.  Fortunately, physical therapy helps this.

Our PTs will work with you to identify what is going on with your bladder.  Just because you have EDS does not mean you are stuck with bladder control issues.  Effective, wholistic pelvic physical therapy, as described here, is helpful to improve bladder function.  Your problem may involve a number of issues (incontinence, nocturia, overactive bladder, pain, urge incontinence, retention, poor stream, etc.).   We specialize in helping people restore functional bladder problems of all types.  Each type of bladder problem needs different treatment methods and we will give you what your bladder and body need, addressing your EDS and working to improve bladder function, pelvic floor dysfunction, core muscle deficiencies, posture or anything else.  Because EDS involves a defect in the collagen proteins that provide strength and flexibility to your connective tissues, we take this in to consideration when designing a treatment program for you.  If you have a hypermobile urethra or bladder, our PTs provide you natural treatments and options to support this hypermobility so that you are less likely to experience stress incontinence.  If you have questions about our physical therapy for pelvic floor dysfunction, Ehlers-Danlos Syndrome or other conditions, call us at 616-516-4334 to speak with a knowledgeable staff member or submit your questions here. 

Our PTs work one-on-one with you, never leaving you to exercise on your own.  We continually are instructing you and coaching you towards improved engagement of the necessary deep core and postural muscles with the pelvic floor to control urine better. 

You can expect treatment that may be exercise based with some hands-on treatments.  Patients come to us with many questions and a deep desire to solve their problem.  If this sounds like you, please call us at 616-516-4334 to speak with one of our knowledgeable staff members and get your questions answered, or submit them here.

Fortunately, we know that pelvic floor physical therapy can alleviate incontinence, painful sex, prolapse symptoms and overall pain.

Because there is a strong amount of bladder problems, such as incontinence or urgency and frequency, with pelvic floor dysfunction in people who have Ehlers-Danlos Syndrome, our PTs are experienced in seeing these problems and helping you improve.

We treat all of our patients, including those who have Ehlers-Danlos Syndrome,  with one-on-one, private appointments that include pelvic floor muscle retraining, strengthening of your core, postural correction and gentle hands-on manual therapy.  We teach you what exercises to do at home, with very specific instructions for how to perform them safely. We take into consideration the unique needs of people who have EDS and partner with you to ensure your therapy is meeting your expectations.  Physical therapy can improve bladder function, including issues such as incontinence, overactive bladder or incomplete emptying.  At Purple Mountain PT, this is our specialization and our experienced physical therapists are ready to help you.  We offer in-person or remote consultations, for those who qualify.  Call 616-516-4334 to talk to one of our staff members or contact us here. 

54% of the people in the EDS study reported urinary urge incontinence

Our clinical experience indicates that some people who have EDS experience the pelvic floor muscles going into high tone and stiffness to compensate for hypermobility.  This extra activity of the pelvic floor muscles can cause the bladder to perceive that you need to urinate and, over time, urinary urgency, frequency or urge incontinence can develop.  Our physical therapy program to help this problem is comprehensive and effective.  If you have questions about our physical therapy for pelvic floor dysfunction, Ehlers-Danlos Syndrome or other conditions, call us at 616-516-4334 to speak with a knowledgeable staff member or contact us here.

This 54% rate of urge urinary incontinence for people who have Ehlers-Danlos Syndrome is much higher than the general population, where published rates range from approximately 7-12% of people.

Our PTs love to help urinary urgency, frequency and urge incontinence.  Often people who have this condition also are getting up at night to urinate, which causes sleep disruptions.  Our treatments for this include a variety of methods to retrain your bladder, so it can calm down, fill up and store urine without giving you urgency and urge incontinence.  The treatment for this is largely hands-on care, like everything else we do it is whole-body treatment.  We will assess your EDS and determine if you have hypermobility, postural issues or movement patterns that are contributing to your bladder frequency and urgency and urge incontinence and include care for this, as well.  We offer in-person or remote consultations, for those who qualify.  Call 616-516-4334 to talk to one of our staff members or contact us here. 

Why pelvic physical therapy is a safe, natural treatment for your bladder problems, pelvic pain and pelvic floor dysfunction.

Looking at the rates of genitourinary symptoms in people who have Ehlers-Danlos Syndrome can be discouraging, especially if you are reading this article and find yourself one of the many people who have these symptoms.  You are not stuck with these problems just because you have EDS.  We can improve your muscular control, joint stability, strength, postural alignment and other factors that cause bladder problems and pelvic floor dysfunction.  Physical therapy has always been a natural option for recovery and offers a number of benefits.  If you are interested in receiving support from Purple Mountain Physical Therapy, our licensed physical therapists specialize in helping adults and children, including people who have Ehlers-Danlos Syndrome.  Our focus areas include pelvic health conditions, spine (neck or back), chronic pelvic pain or TMJ disorders. We offer in-person or remote consultations, for those who qualify.  Call 616-516-4334 to talk to one of our staff members or contact us here. 

If I have Ehlers-Danlos, why pelvic floor physical therapy can help you, including bladder issues. 

We know that Ehlers-Danlos can contribute to you experiencing a number of bladder problems, including leakage or urgency and frequency.  When these problems have been ongoing, the pelvic floor muscles persist in their dysfunction.  Pelvic PT is here to help.  

  • Unlike surgery or pharmaceuticals, our physical therapists work with you using safe, natural and effective treatments that enhance your function and give you some control over your body.
  • Whole-body treatment methods are can benefit a person who has hypermobility, weakness, postural misalignments, improper breathing patterns and more.
  • Bladder control for individuals with Ehlers-Danlos may involve stress incontinence, urinary urgency and frequency, incomplete emptying, recurrent urinary tract infections or other issues (constant urge, bladder pain, for example). We have treatment programs to help each of these bladder problems.  These are adapted and customized according to each person’s needs, tolerance and findings, including if you have EDS.
  • Our physical therapists help bring clarity, education on optimal bladder habits and methods to keep your bladder and pelvic floor happy and healthy. Patients tell us that PT has given them hope and helped them function at a higher level again.   Often people who have EDS feel at a loss for how to change their bladder problems, pelvic organ prolapse or pelvic floor dysfunction.  Our licensed physical therapists create a focused, pragmatic and effective treatment plan for you.

Our physical therapists help people who have Ehlers-Danlos Syndrome, pelvic floor dysfunction and bladder problems.

Our goal for individuals who come to us and have EDS, bladder problems, chronic pelvic pain or TMJ pain is to provide you safe, effective, whole body physical therapy treatment to reduce pain, improve your quality of life and optimize the bladder’s function. This includes the bladder’s ability to fill up, store urine without leaking and effectively contract to freely empty urine.  One important aspect of our treatment model is that we provide one-on-one treatments, up to 55 minutes each visit, with your doctor of physical therapy.  This allows you to establish a trusted relationship with your provider and to advance your program each week.  We offer in-person or remote consultations, for those who qualify.  Call 616-516-4334 to talk to one of our staff members or contact us here. 

Because Bladder Problems and Pelvic Floor dysfunction are higher for individuals who have Ehlers-Danlos Syndrome, we believe that pelvic PT should be the standard of care for you.  In an ideal world, the medical community would routinely recommend physical therapy for bladder and pelvic floor dysfunction for people who have Ehlers-Danlos Syndrome.

Many people find out about our physical therapy on their own.  Some people google and find us, other people have friends and family tell them about us, others find us on Instagram (@purplemountainpt) or Facebook. Even when patients are referred to pelvic physical therapy, the research has found a lot of you choose not to go.  We get it.  We understand you might be scared or anxious to go to pelvic PT.  Our physical therapists offer trauma-informed and compassionate care and we will work with you to devise a plan together.  Patients tell us they wish they had found us sooner, because the treatment has helped them so much.   We are the natural, safe, solution that enhances your bladder control, builds strength, improves posture, resolves pelvic floor dysfunction, alleviates pain and gives you hope.  Suffering with these private, embarrassing pelvic floor problems is not your highest quality of life.  We are here to help you.  If you would like more information about our in-person physical therapy (in Grand Rapids) or our remote consultations, call us at 616-516-4334 or submit your questions here.

If you tired of leaking urine, chronic pelvic pain, prolapse or urge incontinence and you have EDS, our PTs are here to help you.

We are Purple Mountain Physical Therapy, a speciality pelvic health and TM joint PT clinic located in Grand Rapids, MI. We offer in-person treatment and remote consultations.  You don’t need to suffer with these pelvic problems, there is high quality, safe and effective treatment from one of our physical therapists.  Our team of PTs is devoted to pelvic health, including helping people who have Ehlers-Danlos Syndrome.  We can help you improve bladder dysfunction, including overactive bladder, stress incontinence, urge incontinence, nocturia, difficulty emptying, poor stream and bladder pain. Nothing makes us happier than helping you to feel better and more confident how to manage your Ehlers-Danlos for lifelong wellbeing.  We will educate you, teach you, coach you, improve your strength, address your movement patterns and provide you with comprehensive care that is safe and effective for your particular needs. Getting started is easy.  Just call 616-516-4334 to speak with one of our knowledgeable staff and get your questions answered.  Or submit an inquiry here. 

Peace,

Dr. Maureen O’Keefe, DPT founder of Purple Mountain Physical Therapy and specialist in pelvic floor dysfunction, neck, back and TMJ disorders.  All of our physical therapists have advanced post-graduate training to help individuals who have EDS.

Additional articles that may be of interest:

What is High Tone Pelvic Floor Dysfunction?

Tips to Fix Incontinence Naturally

TMJ Disorder Treatment in Grand Rapids

Pelvic Floor Physical Therapy for Overactive Bladder in Grand Rapids

Why Does My Child Keep Wetting Their Pants?

References:

Arunkalaivanan AS, Morrison A, Jha S, Blann A. Prevalence of urinary and faecal incontinence among female members of the hypermobility syndrome association (HMSA). J Obstet Gynaecol J Inst Obstet Gynaecol. 2009;29(2):126–128. 10.1080/01443610802664747.

Chan C, Krahe A, Lee YT, Nicholson LL. Prevalence and frequency of self-perceived systemic features in people with joint hypermobility syndrome/Ehlers-Danlos syndrome hypermobility type. Clin Rheumatol. 2018;38:503–511. 10.1007/s10067-018-4296-7

Coussens M, Lapauw B, Banica T, De Wandele I, Pacey V, Rombaut L, Malfait F, Calders P. Muscle Strength, Muscle Mass and Physical Impairment in Women with hypermobile Ehlers-Danlos syndrome and Hypermobility Spectrum Disorder. J Musculoskelet Neuronal Interact. 2022 Mar 1;22(1):5-14. PMID: 35234154; PMCID: PMC8919651.

Gilliam E, Hoffman JD, Yeh G. Urogenital and pelvic complications in the Ehlers-Danlos syndromes and associated hypermobility spectrum disorders: A scoping review. Clin Genet. 2020 Jan;97(1):168-178. doi: 10.1111/cge.13624. Epub 2019 Sep 1. PMID: 31420870; PMCID: PMC6917879.

Kciuk O, Li Q, Huszti E, McDermott CD. Pelvic floor symptoms in cisgender women with Ehlers-Danlos syndrome: an international survey study. Int Urogynecol J. 2022 Jun 25. doi: 10.1007/s00192-022-05273-8. Epub ahead of print. PMID: 35751670.

Knoepp LR, McDermott KC, Muñoz A, Blomquist JL, Handa VL. Joint hypermobility, obstetrical outcomes, and pelvic floor disorders. Int Urogynecol J. 2013;24(5):735–740. 10.1007/s00192-012-1913-x.

Kohn A, Chang C. The Relationship Between Hypermobile Ehlers-Danlos Syndrome (hEDS), Postural Orthostatic Tachycardia Syndrome (POTS), and Mast Cell Activation Syndrome (MCAS). Clin Rev Allergy Immunol. 2020 Jun;58(3):273-297. doi: 10.1007/s12016-019-08755-8. PMID: 31267471.

Le Huec JC, Aunoble S, Philippe L, Nicolas P. Pelvic parameters: origin and significance. Eur Spine J. 2011 Sep;20 Suppl 5(Suppl 5):564-71. doi: 10.1007/s00586-011-1940-1. Epub 2011 Aug 10. PMID: 21830079; PMCID: PMC3175921.

Mastoroudes H, Giarenis I, Cardozo L, et al. Lower urinary tract symptoms in women with benign joint hypermobility syndrome: a case–control study. Int Urogynecol J. 2013;24(9):1553–1558. 10.1007/s00192-013-2065-3.

Milsom & M. Gyhagen (2019) The prevalence of urinary incontinence, Climacteric, 22:3, 217-222, DOI: 10.1080/13697137.2018.1543263

Mou T, Warner K, Brown O, Yeh C, Beestrum M, Kenton K, Emi Bretschneider C. Prevalence of pelvic organ prolapse among US racial populations: A systematic review and meta-analysis of population-based screening studies. Neurourol Urodyn. 2021 Jun;40(5):1098-1106. doi: 10.1002/nau.24672. Epub 2021 Apr 9. PMID: 33834519.

Roeder, M., Thiel, S., Baumann, F. et al. Increased augmentation index in patients with Ehlers-Danlos syndrome. BMC Cardiovasc Disord 20, 417 (2020). https://doi.org/10.1186/s12872-020-01684-x

Rombaut L, Malfait F, De Wandele I, Taes Y, Thijs Y, De Paepe A, Calders P. Muscle mass, muscle strength, functional performance, and physical impairment in women with the hypermobility type of Ehlers-Danlos syndrome. Arthritis Care Res (Hoboken). 2012 Oct;64(10):1584-92. doi: 10.1002/acr.21726. PMID: 22556148.

Scheper MC, Nicholson LL, Adams RD, Tofts L, Pacey V. The natural history of children with joint hypermobility syndrome and Ehlers–Danlos hypermobility type: a longitudinal cohort study. Rheumatology. 2017;56(12):2073–2083. 10.1093/rheumatology/kex148.

. (2022) Mechanisms of pelvic floor muscle training for managing urinary incontinence in women: a scoping review. BMC Women’s Health 22:1.

 

Tips to Fix Incontinence Naturally

Author| Dr. Maureen O’Keefe, DPT pelvic health physical therapist specializing in treating adults with urinary incontinence.

What can I do at home to improve urinary incontinence?  Some tips for you to help fix your incontinence naturally.

Our physical therapists provide every patient extensive education and self care training to help their urinary incontinence.  Here we detail some general tips that are recommended in some guidelines and through our clinical practice with treating urinary incontinence.  We recommend you work with your PT to figure out what is best for  you.  Because you are not our patient, these tips to fix incontinence naturally are for educational purposes only and serve as a talking point with your provider.  If you are interested in working with one of our licensed physical therapists, call us at (616) 516-4334 to speak with one of our knowledgeable staff members or submit your questions here. 

