Sally’s Victory Over Stress Urinary Incontinence with Pelvic PT

Hello friends!

We’re heading into May, the month with Mother’s day. To celebrate, we’ll have the theme of pregnancy and postpartum in honor of birthing people, and today, we’re talking about stress urinary incontinence. Although pelvic PT helps with many things, stress urinary incontinence after childbirth is one of the hallmark diagnoses that pelvic physical therapists are known to treat. However, it may be not common knowledge that kegels are not always the answer!

Story time –

Let’s talk about one of our patients; let’s call her Sally. Sally came to The Pelvic Model when her youngest child was already 2 years old, and Sally was suffering from stress urinary incontinence since he was born. She would fully leak when she ran to chase him around the house. Like many people, she thought that once she gave birth, incontinence was just something that she’d have to deal with. Fortunately, one of her good friends told her about pelvic floor physical therapy and how much it can help people with a variety of conditions, and she found herself here at The Pelvic Model looking for answers. 

When she arrived, she envisioned herself going to the trampoline park with her kids while remaining dry, getting fit without any leakage, and generally being active without the fear of urine escaping with any type of exertion.

During the evaluation, we found that she was generally weak in her abdominal muscles, pelvic girdle muscles, and pelvic floor muscles. Typically, we’re looking for muscles that are “too tight and restricted” and connective tissue that is restricted. How does restriction contribute to excessive leaking? Well, consider muscles that cannot fully close sphincters because they’re too tight in one position. Or consider muscles that cannot contract and relax appropriately because they move too slowly, with restrictions playing a significant role in that. Fortunately for Sally, her pelvic floor muscles were not restricted, allowing us to proceed directly into strengthening and controlling her muscles, as well as improving impact and endurance.

We first started off with simple exercises to teach her how to engage her core, which consists of her pelvic muscles, diaphragm, abdominal muscles, and back muscles. This typically can take some time. Remember what it was like learning how to kick a ball? Now imagine refining that movement over and over again. The pelvic muscles are often not thought about, and you cannot see these muscles, making the challenge of activating them more difficult than