  1. Monitor your bladder symptoms:  Pay attention to what is going on.  Notice your urinary frequency, flow of urine, how often you wake at night to urinate and any changes in your status. See your provider when things change or if you have any concerning symptoms (pain, burning, difficulty emptying, blood, etc.)
  2. Drink enough water to keep yourself hydrated.  With urinary incontinence,  it is helpful to stay properly hydrated.  Some people avoid drinking water or other beverages due to fear of leaking, but this concentrates your urine and denies your bladder the chance to fill up, which is helpful for bladder function.
  3. Try drinking your water all at once, instead of sipping all day long.  Sometimes sipping water all day long, can exacerbate urinary incontinence.  Instead, for some people, it is helpful to drink a large glass of water all at once.  This also helps your bladder to learn how to fill up and hold urine.
  4. Avoid fluids that irritate your bladder or worsen urinary incontinence.  Each person is different, but common culprits include alcohol, carbonated beverages and caffeine.
  5. Don’t push your pee out.  Urinating in a relax manner, either standing or sitting, optimizes your bladder function and avoids straining the pelvic floor muscles.  Rushing or pushing out your urine can worsen pelvic floor muscle function and exacerbate  urinary incontinence.
  6. Be certain to fully empty your bladder.  Take all the time you need to empty.  Some men benefit from gently milking the urethra to get all of the urine out of the urethra.  For some men, this helps reduce post-void dribbling.
  7. If you experience urinary frequency and urgency, use techniques to calm these bladder spasms.  Things like diaphragmatic breathing, gentle pelvic floor muscle contractions followed by relaxing them, distraction techniques and mental tasks to take you mind off of your bladder can help some men calm bladder spasms.
  8. Urinating every 2 to 4 hours apart is optimal.  We prefer that you try to retrain bladder control to hit these benchmarks.  Some men cannot hold their urine for 2 hours without experiencing severe bladder spasms; you need pelvic PT to calm this problem.  Other men wait too long to urinate and simply overtax the bladder control system because they don’t urinate often enough.
  9. Use the toilet when you feel the urge to defecate.  Constipation and holding in stool can worsen bladder control.  This is one of our best tips to fix incontinence naturally.  Truly, if you have bladder control problems, you need to be certain your bowels are regular.  Our pelvic PTs specialize in treating constipation, bladder, bowel and pain related issues.  If you are interested in working with us, call 616-516-4334 or submit your questions here. 
  10. Eat a healthy diet with enough fiber, fruit and vegetables to keep your bowel movements regular.  Fiber doesn’t help everyone, but in America we are generally not eating enough of it.  If you have urinary incontinence, you must improve your bowel regularity to help your bladder control.
  11. Talk to your physician about all the medications you are taking, because some of them contribute to bladder control problems.
  12. Remain physically active.   We know that more sedentary people have worse control of their urine.  The pelvic floor muscles need to be worked throughout the day and being active and moving around helps these muscles.   For example, in one study men who were physically active one or more times/week had a 51% lower risk of urinary incontinence. Walking for exercise is one tip we offer to naturally help incontinence.  Your pelvic floor and bladder control muscles can benefit from walking.  If exercise causes your incontinence, our physical therapy specializes in resolving leakage that is caused by movement, jumping, running or other exercise.
  13. Maintain healthy body weight.  Belly fat puts more pressure on the bladder control system, for both men and women.  If you have excess weight, working on optimizing your weight can improve your bladder control.  One study found that men who were obese had a 220% increased odds of urinary incontinence compared to men who were normal weight.
  14. Stop smoking or vaping.   In a large study of over 600 women smoking was found to substnatially increase the risk of stress incontinence (involuntary loss of urine).
  15. When lifting, exhale and use good body mechanics  If you hold your breath when lifitng things, you are applying extra force through your bladder and pelvic floor, making it easier to strain and lose urine.
  16. Improve your posture  The optimal alignment of your head, ribcage, low back and pelvis sets you up for better bladder control.  If you know that your posture is not good, you may be orienting your bladde, urethra and pelvic floor in a position where it is easier to lose urine.  Our physical therapy program addresses postural correction as part of our urinary incontinence recovery physical therapy.
  17. Strengthen your core, hips and whole body  If your core, glutes or thighs are not at optimal strength and functioning, then your pelvic floor may go into over-drive to compensate; this is pelvic floor dysfunction and makes it possible to experience urinary incontinence.
  18. Optimize your blood sugar.  There is a connection between diabetes and incontinence.
  19. Don’t assume Kegels will help you  If you have pelvic floor dysfunction (and you do, if you are having urinary incontinence), sometimes the muscles and bladder control gets worse if you do Kegels.  This is why our licensed physical therapists work closely with you to assess and treat your incontinence.  Every patient receives a customized and whole-body treatment program and is closely supervised by their physical therapist.
  20. Work to improve your balance.  The pelvic floor muscles should be responding when you lose your balance and as you walk and move.  We use balance based exercises routinely as part of our pelvic floor rehabilitation programs to comprehensively improve urinary incontinence. If you are interested in working with one of our licensed physical therapists, call us at (616) 516-4334 to speak with one of our knowledgeable staff members or submit your questions here. 
  21. Address any pain you experience.  Pain can upregulate your system and contribute to pelvic floor dysfunction.  Our PTs specialize in treating chronic pelvic pain, endometriosis, interstitial cystitis, TM joint pain, neck and back pain.  If you would like to work with our PTs or have questions about our treatment, call us at 616-516-4334 or contact us here.
  22. Women going through perimenopause or who are menopausal, consider estrogen.  As estrogen declines, urinary incontinence occurs more readily.  If you are menopausal, talk to your provider about topical estrogen, if you are a candidate for it.
  23. Work with a pelvic physical therapist at Purple Mountain Physical Therapy.  Our PTs provide whole body treatments that truly work to resolve urinary incontinence.  If it were easy to solve incontinence, then you would have already figured it out on your own.  We find that our patients struggle for a long time with incontinence and when they come to us, they are finally happy to have someone identify what is going on with their body to help this.  Instead of just reading these tips to fix incontinence naturally, we believe you would benefit from the support and guidance of our pelvic physical therapists.  Our one-on-one physical therapy appointments offer whole-body treatment and solutions for incontinence and go well beyond basic Kegels exercises. In fact, many of our patients do not complete Kegels at all.

If these tips to fix incontinence naturally overwhelm you, take the guesswork out of your problem and work with one of our PTs. Call 616-516-4334 to get your questions answered.

We know that urinary incontinence can be stubborn and difficult to resolve.   We provide you a clear treatment program and framework to resolve your incontinence.  What’s holding you back from getting started?  We’ve been doing this work for years and are here to help!  If you are interested in working with one of our licensed physical therapists to receive a solution to your urinary incontinence, call us at (616) 516-4334 to speak with one of our knowledgeable staff members or submit your questions here. 

Working with a provider who specializes in this treatment offers you a higher level of customized care and opportunity to solve your incontinence problem.   Our PTs offer in-person treatment in Grand Rapids or telehealth visits, for those who qualify.  If you have questions about our treatment, cost or availability, call us at 616-516-4334 or contact us here.

We hope these tips to fix your incontinence naturally give you a starting point, but working with a pelvic PT truly gives you solutions.

Our pelvic and bladder physical therapy gives you natural, exercise-based and manual therapy treatment methods to resolve urinary incontinence.  At Purple Mountain PT, our licensed physical therapists specialize in treating men, women and kids who have bladder, bowel or pain issues.  We love to work with you and provide you insights into what is causing your problem and designing a treatment program for incontinence that is natural, without side effects.  If you are interested in working with one of our licensed physical therapists to receive a solution to your urinary incontinence, call us at (616) 516-4334 to speak with one of our knowledgeable staff members or submit your questions here. 

We offer in-person and telehealth visits, for those who qualify.  This work is an honor for us and we are devoted to helping you overcome urinary incontinence. Don’t hesistate to reach out to learn more.  616-516-4334

Peace,

Dr. Maureen O’Keefe, DPT founder of Purple Mountain Physical Therapy and specialist in pelvic health, neck, back and TM joint physical therapy.

All information is for educational purposes and is not meant to treat you or substitute for working with your own physical therapist or physician.

Since you are looking for tips and natural treatments for urinary incontinence, you may be interested in these other articles we’ve written:

Physical Therapy for Male Incontinence in Grand Rapids

Is There A Connection Between Diabetes and Incontinence?

Endometriosis Physical Therapy Treatment in Grand Rapids

What Can Pelvic Floor Physical Therapy Help With?

Does Pelvic Floor Therapy Work for Prolapse?

What is High Tone Pelvic Floor Dysfunction?

How Much Bedwetting is Normal?

 

References for tips to fix incontinence naturally:

Brown, Heidi W., Candace Parker-Autry, and Angela L. Sergeant. “Bladder and Bowel Continence in Older Women.” Challenges in Older Women’s Health. Springer, Cham, 2021. 163-183.

Bump RC, McClish DK. Cigarette smoking and urinary incontinence in women. Am J Obstet Gynecol. 1992;167:1213–1218.

Engstrom G, Walker-Engstrom ML, Loof L, Leppert J. Prevalence of three lower urinary tract symptoms in men-a population-based study. Fam Pract. 2003;20:7–10

Masterson, Thomas A., et al. “Comprehensive pelvic floor physical therapy program for men with idiopathic chronic pelvic pain syndrome: a prospective study.” Translational andrology and urology 6.5 (2017): 910.

Mobley D, Baum N. Smoking: Its Impact on Urologic Health. Rev Urol. 2015;17(4):220-5. PMID: 26839519; PMCID: PMC4735668.

Nelson RL, Furner SE. Risk factors for the development of fecal and urinary incontinence in Wisconsin nursing home residents. Maturitas. 2005;52:26–31.

Schmidbauer J, Temml C, Schatzl G, et al. Risk factors for urinary incontinence in both sexes. Analysis of a health screening project. Eur Urol. 2001;39:565–570.

Shamliyan TA, Wyman JF, Ping R, Wilt TJ, Kane RL. Male urinary incontinence: prevalence, risk factors, and preventive interventions. Rev Urol. 2009 Summer;11(3):145-65. PMID: 19918340; PMCID: PMC2777062.

Teunissen TA, van den Bosch WJ, van den Hoogen HJ, Lagro-Janssen AL. Prevalence of urinary, fecal and double incontinence in the elderly living at home. Int Urogynecol J Pelvic Floor Dysfunct. 2004;15:10–13. discussion 13.

Van Oyen H, Van Oyen P. Urinary incontinence in Belgium; prevalence, correlates and psychosocial consequences. Acta Clin Belg. 2002;57:207–218

Zhang AY, Strauss GJ, Siminoff LA. Effects of combined pelvic floor muscle exercise and a support group on urinary incontinence and quality of life of postprostatectomy patients. Oncol Nurs Forum. 2007;34:47–53.

How do I retrain my bladder after prostate removal?

Author| Dr. Maureen O’Keefe, DPT pelvic health physical therapist specializing in recovery of bladder control, bowel function and intimacy related concerns after prostatectomy and radiation therapy.

How do I retrain my bladder after prostate removal?

We are so glad you found this page and hope that the information in this article helps you learn about some of the things you can do to retrain your bladder after prostate removal.  We are Purple Mountain Physical Therapy, a specialty pelvic health clinic located in Grand Rapids, Michigan. We offer in-person and telehealth visits to men who are facing prostate cancer and experiencing bladder control issues following treatment.  Physical therapy after prostatectomy and radiation therapy retrains bladder control and bowel control (for men who have bowel problems after radiation).  There are also things you can do at home to help your bladder control recover after prostate cancer treatment.  Here we will provide you information, including research backed recommendations for retraining bladder control after prostate removal, and tips you can implement today to help bladder control.   Call 616-516-4334 to speak with one of our staff or submit your questions here. 

Read on to learn more about how to retrain your bladder plus some tips that you can implement at home!

If you are interested in learning more about physical therapy after prostatectomy, whether you would like an in-person visit or telehealth appointment, you can reach out to our staff at 616-516-4334 or contact us here. 

If you are finding this article because you are going to have or already have had a prostate removal or radiation therapy, we’ve included helpful information here about retraining your bladder, pelvic floor muscle training and other considerations.  

Our licensed physical therapists who specialize in bladder, bowel, pelvic pain and intimacy rehabilitation treat men before and after prostate removal as well as men who experience chronic prostatitis pain or other bladder, bowel or pelvic pain conditions.  Bladder retraining physical therapy before and after prostatectomy is effective and works to decrease your incontinence, retrain your bladder function and improve your pain.  For our patients, we also address erectile dysfunction and teach you what you can do at home to preserve your erectile tissues while your recovery is happening.  If you are interested in learning more about pelvic PT treatments to retrain bladder control after prostate removal or radiation treatment, call us at 616-516-4334 to speak with one of our staff or contact us here. Our physical therapists have post-graduate training and experience specific to male pelvic and prostate rehabilitation.

Physical therapy helps retrain the bladder after prostate removal.

Your bladder control will be impaired following your surgery to remove your prostate.  This tends to be true even for men who have very experienced surgeons using nerve sparing techniques.  The removal of the prostate disrupts your urethra and may change your bladder neck, which makes it harder to control your urine.  The pelvic floor muscles are the key muscles that hold your urine in.  Pelvic physical therapy will assess these muscles and teach you how to rehabilitate them.  At Purple Mountain PT, our pelvic physical therapists are experienced in rehabilitation after prostatectomy and radiation therapy.  If you are interested in inquiring about cost and availability of our licensed physical therapists, contact us here or call 616-516-4334.

Our physical therapists will begin your pelvic floor muscle training therapy to retrain your bladder control at your first appointment.

We find that men do not know how to control their pelvic floor muscles.  We recommend that you come to physical therapy for two visits before you have your prostatectomy.  That way, we can help you figure out where these muscles are and we teach you how to begin training them.  This is called “prehab” and we have research supporting that these two visits, in conjunction with 12 weeks of post-prostatectomy physical therapy will retrain your bladder control and recover your continence quicker than if you don’t have physical therapy.  If you are interested in inquiring about our PT for prostate cancer rehabilitation and working with our licensed physical therapists, contact us here or call 616-516-4334.

In one recent study examining how to retrain the bladder after prostate removal, intensive pelvic floor physical therapy helped these men control their urine quicker than men who did not have bladder retraining PT.  

Losing urine unexpectedly is depressing and anxiety producing.  If you want to improve this problem, work with one of our licensed pelvic physical therapists to help you get better control.  Each appointment is upto 55 minutes in length, private and with your doctor of physical therapy.  We never bounce you around to other providers nor do we leave you alone to exercise by yourself while we treat another patient.  Your treatment will be guided by your physical therapist and include extensive training to your pelvic floor muscles, core and breathing so that you can retrain bladder control after prostate removal.  If you are interested in inquiring about our PT for pelvic floor muscle training, retraining bladder control and addressing any other issues (pain, bowel control, intimacy) that we provide in-person or via telehealth,  contact us here or call 616-516-4334.

Why it is recommended to start physical therapy before your prostate removal.  Research shows that Prehab helps you do better after surgery!

Before you’ve had surgery or radiation, you have an opportunity to discover where your bladder control muscles are located and begin practicing using these muscles, before the area is discombobulated from surgery or radition.  Two physical therapy prehab visits are what the research has recommended and can be invaluable to begin your pelvic floor muscle training exercises.  If you are interested in inquiring about our prehab physical therapy for men facing prostate cancer treatment,  contact us here or call 616-516-4334.

Doing pelvic floor bladder retraining exercises correctly, without using the wrong muscles, and without straining the bladder, prostate and pelvic region is an important part of your recovery.

Our pelvic physical therapists will work with you and teach you how to begin to train these muscles that help bladder control.  The exercises are not easy, but with the experienced eyes of our licensed pelvic physical therapist, you will get the hang of how to engage the correct muscles.  To inquire about our bladder retraining physical therapy, offered in-person or via telehealth,  contact us here or call 616-516-4334.

Reseach has found that two prehab visits are beneficial and give you a plan for what to do following your prostatectomy or prostate radiation treatment.

Some men miss this window of opportunity to commence bladder retraining physical therapy and pelvic floor muscle training prior to their procedures.  We can still help you if you don’t complete prehab, but our patients tell us that these two visits before their prostate removal are really helpful.  If you are interested in inquiring about our PT for pelvic floor muscle training, retraining bladder control and addressing any other issues (pain, bowel control, intimacy) that we provide in-person or via telehealth,  contact us here or call 616-516-4334.

Participants who underwent radical prostatectomy were divided into two groups and pelvic floor muscle training physical therapy began before their surgery for two visits and continued after surgery, for 12 weeks.   

Control Group 1:  Completed some pelvic floor training exercises.  Not as intense or specific as Group 2

  • Control Group:  3 sets of exercise/day.  Received basic and low intensity physical therapy instruction for their pelvic floor exercises.  This included a PT appointment showing them pelvic floor muscle exercise instruction over 2 visits and instructions to complete daily pelvic floor muscle training at home.  They were told to complete 3 sets of 10 exercises a day, lying down sitting or standing up.  Basically, this group did 30 Kegels a day, holding them for 1o seconds and resting 10 seconds between each exercise.

Intervention Group 2:  Completed more intense and focused pelvic floor training exercises under the guidance of a physical therapist and daily at home.  Experienced quicker retraining of bladder control

  • Intervention group that completed more intensive physical therapy pelvic floor exercises when supervised for proper technique:  6 sets of exercises/day, targeting all pelvic floor muscle fibers. This group also received two PT visits prior to their surgery and 12 weeks of post-operative bladder retraining physical therapy.  The pelvic floor exercises and bladder retraining for this group were more intense and extensive than Group 1.  These men completed 6 sets of 10 pelvic floor exercises at home; different exercises than the first group completed.   Their physical therapist instructed them in very detailed technique to properly engage the pelvic floor muscles without cheating.  The exercises in this group were more intense, specifically targeting both the fast twitch and slow twitch muscle fibers of the pelvic floor.   Compared to the first group, these men completed 12 weeks of more repetitions every day and held them for longer duration.   The men in this group completed these exercises in standing.  Participants were guided in physical therapy to avoid muscular substitution patterns and “cheating” with things like holding their breath, squeezing their glutes or other mal-adaptive techniques.

Group 2, the more intensive and specific pelvic floor muscle training program with a physical therapist got men back to controlling their urine faster!  

The men in the intervention group with more intensive physical therapy and pelvic floor muscle training had better urinary incontinence improvement than the men in the control group. 

2 weeks post op men who are dry (continent):   Group 1:  4%     Group 2:  14%

6 weeks post-op men who are dry (continent):  Group 1:  11%     Group 2: 32%

12 weeks post-op men who are dry (continent):  Group 1: 43%     Group 2: 74%  

Our pelvic PTs are experienced in providing this intensive pelvic training physical therapy to retrain bladder control after prostate removal.  If you are interested in inquiring about our PT for prostate cancer rehabilitation and working with our licensed physical therapists, contact us here or call 616-516-4334. 

Completing intensive pelvic floor training exercises, under the supervision of a physical therapist and daily at home, helps retraining of bladder control and faster return of urinary continence.  

If you would like to know how to do these exercises, our licensed physical therapists are here to customize a bladder control rehab program for you.  We will ensure you are correctly completing the pelvic floor training exercises and that you are not straining your surgical or irradiated area.  We provide comprehensive treatment, so if you also have back, hip or abdominal concerns, we treat that as well.  You will be given a focused home program to complete, as well.   If you have questions about our bladder physical therapy program for men following prostate removal or radiation therapy  contact us here or call 616-516-4334.

If you are wondering how to retrain bladder control after prostate removal, the research has been clear that you would benefit from pelvic physical therapy that includes specific and intensive pelvic floor training exercises.

Our PTs at Purple Mountain PT will teach you how to do these exercises. When in an appointment, we provide one-on-one care.  This means that we never leave your side. We make certain you are completing the exercises properly, which is crucial for your recovery.  Most of the men we work with “cheat” (not on purpose!) with contracting the wrong muscles, instead of the pelvic floor muscles.  Working together, we will help you retrain your bladder control and resolve pelvic floor muscle dysfunction.  We tell you what to do at home, because you will need to be committed to doing these exercises daily at home for about 12 weeks and sometimes longer.  Most men tell us that their PT has given them hope, decreased their depression and helped them to feel they have something to work towards.  If you are interested in inquiring about our PT for pelvic floor muscle training, retraining bladder control and addressing any other issues (pain, bowel control, intimacy),  contact us here or call 616-516-4334.

Our physical therapists are here to treat your bladder system and retrain bladder control!

Because our licensed physical therapists specialize in pelvic health, bladder, bowel and intimacy rehabilitation methods, we offer treatment that helps men following prostate removal.  We provide holistic treatment to optimize bladder function.  If you are interested learning more about pelvic floor muscle training, retraining bladder function and addressing any other issues (pain, bowel control, intimacy),  contact us here or call 616-516-4334.

Your bladder needs to be able to:

  • Fill up with urine:  We will help you retrain your bladder’s capacity to stretch and fill up.
  • Calmly hold the urine:  Our physical therapy program for overactive bladder and urinary frequency and urgency help men following prostate removal and even men who simply have overactive bladder problems, unrelated to bladder cancer.   After prostate removal, the continuous and insensible leakage of urine is a problem that our pelvic floor muscle training physical therapy can improve.
  • Empty the urine without difficulty: This is an important part of retraining your bladder and we will teach you and ensure that you are urinating with the optimal, relaxed technique that does not strain your pelvic floor, surgical area or bladder.
  • Empty fully:  For your health, to avoid urinary tract infections, we want you to fully empty your bladder everytime you urinate.  Our bladder retraining physical therapy includes treatment to optimize the bladder muscle’s ability to fill up, hold urine and empty fully.

If you would like to receive physical therapy that helps your bladder recover its ability to fill up with urine, hold urine and empty, please call our office to speak with one of our staff.  We can be reached at 616-516-4334 or contact us here. 

Physical Therapy care following prostatectomy or radiation treatment will include specific training in how to control your urine, advice and procedures at home to preserve your erectile tissue and treatment to help fecal seepage, if you had radiation and experience this problem

At Purple Mountain PT, your appointments are in a private, comfortable treatment room or in our private gym space for exercise-based performance.  They are one-on-one with your physical therapist, meaning that we never leave you with a lesser trained staff member.   You are welcome to bring your spouse or partner and men have told us this has been helpful to have another set of ears to hear everything we teach you.  If you are interested in working with our pelvic PTs who can support your prostatectomy recovery, please call our office to speak with one of our staff.  We can be reached at 616-516-4334 or contact us here. 

If you are unable to come to physical therapy, we offer a paid phone consultation to give you recommendations on bladder retraining.  

Over the years, sometimes friends or family, who live across the country, would reach out for information about what they can do before their surgery or afterwards to help incontinence, pain, bladder function and erectile function.  Friends and family over the years have given positive feedback and gratitude that the phone consultation is helpful; as a result, we offer a paid phone consultation option for individuals who would like to learn more about how to take care of their bladder control, bowel issues, erectile considerations and other concerns before and after prostatectomy or radiation treatment or during watchful waiting (active monitoring).  If you may be interested in having a paid phone consultation with one of our pelvic PTs, call our office at 616-516-4334 or contact us here.  

Tips you can implement for bladder retraining after prostate removal.

  1.  Drink enough water to not be thirsty.  We advise that you do NOT limit your water intake.  Talk to your medical team to find out how much water they feel is best for you.  We cannot specifically tell you how much you need, but, in general, for bladder retraining you need sufficient water to allow your bladder to fill up, hold urine and empty fully.  If you are always limiting your fluid intake your bladder may never experience this opportunity to fill up.
  2. Avoid bladder irritants. Some drinks or foods irritate the bladder and can make it easier to have urinary incontinence after prostate removal.  In general, we advise no alcohol until you are fully continent.  Coffee and caffeine should be limited to zero or one drink/day.
  3. If you are going to have a bladder irritant, dilute it with a glass of water beforehand.
  4. Try to urinate about every two hours.   Emptying your bladder more often than this is not retraining your bladder.  If you are constantly dribbling and losing urine, talk to your doctor about options to help this. There are some devices that may help you during this recovery period.
  5. Walk for exercise.  We know you may leak, but we encourage walking every day for half an hour or more. Walking does activate and help rehabilitate the pelvic floor and hip muscles and this is part of your bladder retraining.
  6. Relax when you urinate.  Be conscientious to relax when urinating. Don’t push your urine out.  Even at the end of urinating, do not push those last bits of urine out.  Instead, to retrain your pelvic floor muscles and bladder control, we recommend teaching yourself to relax when urinating.
  7. Talk to your physician about what you should be doing to preserve erectile tissue.  Your erectile tissue benefits from erections and blood flow.  Often physicians provide you with a prescription for erectile dysfunction, but you are not given clear instructions about the value of taking this to preserve erectile tissue.  Ask your doctor about this.
  8. Don’t ignore abdominal or pelvic pain.  More often than you might think, our patients also experience abdominal pain (from robotic scars and the surgery), penile pain, perineal pain or anal pain.  If this is the case, mention it to your provider and know that pelvic PT can help you.  We specialize in treating male chronic pelvic pain, such as chronic prostatitis, testicular pain and tailbone pain.  Don’t ignore your pain, physical therapy can help you.

To talk to one of our staff, call our office at 616-516-4334 or contact us here.  

All of our licensed PTs at Purple Mountain PT have training specific to male pelvic health rehabilitation, prostate cancer recovery and retraining bladder control after prostate removal. 

This is an important distinction that sets Purple Mountain PT apart from others.  We have not simply adapted “women’s health” PT to our men.  We have specific male-focused pelvic health and prostate cancer rehabilitation training and experience helping men just like you.  We love this work and consider it an honor to help you retrain your bladder control and address other prostatectomy rehab needs.  If you may be interested in learning more about our pelvic PT program to retrain bladder control after prosate removal, call our office at 616-516-4334 or contact us here.  

All of the doctors of physical here at Purple Mountain PT have completed extensive post-graduate male-specific pelvic education for how to retrain the bladder after prostate removal and other pelvic floor problems that men experience.

We believe that physical therapy after prostatectomy, to retrain bladder control, should be standard of care.   We know this is a difficult time in your life and we believe that you deserve to be fully supported by the experienced eye of our pelvic physical therapists.  If you are sitting at home, unhappy with your bladder control and uncertain how to retrain your bladder after prostate removal?Our patients express gratitude to us and tell us that this treatment has improved their depression and anxiety regarding their urinary incontinence and erectile dysfunction.   If you are interested in working with our pelvic PTs who can offer you this type of physical therapy care after prostatectomy, please call our office to speak with one of our staff.  We can be reached at 616-516-4334 or contact us here. 

Peace,

Dr. Maureen O’Keefe, DPT  physical therapist specializing in pelvic rehabiliation for over two decades.

If you are curious about pelvic health physical therapy, these articles may be of interest to you:

Physical Therapy after Prostatectomy

Pelvic PT for Testicular Pain (Orchialgia) in Grand Rapids

Pelvic Pain PT in Grand Rapids

Urinary Incontinence Treatment in Grand Rapids

References:

Centemero A, Rigatti L, Giraudi D, Lazzeri M, Lughhezzeni G, Zugna D, Montorsi F, Rigatti P, Guazzoni G. Preoperative pelvic floor muscle exercise for early incontinence after radical prostatectomy: a randomised controlled study. Eur Urol. 2010;57:1039–43.

Christen WG, Gaziano JM, Hennekens CH. Design of Physicians’ Health Study II: A randomized trial of beta-carotene, vitamins E and C, and multivitamins, in prevention of cancer, cardiovascular disease, and eye disease, and review of results of completed trials. Ann Epidemiol. 2000;10:125–134.

Milios, J.E., Ackland, T.R. & Green, D.J. Pelvic floor muscle training in radical prostatectomy: a randomized controlled trial of the impacts on pelvic floor muscle function and urinary incontinence. BMC Urol 19, 116 (2019).

Scott KM, Gosai E, Bradley MH, et al. Individualized pelvic physical therapy for the treatment of post-prostatectomy stress urinary incontinence and pelvic pain.  [published online December 5, 2019]. Int Urol Nephrol. doi: 10.1007/s11255-019-02343-7.

Shikanov SA. A prospective report of changes in prostate cancer related quality of life after robotic prostatectomy. J Psych Oncol. 2011;29:1157–67.

Stark JR, Perner S, Stampfer MJ, Sinnott JA, Finn S, Eisenstein AS, Ma J, Fiorentino M, Kurth T, Loda M, Giovannucci EL, Rubin MA, Mucci LA. Gleason score and lethal prostate cancer: does 3 + 4 = 4 + 3? J Clin Oncol. 2009 Jul 20;27(21):3459-64.

Weber BA, Roberts BL, Mills TL. Physical and emotional predictors of depression after radical prostatectomy. Amer J Mens Health. 2008;2(2):165–71.

TMJ Disorder Treatment in Grand Rapids

Author| Dr. Maureen O’Keefe, DPT physical therapist specializing in TMJ disorder treatment, neck and back pain and pelvic floor dysfunction.

If you are looking for TMJ disorder physical therapy treatment in Grand Rapids, you’ve found the right place.

We are Purple Mountain Physical Therapy, a PT clinic  providing TMJ disorder treatment in Grand Rapids.  Our doctors of physical therapy provide holistic and one-on-one treatment for people who experience TMJ disorders, myofascial pain syndrome, cervicogenic headaches, thoracic spine pain, rib cage issues, low back pain, chronic pelvic pain and pelvic floor dysfunction.   Problems in these areas have been our focus for years and because of this specialization, our patients tell us that they have finally found relief from their pain.  If you want to stop taking ibuprofen or are looking for comprehensive and natural physical therapy for your TMJ disorder, we are here to help you.  If you are interested in learning more about our TMJ disorder treatment here in Grand Rapids or over telehealth, contact us here or call (616) 516-4334.

What does TMJ Disorder PT treatment involve?

Our goal of PT for your TMJ pain is to decrease your pain, improve your function of your jaw (chewing, opening, talking, closing), address head and neck issues contributing to your jaw pain, correct your posture, improve muscle strength and tightness and teach you what you can do at home to help yourself.  All of our therapies are natural and do not involve any medication, surgery, injections.  Our patients come to us looking for natural and comprehensive ways to finally relieve their TM joint pain.  To improve TMJ disorders, physical therapy includes hands-on manual therapy, posture correction, spinal mobilization, exercise based care and calming the nervous system.   If you would like to learn more about our TMJ disorder treatment in Grand Rapids or via telehealth, contact us at (616) 516-4334 or reach out here.   

You can receive your TMJ disorder treatment we provide in Grand Rapids or via telehealth.

Our clinic in Grand Rapids specializes in treatment for TMJ disorders, spine and pelvic health conditions.  If you are wondering what you can do to help your TMJ pain, we are here to help you.  But, some people live far away from our clinic and would like to have a telehealth visit to help them alleviate their pain.   For telehealth visits or in-person treatment for TMJ disorders, call our office at (616) 516-4334 or contact us here and we can answer your questions and let you know if you qualify for our care.

Our TMJ disorder treatment has a goal of relieving your pain and improving your jaw function.

We reach this goal by improving:

Myofascial pain

Muscle guarding

Joint motion

Strength and muscle imbalances

Fascial and muscle tightness

Posture of the TM joint, head, neck, thoracic spine, rib cage, low back and pelvis.

Myofascial pain commonly is present with TMJ disorders.

“Myofascial” means the muscles and associated fascia and connective tissues are generating your pain.  Our licensed PTs specialize in treating myofascial pain syndrome including TM joint pain, cervicogenic headaches, head and neck pain in addition to pelvic pain, low back pain, pelvic floor dysfunction, SI joint pain, tailbone pain and other pelvic pain conditions.  Because of our advanced training in helping ease myofascial pain, our TMJ disorder treatment in our clinic in Grand Rapids or via telehealth provides you with natural and holistic methods to ease your pain and restore your jaw function.  Contact us here to learn more or call us at (616) 516-4334 to speak with one of our helpful staff.

Your physical therapy evaluation and treatment for TMJ disorder includes a comprehensive assessment to develop a plan of care

First, we want to point out that our goal is to alleviate your jaw pain, improve your function and help you achieve your goals.  Every licensed physical therapist here at Purple Mountain PT in Grand Rapids has experience and training specific to providing PT treatment for TMJ disorders.

We begin your care with an evaluation, which includes a thorough check of your jaw, head and neck.

We need to understand how you developed this condition, what makes it worse, the treatments you have already tried, what makes your pain better and your goals.

We also measure your TM joint motion and note the quality of the motion so we can determine areas that we can treat to improve motion.

We will fully assess your neck, looking for stiffness, postural deficits, fascial restrictions, muscle guarding or weakness.

We begin TMJ disorder treatment at this first appointment so you can begin the recovery process.

You can expect our PT for TM joint disorders to include comprehensive manual therapies & exercise that help relax your muscles, improve joint mobility and alleviate pain.  At Purple Mountain PT, our licensed PTs have advanced training in natural rehabilization manual therapy techniques to alleviate pain, improve joint motion and decrease muscle guarding.  Some of these include myofascial manual therapy, trigger point release, nerve mobilization (to calm nerve pain), joint mobilization, and TMJ, face, skull, neck, thoracic and low back massage treatment methods.  To speak with one of our team members, who can answer your questions about our TMJ PT treatment that we provide either in our clinic in Grand Rapids or via telehealth, contact us at (616) 516-4334 or reach out here.   

Treatment for TM joint disorders at Purple Mountain PT in Grand Rapids  includes exercise

We include face, jaw, neck, shoulder and core exercises in your care, if you need these.  Our exercise based program will be customized to your needs.  Some patients have very stiff fascia and tight muscles, so we may include gentle therapeutic movements and stretches to enhance these muscles and tissues.  Other patients are found to have considerable weakness in some muscle groups and this places more strain on the head and neck.  Common weak areas include the shoulder blades, deep neck stabilizers, postural muscles, glutes and core.  For TM joint pain we also include facial exercises to address the muscles of your jaw that are not feeling good.  To inquire about cost and availability of our PTs for your TM joint pain or to have any other questions answered,  contact us at (616) 516-4334 or reach out here.   

Your treatment for TMJ disorder will also include whole body care

Patients often know that, in addition to the pain in their TMJ region, they also sometimes may have low back pain, hip pain, knee pain, shoulder pain or other areas that don’t feel 100%.  Our PTs will include treatment to your whole body because we have found that if we singularly focus on your TM joint, we won’t be able to fully correct your posture, fascial restrictions, core weakness and other contributors of your pain.  Our patients consistently tell us that they are looking for a whole body approach and finding our licensed PTs has been so helpful.  For example, it is common that a patient who comes to us for TM joint pain also has weakness or tension in their shoulder blades and this is altering their head, neck and jaw.  Both our experience treating patients who have TM joint disorders and our post-graduate training in rehabiliation of jaw, neck and spine problems has confirmed that holistic care will benefit you the most.  At each appointment you can expect your PT to customize your treatment based on your needs and this may include hands-on massage techniques, exercise based corrective exercises, postural correction, balancing the nervous system or other physical therapy treatments to help you.   If you are suffering from TM joint pain and would like to work with one of our physical therapists, call our team today to get your questions answered.  We can be reached at (616) 516-4334 or Contact Us here.

Physical Therapy for TMD can help both acute and chronic TMJ pain.

Temporomandibular disorders is a broad category of conditions related to the TM joint. Sometimes the pain has been going on for a long time, other times you may be having TM joint pain for the first time in your life.  In either case, our PTs are here to help you.  Call us at (616) 516-4334 to learn more.

PT for Acute TMJ pain

New TMJ pain, which we would consider to be acute, benefits from tender loving care to fully resolve and set you up so this doesn’t come back.  For acute pain we recommend our physical therapy that includes corrective exercises and massage, manual therapies and gentle joint mobilization to the head, neck and jaw.  These physical therapy interventions also help you learn what you did to cause the problem and we give you a complete home program to help your TM joint pain and to avoid this coming back.  To learn more about our PT treatment for TM joint pain, contact us here or call (616) 516-4334 to speak with one of our knowledgable representatives to learn more.

PT for Chronic TM joint pain

Often, we find our patients have experienced years of chronic TMJ pain, with flare up episodes occurring somewhat regularly.  It is common that our patients tell us they can recall having TMJ pain many years ago and lately it has been increasingly bothering them.  Our physical therapists treat many kinds of chronic  jaw pain conditions including TMD, TM joint arthritis, temporomandibular disorders, TMJ syndrome, TMJ myofascial pain syndrome, head and neck pain related to your TMJ, cervicogenic headaches and others.   Some of our patients have never had any medical treatment to their TM joint.  Other patients come to us having already tried bite guards, dental work, ibuprofen or other anti-infammatories, sometimes injections or other treatments.  Whether you have tried everything or tried nothing, our licenced PTs are here for you to help you get relief.  The goal of our holistic PT is to ease muscle guarding, improve jaw motion, correct posture,  decrease neck tension and stiffness, teach you exercises, improve strength deficits, and advise you on what to do to help yourself.  If you would like to learn more about our PT treatment for TM joint pain, contact us here or call (616) 516-4334 to speak with one of our knowledgable representatives to learn more.

Why we opened our clinic in Grand Rapids with a focus upon providing TMJ disorder treatment and pelvic health physical therapy

We love to help people who have TMJ pain or pelvic health care needs.  Our physical therapists have worked in very busy, general orthopedic clinics and have helped rehabilitate every “common” orthopedic injury you can imagine from plantar fasciitis to knee surgeries, rotator cuff injuries and fractures.  As part of our experience in these settings, we embarked upon advanced post-graduate coursework  to advance our skills.  For Dr. Maureen O’Keefe, DPT, founder of Purple Mountain PT, this training included considerable coursework and therapeutic interventions to specifically treat spine (neck & back), jaw and pelvic conditions.  In fact, her doctoral thesis was in the field of pregnancy related physical therapy treatment and this was back in 2003.  She found that to be able to truly help people recover, it was best to specialize in these areas of neck and back pain, pelvic conditions (bladder, bowel, intimacy and pain) and TM joint disorders.  Purple Mountain Physical Therapy is a PT clinic devoted to providing our patients with TM joint disorder treatment here in Grand Rapids.  We partner with our patients and pledge to give you our best effort to get you out of pain.  It has taken years of doing this work to fine-tune these treatment skills and all of our PTs are trained in TM joint disorder treatment, pelvic health rehabilitation and neck and back pain recovery natural treatment.  We focus on these areas so that you can receive results.  If you would like to learn more about our PT treatment for TM joint pain, contact us here or call (616) 516-4334 to speak with one of our knowledgable representatives to learn more.

Why Should I Choose Purple Mountain Physical Therapy?

Here at Purple Mountain PT, we have set up our clinic with your needs in mind.  Our TMJ disorder treatment here in Grand Rapids or via telehealth is comprehensive and holistic.  We provide one-on-one appointments with your doctor of physical therapy.  Treatment for TM joint disorders and pain is customized to your needs at each visit.  We never leave you by yourself to complete exercises without our supervision or guidance.  Each appointment is upto 55 minutes in length and this is necessary to provide you a complete appointment.  We don’t cut visits short or partially treat you and leave things untreated.  Our therapists are devoted to being specialists in treating TMJ disorders, neck and back pain and pelvic health conditions.  Because of this, we have advanced training, well beyond what is taught in the doctor of physical therapy program.   Perhaps, most importantly, you choose us because we are here to give you results.  We provide compassionate and trauma informed care and truly enjoy getting to know our patients.   If you would like to learn more about our therapist’s cost and availability, reach out to us at (616) 516-4334 or contact us here.

More About Purple Mountain PT

Our therapists are doctors of physical therapy and are fully trained in general orthopedics plus have specialization in TM joint pain, neck, back and pelvic conditions.  We help many people who experience chronic pelvic pain or chronic TM joint pain.  We love this work and are continually completing advanced training and reading research to give our patients the best chance of feeling better.  We consider it an honor to help you.  If you would like to learn more about us, contact us here or call (616) 516-4334.   Here is some more information about our practice:

TMJ and TM Disorders Therapy

Pelvic Pain Physical Therapy in Grand Rapids

Physical Therapy for Neck Pain and Headaches

Why Can’t I Push Out My Pee?

Author| Maureen O’Keefe, DPT specialist in bladder, bowel and pelvic pain physical therapy

Why Can’t I Push My Pee Out?

If you have heard that pushing your pee out is bad for you and are wondering why, we have answers for you.  We are Purple Mountain PT, a specialty pelvic health and TM joint disorder clinic located in Grand Rapids, MI.  Our focus on pelvic heath includes teaching our patients how to control their urine, which also means that some people have to re-learn how to relax when peeing so they don’t push their pee out.  To learn more about why you shouldn’t push your pee out, read on. If you know this is a problem for you and you wonder if our physical therapy, which is offered in-person at our clinic or via telehealth, may help you, contact us here.  

If you Push your pee out, even slightly, you are straining your pelvic floor!

Under healthy bladder circumstances, the bladder (which is a muscle) should be able to quietly fill up and expand with urine, keeping a low pressure in the bladder. The proper mechanics of urinating are that a signal to the brain occurs letting you know that you need to urinate, you calmly walk to the bathroom, you calmly relax and the bladder should contract strongly, greatly increasing the pressure inside the bladder, thereby releasing urine while the urethra should open and the pelvic floor should relax and lengthen.  When someone needs to push their pee out, they are forcing pee out through a closed door and straining everything.  If you want to stop pushing your pee out and treat your pelvic floor dysfunction, but have some questions about our physical therapy, contact us here or call 616-516-4334.

What is your brain learning when you push your pee out?

If you consistently push your pee out, you are developing a habit that is teaching your brain that your pelvic floor should activate and tighten when you need to pee.  That’s not what we want your body to be doing!  This can be challenging to un-learn, but we help people overcome this issue all the time.  If you have questions about our costs and availability of pelvic floor physical therapy, call us at (616) 516-4334 or contact us here.

Consistently pushing your pee out can lead to the pelvic floor muscles getting confused when you need to urinate.

Our patients often tell us that they do not strain or push their pee out.  Then, after we talk to them and explain what we mean by straining and pushing, they pay more attention and find that they are doing this.

Why would someone push their pee out?  If you are like our patients, you tell us you do it for several reasons:

  • You Push your Pee Out to Finish Peeing. 

To “get it all out.” Incomplete bladder emptying is a common problem for a lot of people, so we understand that you are trying to do a good job and empty your bladder fully.  However, if you need to push your pee out to empty your bladder, this is a sign of pelvic floor and bladder dysfunction.  You are straining your system and causing harm and teaching your brain the wrong method for fully emptying.  Our physical therapy for this problem provides holistic care that fully assesses and treats your body to determine how we can recover your normal bladder and urinating function.  The patients who find us tell us that this PT has changed their lives for the better.  If you have questions about our care, please reach out here. 

  • You Push Your Pee Out to Start Your Pee.  

Some patients tell us that they sit on the toilet and nothing happens unless they push.  Sometime they are pushing their pee to start the flow of pee because they can’t get the flow to start without a push.  If you need to start your pee with a push, we can help you.  Reach out to us here.

  • You Push Your Pee Out to keep your urine flowing, because your stream trickles, stops or stops & starts. 

Some of our patients have trouble with their urine flow stopping or coming to a slow trickle when they haven’t fully emptied their bladder.  Therefore, to keep the urine flowing they must pee.  Our physical therapy helps stop this problem.  Contact us here to learn more.

  • You Push Your Pee Out to Hurry it Up!  You are in a rush!  

We’ve all been there, when we need to urinate, but we only have seconds to do it.  So, we push our pee to hurry it up.  We are here to tell you to stop doing this!  It is harmful to your bladder, pelvic floor, brain and organ support.

When you urinate, your pelvic floor should lengthen and your urethra should open and dilate, so urine can flow.

If you push your pee, this usually involves tensing your pelvic floor instead of relaxing it!  The pushing also generates non-helpful pressure around the urethra and bladder neck, which strains that area and can lead to bladder control problems and possibly pelvic organ prolapse.  If you are interested to learn more about our physical therapy, contact us here or call 616-516-4334.

With many years of pushing your pee out, you may notice that it gets more difficult to start the flow of your urine.  Then, once your flow is actually happening, it may stop.  A frustrating pattern may develop, such as the following:

  1.  My pee won’t start, so I push my urine to get it to start
  2. My urine flow trickles, so I have to continue to push
  3. Even when I push, my urine flow stops, so I have to push my pee even harder
  4. I don’t feel like I emptied fully, so after I leave the bathroom I feel like I have to go again
  5. Sometimes when I stand up after urinating, then some pee will trickle out onto my underwear.

Over time, this urine not starting, flowing, then stopping flowing can be a sign of the pelvic floor muscles and bladder getting confused.

Unfortunately, pushing your pee out teaches your muscles, urethra and bladder the wrong things to do to facilitate normal, relaxed urinating.  What can happen is that the pelvic floor muscles learn to be tense when peeing, instead of relaxed.  Repeated tensing of these muscles can lead to adaptive shortening or stiffness of the muscles.  Stiffness and tension in the pelvic floor muscles is also called “high tone pelvic floor” or sometimes it may be called “hypertonic pelvic floor dysfunction”.  Our PTs provide you an assessment that identifies if this is happening for you and treatment that addresses your whole body and is needed to resolve pelvic floor problems.  If you are interested to learn more about our physical therapy, contact us here or call 616-516-4334.

Pushing your pee out leads to problems in the pelvic floor muscles.  All of these things listed below are various ways of saying you have pelvic floor dysfunction:

High tone pelvic floor, pelvic floor dysfunction, stiff pelvic floor, hypertonic pelvic floor, short pelvic floor, trigger points in your pelvic floor, weakness of the pelvic floor, tightness of the pelvic floor.

If you want to stop pushing your pee out, go back to the basics of retraining your normal peeing mechanics.  This means:

Step One:  When you feel the need to urinate, honor this need by calmly walking to the bathroom

This is an important part of healthy bladder mechanics.  Too often, our patients have lifelong history of never using a public restroom.  This is unhealthy and leading you to have bladder issues down the line.  If you would like to take care of your bladder issues and pushing your pee out problem, contact us here or call 616-516-4334.

Step two: Sit on the toilet (or stand if you choose to stand) and relax, first by breathing.

Breathe using your diaphragm and creating 360 degree breaths.  360 degree breaths mean that your entire ribcage opens like an umbrella when you inhale and descends like a closing umbrella when you exhale.  This breathing should be gentle, slow and relaxing breathing.

Step three:  Soften and lengthen your pelvic floor.  If you’ve been pushing your pee for a long time, this will be tricky. But, practice makes perfect.  Repetition is your friend!

Sit on the toilet, breathe and let go of your pelvic floor.  Try to keep your abdomen fairly relaxed.  Allow for your urethra to soften.  Imagine your bladder, urethra and pelvic floor melting and everything dumping easily into the toilet.  Be relaxed throughout this.  If you push your pee out, truly try not to do it this time and in future attempts.  If you are interested to learn more about our physical therapy, contact us here or call 616-516-4334.

Step four:  Wait patiently for all of the urine to get out.  Do not rush your urination or cut it off before you are finished.

Incompete emptying is not good for you.  It can lead to build up of bacteria and/or a constant urge to urinate.  As best you are able, we would like you to patiently sit on the toilet and fully empty your bladder.  If you have pelvic organ prolapse, you may have some “kinks” in your anatomy that render emptying your bladder fully difficult.  If this is the case, then gentle rocking or positional changes can be helpful to further tip your pelvis and get some more pee to come out, without pushing your pee out.

Step 5:  Consider double voids!  Double voids are when you have finished peeing, but you suspect there may be more pee that needs to come out, so you try to pee again.

There are a couple of ways to double void.  One is simply to sit on the toilet longer and to repeat the breathing, relaxing, letting go efforts of peeing.  The second is to finish your first pee, wipe yourself, stand up, shift your pelvis a bit, then sit down and try to pee a second time.  This second time you will again breathe with your diaphragm, relax and let go of your pelvic floor.   Some patients have success getting more pee to empty doing double voids.  If you are interested to learn more about how to improve your need to push your pee out, contact us here or call 616-516-4334.

Step 6:  If you cannot fully empty your bladder you may consider using other tricks, such stimulating your sacrum to see if it helps your system to eliminate.

This is a technique that comes from our spinal cord injury patients, who have trouble with voiding.  Sacral stimulation is simply very gently touching, almost tickling, the area of your sacrum, which is located just below your low back.  The nerves that control this area and give you sensation here also can influence your bladder and pelvic floor.  Some people find that gently touching or stroking this region can help you to pee without pushing your pee out.

Step 7:  Running water is an option to facilitate urinating, but use it on a limited basis

Running water:  most of us are familiar with the idea that if you hear running water, it may give you an urge to pee.  If you truly cannot get your urine to come out when you relax, you can try running the water and seeing if this helps.  We don’t love this tip, because it can condition your bladder to react to running water, which isn’t the greatest issue to have.  But, using this sparingly is an option.  If you have questions about the symptoms you are experiencing and wonder if we may be able to help you, contact us here or call 616-516-4334.

Step 8:  If you’ve urinated and you can tell you just can’t get all of your urine out, reach out to us at Purple Mountain PT. We are here to help you

If you finish urinating and you still feel like you need to go, we can help you.  Or, if you are struggling with recurrent urinary tract infections, we can help you.  Or, if you simply cannot pee without pushing your pee out, we can help you.   Our PTs are specialists in bladder disorders, pelvic floor dysfunction and retraining your body how to pee.  Our whole body treatment taps into the power of your spine, nerves, organs, breathing, pelvic floor and more to facilitate your ability to urinate with ease.  If you are interested to learn more about receiving physical therapy with us, contact us here or call 616-516-4334.

Step 9:  Final tip if you continue to have bladder problems and always need to push your urine out:  keep in mind that you have pelvic floor dysfunction and may also have constipation.  Our PTs treat constipation and resolving bowel issues can improve your bladder function.

We hope this gives you some insights and tips into why you should not push your pee out.  Usually our patients come to us and have several issues going on with their body.  For example, some people push their pee out + know they have a diastasis recti abdominis + experience stress incontinence on occasion.  Other people have endometriosis + painful intimacy + push their pee out.  Some patients have urinary frequency + push their pee out.  Commonly, the women we help have pelvic organ prolapse + push their pee out.  Most of our patients have low back pain + pelvic floor dysfunction.  Our licensed physical therapists are here to help you feel like yourself again.  Not only do we specialize in helping people who need to push their pee out, we also specialize in pelvic pain and pregnancy and postpartum care.  If you have questions about whether our PT may be able to help you, either in person here at Purple Mountain PT in Grand Rapids, Michigan or via telehealth, call us at 616-516-4334 to speak with us to ask your quesion or contact us here. 

Purple Mountain Physical Therapy, located in Grand Rapids, Michigan, is a specialty pelvic health and TM joint disorder clinic.  We treat adults and children who experience any problems with peeing, pooping or pain.  If you are pushing your pee out, rest assured that you are not alone and that we can provide you care to improve this.  Getting your pushing problem resolved is important so you don’t give yourself a pelvic organ prolapse, anal fissures, nerve strain, pelvic pain and other associated pelvic floor dysfunction problems.  Because we help people with all ranges of pelvic, hip, back, spine and TM joint conditions, we are uniquely qualified to provide you care for your issues.  Our patients most appreciate the compassionate and private treatment we provide that is one-on-one with your physical therapists.  We consider this work to be an honor and our patients tell us our treatment is more comprehensive, healing and beneficial than they’ve experienced elsewhere.  Not local?  No problem, we provide telehealth visits and consultations, also.  We pledge to give you our best! Call 616-516-4334 to get your questions answered or reach out to us here.

Peace,

Dr. Maureen O’Keefe, DPT specializing in pelvic health, neck, TM joint, back and hip problems since the 1990s!  Our team at Purple Mountain PT is here for you, when you are ready!  We look forward to meeting you!

Why is My Child’s Poop So Big?

Author| Dr. Maureen O’Keefe, DPT pelvic floor and bladder/bowel physical therapist

Why is My Child’s Poop So Big?

Getting to the Bottom of Poops So Big They Clog Toilets…

We’re going to do a deep dive into kids who have big poops!  Although this may sound like a joke, this is actually a medical issue and you aren’t the first person to ask us why their child’s poop is so big.  Here at Purple Mountain Physical Therapy, our pediatric bladder and bowel physical therapist is trained to help children achieve bowel and bladder control.  Below we cover lots of details about what’s going on for kids who have big poops and PT options.  If you would like to call our clinic to learn more, we can be reached at (616) 516-4334 or contact us here.

If you are wondering why your child’s poop is so big, it is likely your child has constipation and may benefit from pediatric bladder and bowel physical therapy.

We provide physical therapy for children who struggle with bladder and bowel control, including kids who experience a range of symptoms such as enuresis (urinary incontinence), bedwetting, constipation and big poops.  It may surprise many parents to learn that sometimes the main symptom of constipation is a big poop.  Our licensed physical therapist who treats pediatric bladder and bowel conditions offers a variety of physical therapy treatments and evaluation methods to determine what is causing big poops and to improve your child’s issues.  When parents come to us perplexed and wondering why is their child’s poop so big, we are able to provide you answers and a treatment path forward to resolve this problem.   If you are interested in learning more about our methods, call (616) 516-4334 or contact us here.

The M.O.P. Method (Modified O’Regan Protocol) helps constipation, including kids who have poops so big they clog toilets.

One approach we provide for pediatric bladder/bowel problems is the Modified O’Regan Protocol (M.O.P.), which helps with enuresis, encopresis, constipation, bowel movements that are extra-large and urinary tract infections.  M.O.P. is a method to help resolve enuresis (including both daytime and nighttime urinary incontinence) and encopresis (fecal incontinence).  Success with the MOP Method resolves constipation, big poops and urinary incontinence.  The MOP Method receives its name after Dr. O’Regan, who is the first physician to have developed this protocol in the 1980s.  Because the protocol has been refined and modified, it is now called the MOP Method (Modified O’Regan Protocol).  Our therapist’s training in the MOP Method is unique in our community and provides families excellent support for their child’s bladder and bowel issues.  If you are asking yourself, why is my child’s poop so big, we are here to help give you answers.  To learn more about Purple Mountain Physical Therapy and our methods to help children who have large poops, constipation, bedwetting and enuresis, call (616) 516-4334 or contact us here.  

The MOP Method has been developed by Dr. Steve Hodges, MD, internationally renowned pediatric urologist, researcher and associate professor of pediatric urology at Wake Forest School of Medicine in North Carolina. 

Dr. Hodges is highly regarded worldwide in the field of potty training, pediatric urology and treating bedwetting, constipation and bladder control problems.  The M.O.P. Method is based on research, clinical experience and patient success that has found that a rectum filled with stool (constipated) that does not empty fully, causes bladder control problems.  As you can imagine, a child with a constipated colon will generate a large poop, sometimes that clogs the toilet.  To learn more about Purple Mountain Physical Therapy and our methods to help children who have large poops, constipation, bedwetting and enuresis, call (616) 516-4334 or contact us here.  

The Modified O’Regan Protocol (M.O.P.) helps with children’s Enuresis, Encopresis, Constipation, Poops that are So Big They Hurt and Urinary Tract Infections

Our pediatric bladder and bowel physical therapists here at Purple Mountain PT have trained in the MOP Method.  To inquire about cost and availability of our services, call us at (616) 516-4334 or contact us here.

The most common sign of constipation is huge bowel movements.  Does your child have poops so big, they clog toilets?  

Parents, you should be taking note of the size and shape of your child’s stool.  Big bowel movements coming out of a young child are signs of constipation.  If you are wondering why your child’s poops are so big, it is because the colon in these children gets backed up with stool and stretched out.  An enlarged, dilated, full colon is not healthy in childhood or adulthood.  To inquire about our pediatric bladder and bowel physical therapy, call us at (616) 516-4334 or contact us here.

The M.O.P. Method provides for using a variety of means to resolve chronic constipation and improve the size and shape of bowel movements so your child’s poop is not so big anymore. 

There is some flexibility within the M.O.P. process, as each child may require a personalized approach to determine what works best.  The use of enemas, laxatives, diet, exercise and behavioral changes may be trialed in this approach.  Our pediatric bladder and bowel physical therapist will guide your child and parents in the options and best methods to help your child experience improvement in bladder and bowel function and control.  If you know that your child has poops that are so big to clog a toilet, instinctively you have a sense that this is not optimal.  To learn more about Purple Mountain Physical Therapy and our methods to help children who have large poops, constipation, bedwetting and enuresis, call (616) 516-4334 or contact us here.  

The beauty of the approach is that as your child cleans out constipation, you will notice improvements in bladder control, both enuresis and nocturnal enuresis, in the size of poop (no more clogged toilets!) and in their bloating.

When your child experiences dry nights or days, parents often report hope and a lifting of the stress that enuresis had been causing.  If your child also has encopresis, you are monitoring this, as well and should notice improvements in bowel regularity, also.  You will also notice that your child’s poops are not as big anymore.  If you would like to learn more about how to help your child normalize the size of their poops and gain urinary control at nighttime, call us at (616) 516-4334 or contact us here.

The M.O.P. Method requires a commitment on the part of the child and family, because resolving ongoing constipation, bedwetting or daytime loss of urine (enuresis) is not a simple and easy fix. 

Our experience has taught us that the ongoing attention to bladder and bowel functioning, to avoid recurrent constipation, is important for success to be achieved.  Parents and children must be vigilant to monitor daily bowel habits.  In particular, things like illnesses, medications, diet changes, changes in activity levels and dehydration can all contribute to the return of constipation. Dr. Hodges suggests that children may benefit from daily osmotic laxatives, even after they have achieved bladder and bowel control, due to how easy it is to slip back towards constipation and holding in your poop.  To inquire about our pediatric bladder and bowel physical therapy, call us at (616) 516-4334 or contact us here.

At Purple Mountain PT, helping children and adults overcome bladder and bowel troubles is our life’s work.  Kids who clog toilets can benefit from PT.

We are devoted to providing our patients exceptional care, delivered in a compassionate, holistic and welcoming setting.    We use developmentally appropriate physical therapy interventions, such as the M.O.P. Method, biofeedback, exercises, games, practicing toilet postures and teaching children how to listen to the signals of their body.  Our greatest joy occurs when our pediatric patients or their parents report to us improved confidence and achievement with bladder and bowel control.  To inquire about our pediatric bladder and bowel physical therapy, call us at (616) 516-4334 or contact us here.

If you are wondering:

*Why your child’s poop is so big. 

*Why your child is able to clog the toilet.

*Why your child’s abdomen is distended.

Then you should consider constipation and the possibility that your child’s colon is distended.  This can be improved!

Constipation is the single most prevalent childhood medical condition.  Kids who have big poops are constipated!

Dr. Hodges notes that constipation is the single most prevalent childhood medical condition.  And, yet, it is usually unrecognized.  Consider this: kids with no signs of constipation often get better with a comprehensive bowel program.  Isn’t that surprising, that your child may have no signs of constipation (maybe their only problem is bedwetting, for example), and treating the constipation helps their main problem (bedwetting)?!  To inquire about our pediatric bladder and bowel physical therapy, call us at (616) 516-4334 or contact us here.

Can my child be constipated and I don’t know it? 

Yes, constipation is occurring much more often than most families recognize.  It is very easy to miss the signs of constipation.

Constipation can be happening when:

A child has a daily bowel movement, yet the movement is incomplete, strained or painful.

A child has a regular schedule of a bowel movement. Parents tell us “He always had a bowel movement every 3 days, so we thought this was his schedule and he was not constipated.”

A child has a big poop.  Often the large poop is a reflection of backup of stool.

Constipation may be missed when the child has no symptoms.

Constipation may be missed when it begins after a viral or bacterial illness, especially if the child required antibiotics. The family may not realize that the child experienced constipation that now becomes chronic.

Encopresis is a fancy term for childhood fecal incontinence or soiling of their underwear. 

Encopresis is the involuntary loss of stool.  Encopresis most commonly occurs in kids who are 4 years old or older who have long-standing constipation.  Typically, the fecal incontinence occurs when impacted stool builds up in the colon and rectum and becomes too large.  The liquid in and around the stool leaks out, staining the child’s underwear.  Sometimes the solid stool is also lost involuntarily.  Under these circumstances, you will notice that your child’s stool is very big.  Other times, the expulsion of the backed-up stool causes a mess of liquid and solid stool.   To inquire about our pediatric bladder and bowel physical therapy, call us at (616) 516-4334 or contact us here.

Ongoing retention of stool causes colon distension (stretching), a child to have big poops and loss of control over bowel movements. 

Our pediatric bladder and bowel physical therapist implements various methods to help retrain your child’s system to move stool, to use the toilet, to reduce constipation and to resolve encopresis.  Although encopresis may be frustrating or embarrassing for a child or parent, treatment is successful.  And one successful measure of treatment is the size and shape of bowel movements.  When properly treated, you won’t be asking yourself why your child’s poop is so big.  Instead, you will notice that their stool size and shape is appropriate of their age and food consumption.

When the constipation is improved, your child will also experience improvement in urinary incontinence, including daytime enuresis and nighttime bedwetting, as well as reduction in painful bowel movements, holding in bowel movements and poops so big they clog toilets.

By partnering with our physical therapist, families tell us that their stress levels and worry about their child’s social-emotional development eases.  To inquire about our pediatric bladder and bowel physical therapy, call us at (616) 516-4334 or contact us here.

Does Your Child Have Toilet Avoidance for Pooping?

Unfortunately, it is very common for children to completely avoid the toilet when they need to have a bowel movement.  We often see children who are dry with urinating, but ask for a pull up to have a bowel movement.  When a child holds in their bowel movement, they will develop constipation, gas, bloating, poops that are big and pain when trying to defecate.  When you are wondering why your child’s poop is so big, look at their daily bowel movement habits and you will notice a trend towards constipation.  If your child has this problem, our licensed physical therapist can help guide you and your child towards using the toilet to complete a bowel movement. To inquire about our pediatric bladder and bowel physical therapy, call us at (616) 516-4334 or contact us here.

MiraLAX is a good first step to try to get the colon empty, but does not work for all children.

Children who have chronic constipation, withholding of stool, incomplete emptying of the colon or encopresis, may benefit from trying MiraLAX to help facilitate softer stools.  Some children hold their stool in, because the stool is very big, hard and painful.  By softening the stool, the child can experience a more comfortable bowel movement.  With encopresis, a condition of fecal incontinence caused by overflow (they literally explode with stool), MiraLAX may not be effective for some kids.  Some kids don’t get relief at low MiraLAX doses and the next higher dose causes diarrhea, which also is not an effective solution.  Our pediatric bladder physical therapist is trained in MiraLAX titration protocols and can help guide you and your child through a MiraLAX regime.  MiraLAX can be a good first step and when implemented with other physical therapy methods (exercise, biofeedback, behavioral changes, toileting practice, etc.), our goal is that your child experiences improved bladder and bowel control.  If MiraLAX is not effective for your child, there are other options and our physical therapist can help you navigate the choices and monitor your child’s responsiveness, as well.  To inquire about our pediatric bladder and bowel physical therapy, call us at (616) 516-4334 or contact us here.

Dr. Sean O’Regan in the 1980s recommended nightly enemas for constipation and bedwetting.  The MOP Method builds on this work and also offers other treatments.

Since the 1980s, Dr. Sean O’Regan, recommended nightly enemas for constipation and bedwetting.  Dr. Hodges explains that this information seems to have been forgotten and instead of using enemas, MiraLAX became the treatment method for constipation.  Unfortunately, MiraLAX is often not implemented in an effective manner to resolve constipation and bedwetting.  Our pediatric bladder and bowel physical therapist is trained in the M.O.P. Method of effectively titrating MiraLAX or using other interventions to help constipation.  We can help advise you in implementing the protocols and will work with your child and family to come up with a program that is agreeable and do-able.  When you and your partner are asking each other, why is my child’s poop so big, you know that something isn’t right.  Our physical therapy can help your child resolve their constipation and bladder control issues.  We are happy to partner with your urologist, GI specialist or pediatrician to help this.  In fact, we have found that physician offices appreciate our guiding you on this protocol, as they don’t have the time to coach you through this.  To inquire about our pediatric bladder and bowel physical therapy, call us at (616) 516-4334 or contact us here.

Pediatric Bladder and Bowel Physical Therapy Includes a Range of Therapies to Improve Constipation, Poops that are So Big They Cause Pain and Urinary Incontinence

Our pediatric PT will provide you and your child with whole body care. Your child’s care is specific to his or her needs.  We work with children with all range of ability and cognitive function and can modify our methods to meet the comfort and needs of your child.  Some things that could be included:

  • Exercise to improve hip, core and pelvic floor coordination
  • Dietary and chewing strategies to optimize digestion and the gastrocolic reflex.  We wrote an article about how important chewing is, you can read it here.
  • Examination and treatment to your child’s abdominal wall and investigation to see if your child has a diastasis recti abdominis.
  • Manual therapy, visceral mobilization and gentle hands-on external techniques to facilitate bowel motility and bladder control.
  • Play based activitities that promote effective breathing and motor patterns necessary for bladder and bowel function
  • Biofeedback to teach your child to learn how to perceive their pelvic floor muscles and the urge to urinate and defecate.
  • Recommendations for sports and athletic pursuits that can improve the neuromotor control that bowel and bladder function requires.
  • Toileting posture, practice and techniques to urinate and defecate.
  • The M.O.P. Method and overseeing your implementation of this method at home.
  • To inquire about our pediatric bladder and bowel physical therapy, call us at (616) 516-4334 or contact us here.

Purple Mountain PT is the leading pediatric bladder and bowel physical therapy center in Grand Rapids, Michigan.  We are devoted to helping you and your child with any pelvic health needs, including if your child has big poops!

Purple Mountain Physical Therapy is located in Grand Rapids, Michigan.  We specialize in pelvic physical therapy for children and adults.  We are here to help support kids and families.  Our pediatric bladder and bowel physical therapist has advanced post-doctoral training and experience, including in the M.O.P. Method, potty training, bedwetting, urinary incontinence (enuresis) and pediatric bladder and bowel norms and developmental milestones.  Parents tell us that our evaluation and treatment for their child’s bladder and bowel provides peace of mind, hope and answersthe question, Why is My Child’s Poop So Big?   The families who come to us tell us that they feel less stress around the issue of their child’s bladder and bowel function.   We treat kids and adults and have advanced training in pelvic health physical therapy, including treating chronic pelvic pain.   If you experience pelvic pain, you may like to read this article we wrote about pelvic PT for pain.   If you are interested in learning more about our therapy, call (616) 516-4334 or contact us here.

Peace,

Dr. Maureen O’Keefe, DPT specialist in pelvic PT

 

 

Should My C-section Scar Still Hurt?

Author| Dr. Maureen O’Keefe, DPT specialist in pregnancy and postpartum recovery and c-section scars that hurt.

Should My C-section Scar Still Hurt? 

At Purple Mountain PT our patients often ask, “should my c-section scar still hurt?” We are pelvic floor physical therapists specializing in pregnancy and postpartum recovery and we have a special place in our heart for moms who birth via cesarean delivery. We offer a treatment program to optimize your postpartum recovery, take the guesswork out of what you should and should not be doing and to promote effective C-section scar healing and abdominal muscle recovery. A cesarean birth is a painful medical procedure, because it is major surgery. After any major surgery, it is best to work with a licensed physical therapist who specializes in treatment plans and rehabilitation for your particular condition. If your c-section scar still hurts after you would reasonably expect it to be fine, please reach out to get the support and treatment you need. Also, if in the early days of healing, you experience more pain than would be expected, get started with physical therapy right away. If you would like to learn more about our program to help alleviate scar pain for women after cesarean section, contact us here.

About 7 in 100 Women will have chronic C-section scar pain. The good news is that PT can help alleviate this pain.

A cesarean delivery is major surgery and you should be supported with the help of a licensed physical therapist on your c-section recovery journey. Your incision site may be the visible signs of your surgery, but your c-section scar tissue goes much deeper than the layers of skin, muscle and connective tissue. Most of us expect that this painful medical surgery will not be a cake-walk in the early days. But, very few of our patients were told they have a 7% chance of having chronic scar tissue pain after cesarean delivery. This is unacceptable and, we think, women should know that this is a risk factor following cesarean section and that physical therapy can help your pain. If you would like to learn more about our treatment to help alleviate scar pain for women after cesarean section, contact us here.

A C-Section That Has Healed Nicely Should have the Following:

  • Your C-section scar should not hurt you, at rest or when moving
  • You should move freely without pulling or pinching. The layers of skin, connective tissue, muscle, fascia and organ should move easily.
  • The scar should be able to move freely all directions, without restrictions.
  • It should not pucker anywhere along its length
  • The abdominal muscles should contract, relax and be able to maintain non-bloated appearance
  • You should be able to wear pants and all clothing touching it without pain.

Will Physical Therapy Help My Scar Tissue and Postpartum Recovery?

Yes. Our licensed physical therapists help women following their pregnancy and we treat all types of scars, including painful scars, c-section shelf scars, scars with adhesions, scars that underwent revision surgery and tunneling scars. We take the guesswork and uncertainty out of your c-section recovery so you’re not confused when looking at the jumbled layers of skin that are in your incision site. If your c-section scar hurts, it is telling you that something is not right and your healing process would benefit from a licensed physical therapist to develop a treatment plan to ease c-section scar pain. To answer your questions about treatment for c-section scars, contact us here.

C-sections that hurt more than expected in the first 24 hours have a greater risk of long term pain.

For some people, the first 24 hours post-cesarean are miserable. Unfortunately, data suggests that women who experience higher than expected pain levels in the first 24 hours have a higher risk of developing chronic pain from their c-section scar. Your surgeon may have done everything right, but a nerve can get sewn in just-the-wrong-way to cause ongoing pain. Or, perhaps your body experiences high pain levels following any trauma, like a cesarean birth. If you have higher than expected pain levels in the early days of your recovery, don’t delay starting physical therapy.

Your scar tissue is healing and laying down from the very first days after your surgery. If you are having more pain than expected, skilled PT can provide gentle movement based and hands-on based manual therapies to promote more effective healing and calm down your pain. At Purple Mountain PT, our postpartum physical therapists partner with you and provide whole body care that is helps calm down your pain, improve your abdominal wall integrity and strength, restore posture, resolve pelvic floor dysfunction and improve your overall fitness and ability to function. If you are interested in learning more about our physical therapy for postpartum recovery, including c-section scar recovery, call us at (616) 516-4334 or contact us here.

What does a physical therapy treatment plan include for the healing process following cesarean delivery?

We always want to resolve any pain. If your c-section scar hurts, we will alleviate this. We are also fully trained in orthopedic physical therapy and treat all neck, back, hip, leg and feet pain.

Our treatment plans will help you resolve your pain so you can move without difficulty and have greater confidence in your body. We use a variety of treatments to help ease your pain. These will combine exercise with manual therapy. The exercises include a variety of things to enhance strength, muscular coordination, pelvic floor muscle activation, to reduce trigger points and balance your pelvis, abdomen and low back. We also include manual therapies such as specialized joint mobilization, pelvic balancing exercises, manual therapy to address muscle stiffness, scar tissue adhesions, trigger point release or visceral restrictions. If you have questions about your c-section scar, contact us here.

All scars are treated, including c-section scar tissue as well as any scar from prior surgeries or injuries.

Sometimes women who had a cesarean birth are surprised to learn that vaginal deliveries can also result in scars, located in the perineal area whether from episiotomy or tearing. We can help all types of scars by using our hands-on scar mobilization techniques, visceral mobilization and fascial release.

Our manual therapy methods also help with endometriosis related adhesions and pain. We specialize in helping people overcome chronic pelvic pain, including endometriosis. If you had a c-section and also have endometriosis we would recommend getting PT as soon as possible to optimize your visceral mobility, scar tissue healing process and bowel/bladder function. If you have endometriosis and also a c-section and would like to learn more about our treatment for both conditions, call us at (616) 516-4334 or contact us here.

Abdominal muscle and tissue recovery is part of your treatment plan to help alleviate c-section scar pain and improve your ability to function.

We include diastasis recti abdominis and abdominal wall elongation recovery into your treatment plan to address your scar tissue. Our patients tell us that our diastasis recovery program lifts their confidence and demystifies what they should be doing to restore their abdominal wall appearance and function.  Following pregnancy, your abdominal muscles are elongated and often impaired. Additionally, the linea alba connective tissue can have trouble transferring load as your move through daily movement. Part of your treatment plan will include specific and detailed assessment of the integrity of your abdominal wall to determine if you have a diastasis recti abdominis, ongoing abdominal wall elongation (from the pregnancy) and impaired abdominal muscle activity. If you wonder if you have a diastasis recti abdominis, or what is going on with your “c-section shelf” or have general questions about your c-section scar call us at 616-516-4334 or contact us here.

We customize an exercise rehabilitation program to improve your strength. Postpartum moms need to retrain their muscles and body!

To alleviate c-section scar pain, any pelvic girdle or low back pain, neck and TM joint pain, our licensed physical therapists provide whole body care. By properly assessing you and providing private, one-on-one appointments that are upto 55 minutes in length, we give you the time necessary to effectively treat your symptoms. We will also help you improve your hip and glute strength, restore your pelvic floor function and more. If you have questions about our treatment plan for postpartum recovery following cesarean section so you can optimize your healing process, please contact us here or call 616-516-4334 to learn more.

C-section recovery research found postpartum PT with a pregnancy, postpartum and pelvic health licensed PT gets you feeling better.

Do you want less pain, the ability to exercise and higher satisfaction with your c-section recovery? What’s holding you back? 

Physical therapists who specialize in pregnancy and postpartum recovery have been saying for years that all women should be provided with physical therapy after giving birth. Research has shown that postpartum women who receive physical therapy have less pain and better ability to exercise. Being pain-free and physical fit are crucial for our quality of life, the ability to take care of others, to being in a good mood and to having the energy that being a mom demands. If you are interested in our postpartum PT program, call us at (616) 516-4334 or contact us here to have your questions answered.

Which group of women would you want to be in? All of these women had cesarean delivery, they were divided into two groups:

Group 1: These C-section moms completed postpartum physical therapy and were able to get back to exercise, completed a core retraining program (abdominal muscles, low back and more), had less pain and expressed higher satisfaction.

Group 2: These C-section moms did not complete postpartum physical therapy and they had more pain, were less able to exercise, were uncertain about how to get their core to recover and felt overall less satisfaction in their healing process and postpartum recovery.

It’s an easy choice, really. Of course, we all want to be part of Group 1! All you have to do is call us at 616-516-4334 or contact us here to start your postpartum recovery program. This research found that postpartum physical therapy twice a week for six weeks resulted in less pain, higher ability to exercise and higher patient satisfaction. Why wouldn’t you prioritize this for yourself?

Each of us deserves to not have pain, to move and exercise and to feel good about our postpartum recovery.

If you are going through your c-section recovery, our treatment plans will ease your mind and provide you with customized rehabilitation that takes the confusion out of your healing process. Our treatment plans are based on your specific evaluation findings and customized to your body. If you have c-section scar pain, or any pain in your postpartum period, our pelvic physical therapy program will help you resolve pain, improve strength, restore your pelvic floor muscles and get back to the things you love. At Purple Mountain PT we implement the measures that this research found helps you: core retraining, safe and structured stretches, hands-on treatments, education in what to be doing at home. If you have questions about our treatment plan for postpartum recovery following cesarean section so you can optimize your healing process, please contact us here or call 616-516-4334 to learn more.

Our physical therapy provides you scar massage and visceral mobilization to help all of your scar tissue slides and glides better. Scar massage can help collagen remodel in a beneficial way!

Our patients tell us that the hands-on treatments they received eased their c-section scar pain, improved the appearance of their abdomen, alleviated pelvic floor dysfunction symptoms and generally helped them to feel better. We are licensed physical therapists with post-graduate training specific to pregnancy and postpartum recovery, pelvic health and orthopedic physical therapy. We help women who had cesarean section deliveries or vaginal births. You can expect to receive a variety of specialized manual therapy techniques that ease tension, help adhesions, promote normal organ mobility, improve blood flow, resolve muscular trigger points, enhance joint motion and restore postural alignment. If you labored and tried for a vaginal delivery before ultimately having a cesarean delivery, please understand that your body went through a lot of stress and strain, both vaginally to the pelvic floor and ultimately with your major surgery. For c-section scars that hurt, you can expect care directed to your whole-body, because everything is connected and tension, restrictions or tightness in one area can impair the mobility of the layers of tissue in your c-section scar that hurts or is adhered.

If you want a healthy, mobile, unrestricted scar so that you can run, push, pull, lift and move without feeling the scar, give us a call at 616-516-4334 or contact us here. We treat EVERY scar (whether it is cesarean, laparotomy, vaginal birth, hernia, hip surgery, robotic or other scar) to get the scar moving optimally and so that your c-section scar won’t hurt.

Your C-section Scar may be contributing to your bladder control problems.

Cesarean delivery requires an incision site that is very close to your bladder. You will lay down scar tissue right near your bladder. Sometimes this scar tissue causes impairment with bladder filling or emptying or can disrupt the pelvic floor muscles and how they function. You may develop urinary frequency, urgency, urge incontinence, stress incontinence, difficulty emptying or lots of waking up at night to urinate. For women who had vaginal deliveries, it is well known that pelvic floor dysfunction, episiotomies or perineal tearing can also contribute to bladder control troubles when postpartum. Our postpartum recovery treatment plan includes care for your bladder, as well. If you had a c-section and now also have bladder symptoms, such as painful filling of your bladder, urinary urgency and frequency or incontinence, to learn more about our treatment call us at 616-516-4334 or contact us here.

Your C-section scar may be contributing to your Pelvic Organ Prolapse

Because the abdomen, pelvic organs and pelvic floor are so intimately connected, any disruption to the integrity of one of these areas can impair the others. Therefore, it is possible your C-section scar is impairing the support of your pelvis and contributing to prolapse. With pelvic organ prolapse we always work to optimize all of the support structures for your organs and vagina. Scar tissue and scar pain can both lead to pelvic floor muscle dysfunction and impairments in the support of the pelvic organs. For any patient who underwent cesarean or vaginal delivery, we always assess your pelvic floor muscles, organ support structures and look for signs and symptoms of pelvic organ prolapse. Rest assured, there are many things we include in our treatment plan that help improve pelvic pressure, urinary incontinence, c-section scars that hurt, scar tissue adhesions and pelvic organ prolapse symptoms.

Many of our patients live in fear of prolapse. Someone vaguely told them that they have a prolapse, which can be scary to hear, but did not advise them on what to do about it. We will clear your mind and give you a detailed treatment plan to address your prolapse. This is our life’s work and we are happy to share it to help you. Call us at 616-516-4334 to learn more or contact us here.

If your c-section scar hurts, we are here to help you!

We’ve detailed some of the considerations we include in our postpartum recovery treatment plan following cesarean delivery and many of these also apply to vaginal birth. The early days of recovering from this painful medical procedure should be effectively managed with high quality support from your surgeon and associated medical professionals. As you progress through your postpartum recovery, you should expect your c-section scar to begin to hurt less and eventually to have no pain. Our licensed physical therapists have post-graduate training in manual therapy methods to help all types of scars. For anyone who has a c-section scar that hurts on an ongoing basis, please know that it is never too late to get help for this from one of our physical therapists. Chronic c-section scar pain is not something to be ignored. We find many women put themselves on the backburner, prioritizing their children and other people’s needs over their own needs. We also find that women tell us they are frustrated, exhausted and feel ignored when they raise complaints of their c-section scar hurting. A frustrated, tired and ignored mom is not in the best moods and not up for all the things that may be required of her. If you are feeling this way, please reach out to us because we can help you. At Purple Mountain PT, we specialize in postpartum recovery, including cesarean birth healing and vaginal delivery rehabilitation. We provide treatment both in person at our clinic in Grand Rapids, Michigan and virtually via telehealth. Contact us here to learn more about our postpartum recovery treatment plan or call us at (616) 516-4334. We help women who are in pain every day and we can help you, also. We’ve written about PT for pain here and you may be interested to read that information.

Peace,

Dr. Maureen O’Keefe, DPT

The Journal of Women’s Health Physical Therapy published the research that showed that 6 weeks of PT following cesarean section improved pain and ability to exercise. The article is titled: Physical Therapy in addition to standard of care improves patient satisfaction and recovery post-cesarean section.

 

Why Does My Child Keep Wetting Their Pants?

If your child is struggling with daytime wetting, we have physical therapy treatment that can help.

At Purple Mountain PT we provide physical therapy treatment for pediatric urinary incontinence (diurnal enuresis and nocturnal enuresis). 

Parents, we understand you may feel frustrated or uncertain about why your child keeps wetting their pants and what you can do to support them. Our doctors of physical therapy are pediatric bladder and bowel physical therapy specialists. Our physical therapists are trained in the unique bladder and bowel developmental needs of children, and the therapy that kids receive for bedwetting, or any bladder & bowel condition, is specific to pediatric needs. If interested in learning more about our physical therapy for kids who have bladder or bowel control challenges, contact us here.

Our physical therapy treatment for kids who have diurnal enuresis and bedwetting can improve self-esteem, social engagement and alleviate household stress. 

One of our greatest joys is when a child returns to PT with a broad smile and exclamation of their busy social life! It truly is a gift for us to witness, because we understand that bladder and bowel control issues, including bedwetting, often inhibit a child’s social interaction and may increase their anxiety. With bedwetting, children and sometimes parents, also, experience embarrassment or social avoidance of overnight outings.

At what age is wetting the bed or daytime wetting considered a problem?

Daytime loss of urine (also called diurnal enuresis, daytime wetting or daytime urine accidents) occurs in 3-4% of children between the ages of 4 and 12. It is twice as common in girls than boys.

Most children develop control of their bladder when sleeping between ages two and five. 16-20% of children upto age six experience bedwetting (also called nocturnal enuresis). At age 6, we would expect that children should be able to control their urine when sleeping. If your child is struggling with bedwetting or daytime bladder and bowel issues, our pediatric physical therapy program is here to help. We work with children of all ages, helping them to learn effective bladder and bowel control. If interested in learning more about our physical therapy for kids who have bladder or bowel control challenges, contact us here.

Achieving bladder and bowel control is a complicated neuromotor task! Don’t get angry with your child who keeps wetting their pants!

Most parents recognize how amazing it is when your infant learns to roll over and then advances to crawling and walking. The crawling stage is actually very important for their future bowel and bladder control, because it helps their core strength and their pelvis alignment. When children potty train, the neuromotor control that is happening is abundant! There is so much that goes into holding urine and stool and an equal amount of coordination and motor planning is needed for a child to recognize the sensation of needing to urinate or pass a bowel movement. Once they feel the urge, they need to stop what they are doing (which might be a fun activity!) and go to the toilet. When in the bathroom, their ability to control their pelvic floor muscles comes into play. Commonly, our patients push their urine or stool out. Or they may have urinary stream that stops and starts. Or they might not actually finish urinating or passing the stool. If your child keeps wetting their pants, we will help uncover the things contributing to this. To learn more contact us at 616-516-4334 or contact us here.

We will help identify the mal-adaptive habits or methods your child uses to urinate and defecate. 

We work with you and your child to find the underlying causes of daytime or nighttime incontinence (nocturnal enuresis). Our treatment methods are designed to help your child to learn what is normal frequency of peeing and defecating. We also help your child learn what the urge to urinate or defecate feels like. We encourage your child to listen to their body and use the toilet when they experience an urge. Parents tell us that all of our physical therapy for bladder and bowel control is so helpful to have another adult talking to their child, re-enforcing what has often been said by the parent. Parents get tired of saying to their child “Do you need to go the bathroom?” or “Please, go to the bathroom, you haven’t gone in hours.” And it is common that the child’s response is “I don’t need to go.” That’s frustrating for parents. We help take the frustration out of the circumstance; let us support your child towards understanding their body and gaining bladder and bowel control. If interested in learning more about our physical therapy for kids who have bladder or bowel control challenges, contact us here.

The International Children’s Continence Society recommends treatment for bedwetting for any child 6 years old or older: 

Treatment is not only justified but mandatory.” – ICCS Standardization document 2010

What if my child is a pre-teen or older, can physical therapy help bedwetting for these ages? Yes we can!

We work with any person under the age of 18 who experiences bedwetting. Even though this is a private matter inside your home, the truth is that there are countless adolescents and teens who struggle with bedwetting. We recommend getting treatment at an earlier age, simply because it can help ease anxiety and household stress and promote your child’s social skills when bowel and bladder control has been achieved. However, if your child is “older”, have no fear, we commonly help adolescents and teens who have bedwetting. To learn more about our physical therapy to help your child’s bedwetting, contact us here.

What does bladder and bowel physical therapy do for incontinence (diurnal enuresis) or bedwetting?

We begin with an evaluation that fully analyzes bladder and bowel function, both daytime and nighttime, developmental levels and motor control. We provide a variety of therapeutic interventions to help your child learn to not keep wetting their pants.

We know it is frustrating for both you and your child when your child keeps wetting their pants. Our PT will uncover things that are contributing to this happening. We may ask you a variety of questions regarding your child’s bladder and bowel function. These could include

  • Toilet habits and behaviors, in particular does your child hold their urine too long, avoid bowel movements, or not empty completely?
  • Ball-park quantification of daytime urinary stream
  • Ballpark quantification of nighttime urine loss
  • Urinary flow characteristics
  • Urinary urge
  • Sleep quality, movements, habits, bedtime. Arousal during sleep.
  • Urinary frequency during daytime
  • Dietary habits, timing of foods, fiber, fluid intake and types of food and drink
  • Bowel habits including frequency, timing, sensation of the need to void, straining, pain, bloating or other.
  • Abdominal bloating, pain or cramping
  • The efforts you have made that have failed to achieve sleeping through the night without loss of urine
  • Urinary tract infection history.
  • Developmental milestones for motor and speech.
  • Urinary urge and your child’s reaction to urge
  • Bowel movement urge and your child’s reaction to urge
  • Toileting postures
  • Your child’s physical activities and sports
  • Any pertinent medical history. This could include anything, including: learning disabilities, congenital anorectal malformation, diabetes, spina bifida, down syndrome, autism, any developmental delay, anxiety, ADHD or any other condition.

If interested in learning more about our physical therapy for kids who have bladder or bowel control challenges, contact us here.

Our goal is to fully support you and your child and provide developmentally appropriate care. As such, our families tell us that the PT for their child’s bladder and bowel control challenges has been therapeutic, empowering and uplifting. 

Your child’s physical therapy will be comprehensive and fully work to address daytime and nighttime bladder and bowel issues.

Quite often families come to us and are not aware of any daytime bladder issues and report their child has daily bowel movements. However, upon further inquiry we often find that children do, indeed, have non-optimal bladder and bowel daytime function. If we want to alleviate bedwetting, we must optimize daytime bladder and bowel function. If interested in learning more about our physical therapy for kids who have bladder or bowel control challenges, contact us here.

We use a variety of methods to improve your child’s bladder and bowel control. These include:

  • Biofeedback to help your child learn to release and tighten the bladder and bowel control muscles.
  • Core strengthening for any child who has low tone, weak core or lower strength
  • Breathing exercises
  • Training to improve your child’s awareness of what an urge to urinate and defecate feels like. Improving their sensory understanding of their body is crucial. Children often are completely unaware of the need to void.
  • Toileting practice, teaching them proper posture, breathing, release of their pelvic floor muscles and relaxation during both a bowel movement and urination.
  • Dietary recommendations to facilitate complete bowel movements daily, without straining.
  • Constipation remedies including dietary suggestions, manual therapy and exercises to facilitate complete defecation.
  • Partnering with your pediatrician and advising you on protocols to facilitate a bowel clean-out. Often children who have bedwetting or daytime wetting their pants issues, have constipation.
  • Coaching your child in toileting habits, sleep habits and healthy bladder and bowel habits.
  • Gentle manual therapy methods (external only) to facilitate intestinal motility, awareness of their body and relief of muscular guarding.

Pediatric physical therapy for a child who keeps wetting their pants or experiences bedwetting must always assess and treat constipation!

When a child experiences urinary incontinence, whether daytime or when sleeping, quite often constipation is present. The nerves for the rectum and bladder are near each other, so if the rectum is full of stool, this can throw off bladder function. Additionally, a full rectum may physically push the bladder, contributing to bladder spasms and unexpected loss of urine, during the day or with bedwetting. To learn more about our physical therapy for kids who have bladder or bowel control challenges, contact us here.

Physical therapy to help any child who is wetting their pants or experiencing bedwetting is provided in a safe, private treatment space in an uplifting environment that is developmentally appropriate. Parents are always included!

At Purple Mountain PT, our treatment rooms are designed for our patients to experience a therapeutic setting. We work with you to create a partnership with you and your child that facilitates true progress with their bladder and bowel challenges. Because this is our life’s work, we are sensitive to the embarrassment that children may face and, as such, we use discrete and appropriate methods throughout your care so your child actually wants to come to PT. Our approach is positive, encouraging and therapeutic. We celebrate your child’s success and intentionally motivate your child to achieve the goals we create together. We love working with pre-teens and teens and find that they connect with our physical therapists because we are athletes, students and engage them in conversation on topics they enjoy, such as their sports or musical theater or band. If interested in learning more about the work with do with kids of all ages, contact us here.

Biofeedback and pelvic floor muscle training are helpful components of treatment for a child who experiences enuresis or nocturnal enuresis. 

The pelvic floor muscles, in coordination with breathing and the abdominals, are responsible for both storing/holding urine and stool and letting it go in the toilet. Some children don’t yet know how to effectively control these muscles. They may have learned mal-adaptive habits such as holding their urine too long, avoiding defecating, not using a public toilet or not drinking enough water. Sometimes the pelvic floor muscles get confused and need to be retrained. Our physical therapy for pediatric bladder and bowel control will help your child learn how to better understand and control these important muscles. To learn more, contact us here.

Behavior modifications can help facilitate urinary and fecal control!

Often we find that our patients simply don’t like to use the toilet. They may avoid it all together or simply choose to use the toilet rarely. They may, in fact, not even feel the urge to urinate or perceive the need to pass a bowel movement. Often the kids legitimately did not realize they wet or soiled themselves. Parents may grow frustrated by this, but there is no benefit to getting angry with your child. Indeed, the lack of control is legitimately beyond their awareness. A child with this lack of awareness and, even a child who has awareness, but still wetting their pants sometimes, often benefits from behavioral modifications. We coach your child, using motivational techniques and education, to make better choices and to learn how to better take care of their body. We will teach your child optimal toileting posture and methods to pass urine and stool. Hint, they should not be rushing or pushing their pee or poop out! Our expertise and training helps identify these underlying habits and coaches you and your child so that bladder and bowel habits are optimized. Here is a link to a booklet about pediatric bedwetting that may be helpful for families to use at home. If interested in learning more about our physical therapy for kids who have bladder or bowel control challenges, contact us here.

To stop bedwetting and daytime wetting, positivity helps! Our physical therapy works to stop bedwetting, to improve daytime continence and to boost self esteem!

One key to our success with your child is we comprehensively treat your child and identify numerous items that may be contributing to their challenges with bladder and bowel control. 

We reward your child and help them to feel motivated to have success! We love to see a child proud of themselves and report success!

Purple Mountain Physical Therapy provides developmentally appropriate physical therapy for pediatric bladder and bowel control issues. We work with all ages and offer treatment that empowers kids to feel proud of their achievement. Because we are pelvic health physical therapists who also treat adults, we understand that bladder and bowel issues are prevalent across the lifespan. It is our hope that if we can support kids towards better pelvic health, some of them will not develop adult issues with their bladder and bowel function. Our doctors of physical therapy promise to give you our best! To learn more about our physical therapy to help your child’s challenges with bladder and bowel function, call 616-516-4334 or contact us here.

Peace,

Dr. Maureen O’Keefe, DPT and the Purple Mountain Physical Therapy Team

 

What is Pelvic Floor PT?

Author| Dr. Maureen O’Keefe, DPT

What is Pelvic Floor PT?

No worries if you’ve never heard of pelvic floor PT! We cannot tell you how many times we have heard “I never knew that this physical therapy existed.” In 2022 I am marking 25 years of being a pelvic health physical therapist! This is not a new field of physical therapy, it has been well established for decades. If you are interested in learning more about how pelvic PT can help your condition, reach out to us here.

Pelvic Floor PT resolves pelvic pain, bladder, bowel, prolapse and intimacy problems.

This is the most succinct way of describing what is pelvic floor PT. We solve all pelvic problems, including bladder & bowel troubles, pelvic organ prolapse, intimacy pain, and pelvic, hip, and low back pain. Sometimes the issues are directly related to pregnancy and childbirth, whereas other times the condition has nothing to do with pregnancy. In fact, we treat children who have troubles with bladder and bowel control and also treat men who experience pelvic pain or bladder/bowel challenges.

So, how does pelvic floor PT treat your pain? Help your prolapse? Improve your bladder & bowel struggles?

We restore your body’s ability to function without pelvic pain, hip pain, back pain, urinary, bowel and sexual challenges. We do this by assessing your whole body to determine where you may have issues that are contributing to your pelvic problem. We then create a customized treatment program that may include a combination of exercises and manual therapy. Our objective is to optimize your bladder and bowel, ease tension along the length of pinched nerves, improve blood flow to tissues, reduce muscle trigger points, fascial tension and scar restrictions in the abdomen, pelvic floor, hips, spine or elsewhere. We use joint mobilization and other techniques to balance your pelvis and spine to provide full and pain free movement at your joints. If you are interested in getting started, reach out to us here.

Pelvic Floor PT begins with an Evaluation to understand your goals & symptoms and determine the underlying contributions to your condition.

At Purple Mountain PT every appointment is private, with the same doctor of physical therapy and is upto 55 minutes in length. This allows us the time to provide you comprehensive care that gives you results. We begin your care with an evaluation, where we discuss in a comfortable, private treatment room your symptoms and goals. These things guide our next steps in the evaluation. We may be assessing and treating your posture, thoracic spine, low back, hips, knees, feet and abdomen. The pelvic floor muscles are a group of muscles that line the bottom of your pelvis. With your permission, we also assess and treat these muscles to determine their status. We check your core strength, including the integrity of your abdominal wall to look for diastasis recti abdominis or ongoing elongation problems often related to low tone or pregnancy disruptions. We assess the strength, coordination and effectiveness of all of your core muscles, including your low back, hips, pelvic floor and breathing. Research has found that with low back pain a person also has pelvic floor dysfunction, so we do address any low back problems, even if this is not your primary issue. Research has also found that with low back pain the low back muscles lack endurance, so your care will include specific exercises to re-train these muscles. If you are interested in learning more about our pelvic floor PT program, contact us here.

Research has shown us that the pelvic floor muscles commonly have a variety of problems such as being:

  • Sluggish: they don’t contract as quickly as needed (Hence leakage)
  • Stiff: they tend towards being short and contracted. When this is the case you can experience pain, leakage, bladder spasms, constipation or any number of other problems.
  • Weak: because they are stiff and sluggish they cannot generate the power needed
  • Lacking endurance: these muscles are postural muscles and should be working all day long for you. When you have pelvic floor dysfunction they get tired out quickly and you develop symptoms.
  • Dis-coordinated: the muscles should be part of a symphony of muscular coordination with your low back, hip, abdominal and breathing muscles. Instead, these muscles get all mixed up.
  • Stressed out. For REAL. These muscles have autonomic nervous system components in them, so they react to all stress.
  • High Tone: with high tone pelvic floor, the muscles do not relax and lengthen effectively. If this is the case you may experience pain, urinary leakage, urinary frequency and urgency, nocturia, painful intimacy, constipation, hemorrhoids, prolapse or other symptoms.

Our treatment program have a goal of resolving this pelvic floor dysfunction and we do this by providing whole body care that effectively coordinates all of your muscles, so no one muscle group is over-burdened or strained.

You will feel supported, understood and cared for.

At Purple Mountain PT we provide trauma informed and therapeutic care. From the first moment you contact our office, we want to meet your needs. We answer your questions, explain what to expect and welcome you. Each appointment is upto 55 minutes in length, in a comfortable, private treatment room and with the same doctor of physical therapy. This is an important thing to note because not all physical therapy is set up for this level of success. Over many years of doing this work, we have learned that you need to establish a trusted relationship with your provider. And we need to work with you so we can learn what you need and adjust our treatment accordingly from week to week. If you bounce around from provider to provider some things are always lost in translation. To speak with our care coordinator and get your questions answered, call us at (616) 516-4334 or contact us here.

Pelvic Floor PT is Holistic

The holistic nature of this care means that we will be assessing and treating all of your joints, fascia, muscles, nerves, blood flow and all areas in the spine and abdomen that are related to bladder and bowel function. High quality pelvic PT truly assesses and treats your entire body. This is because the neck, feet, rib cage, posture, hips and lower extremities all affect your pelvic floor. Our patients are often surprised that we will be working their myofascial tissues of their shoulder blades because we know that the bladder can have regions near the shoulder blades that influence bladder control. Our treatment commonly includes myofascial mobilization, trigger point release, visceral mobilization, joint mobilization, stretching, strengthening, coordination exercises, breathing exercises and more. The hands-on treatment that we provide in conjunction with exercises that improve your muscle coordination, strength, endurance and flexibility are key to getting you feeling better. If you are interested in learning more, reach out to us here.

One recent patient, amazed at how much better she felt following an appointment, asked us “How do you know ALL OF THIS STUFF?” Well, this is our expertise and we’ve devoted ourselves to ongoing learning. Our team at Purple Mountain PT has been doing this for many years and we’ve learned a lot by working with people just like you. We continually keep up with research and pay attention to what works for our patients.

We also include neural calming strategies so that your autonomic nervous system can balance.

The pelvic floor muscles are unique in that they have autonomic nervous system fibers innervating them. This means that if you are stressed, anxious, excited, depleted, fearful, angry or experiencing emotional turmoil, your pelvic floor muscles can respond to these emotional states. Our pelvic PT methods include ways to calm and balance this aspect of your nervous system, so that your pelvic floor is not continually over-reacting to the stress of life.

Pelvic floor Rehabilitation provides treatment specific to conditions related to the pelvis: the joints, nerves, muscles, connective tissue, organs, and blood supply.

Everything that is housed in the pelvis and above and below the pelvis (abdomen, back/spine, thighs) are part of pelvic floor PT. We help people overcome problems related to a long list of conditions, such as:

If you have any of these problems, reach out to us here.

The pelvic floor muscles are just a small fraction of what might need treatment. This is the surprise of pelvic floor PT! It isn’t limited to just one set of muscles.

Physical Therapy, by its nature, is a movement based approach to rehabilitation. Pelvic PTs include exercise, movement, strength, conditioning, stretching, balance and dynamic movements into your program. We teach you how to get those pelvic floor muscles to be responsive. We don’t want them sluggish and dis-coordinated. We use a variety of exercises and biofeedback to teach you how to rehabilitate these muscles.

By treating all members of the team (your neck, back, feet, knees, hips, etc.), we can restore your pelvic floor.

Your pelvic floor muscles are always responding to and supporting other areas of your body. For example, when you walk, your feet hit the ground and send ground reaction forces up your leg into your pelvis. Therefore, if you lack foot or ankle mobility, you may be jarring your pelvis more than optimal. This is why a high quality pelvic floor PT program will treat your whole body. We have to evaluate and treat all of the “teammates”. These include your joints, ligaments, muscles and fascia of your back, abdominals, diaphragm and other breathing muscles, shoulder blade and upper back postural muscles, inner thighs, glutes and hips, quads and hamstrings. All of these things work together to allow you to move easily, to sit without pain, to pee freely, to hold your urine at will, to have a normal bowel movement, to experience sexual pleasure. If you are interested in getting started, reach out to us here.

Your Fascia is Continuous From Head to Toe. Therefore, if your pelvis isn’t feeling good, we must find fascial restrictions that are causing problems.

The connections, especially fascia connections from the pelvic floor muscles to the bony pelvis, tailbone/coccyx, sacrum, abdomen, rib cage, shoulders and legs are hugely influential on the function and status of your pelvic floor. In pelvic floor PT a lot of the care you receive is actually directed to fascia, tissues and joints that are far away from your pelvic floor, but are having a profound impact on the pelvic floor function. The pelvic floor muscles and pelvic fascia contribute to our pelvic stability so that we can walk, keep our balance, roll in bed, climb stairs and generally move smoothly. If the pelvic floor muscles are not functioning well a person may experience pelvic organ prolapse, sexual or urinary dysfunction, postural compromise and altered breathing mechanics.

Purple Mountain Physical Therapy is a specialty pelvic floor PT and TM joint disorder clinic located in Grand Rapids, MI. Our doctors of physical therapy provide expert care for pelvic floor dysfunction and bladder, bowel or intimacy related problems. Many of our patients come to us frustrated due to chronic pain, whether it is hip pain, back pain, neck pain, TM joint disorders or pelvic pain (such as abdominal pain, pubic, SI joint or deep inside). We have advanced training and experience helping individuals overcome chronic pain. There is not a formula to overcome chronic pain. Instead, we provide individualized and comprehensive care that is customized to each person’s findings. Our patients tell us finding our treatment has been the most important thing they’ve done to help their pain! We are honored to help you. Call 616-516-4334 to get your questions answered or reach out to us here.

Peace,

Dr. Maureen O’Keefe, DPT

 

 

When is it more than just being a picky eater?

This is a guest blog post by Courtney Joesel MA, CCC-SLP from Building Blocks Therapy Services. Building Blocks Therapy Services offer speech, language and feeding therapy for infants through adults. Please visit www.buildingblocksgr.com or call (616) 570-0925 to learn more.

When is it more than just being a picky eater?

Recently, I was able to sit down and discuss the common threads with the team at Purple Mountain PT. One topic of discussion was feeding disorders and the impact that digestion and motility can have on the body. Building Blocks Therapy Services offers feeding therapy throughout the lifespan.

We often hear the phrase “picky eater” being used as children grow up for those that tend to prefer certain foods and/or in specific ways. Maybe you know of or have a heard of a child only eating certain brands of yogurt or only eating certain colors or shapes of fruit snacks. Mealtimes may be stressful, but when is this just a phase versus a disorder that needs intervention?

How prevalent are feeding disorders?

According to various studies, parents report “picky eating” at a prevalence rate of up to 50%! (The definition of picky eating varied across studies). Additionally, only about on third to one half of these children will “outgrow” their picky eating in a 2-3 year time span.

 Surprisingly, 1 in 4 children are reported to have some sort of feeding disorder in their childhood. This is also reported to be of higher prevalence for children with developmental disabilities.

Signs of more than picking eating

Picky eating is a very common phase that children will go through anywhere during the 2-5 year old range. This “phase” should not extend a lengthy period of time. If the child was an adventurous eater and did not present with any mealtime difficulties prior, the child will likely increase their food repertoire. Here are some red flags of feeding concerns that may warrant a referral to a feeding specialist:

  • Coughing throughout meal or when drinking
  • Abnormal bowel movements
  • Eats less than 20-30 different foods at 2.5 years of age
  • Gags with new or no nonpreferred foods
  • Limited variety of textures
  • Eating only easy to swallow foods
  • Food refusal

Influences of gut problems

There are many developmental stages that are important for a child to experience to build their feeding skills. Influence on early feeding experiences can have an impact on the children’s feeding development. Such as a history of reflux during infancy, their body experienced an adverse reaction to feeding. Additionally, if the child is not completely emptying their digestive system, this can impact their hunger drive.

Feeding disorders can have a basis in different area such as oral skills, sensory, or behavioral. It is important for the skilled clinician to assess and determine the individual plan of care for the best approach for the child.

Ways to tackle mealtimes with a picky eater

Children who are going through a period of picky eating can make mealtimes stressful for them and their families. Creating a structure to mealtime is extremely important. An example of this could be

  1. Washing hands before the meal
  2. Sitting in a well supported chair with feet supported
  3. Presenting all foods to child on the plate without pressure to eat. Can use an “all done” bowl
  4. Do not have distractions such as tv or toys. Have conversations and engage with child
  5. Expect the child to stay at the table
  6. Signal end of meal by washing hands or wiping area clean

How we can help

Building Blocks Therapy Services is a speech therapy clinic in Grand Rapids, Michigan. Our clinicians treat infants through adults with speech, language and feeding disorders. We are highly trained in oral function and looking to treat the foundational deficits to improve the symptoms. Many families are dismissed regarding their concerns with their child’s food intake or symptoms. Our therapy programs are individualized to the child and families needs. Often, after initiating treatment, families report increases in willingness to try foods, calmer mealtimes, and increased food intake. If you are interested in learning more please visit www.buildingblocksgr.com or call (616) 570-925.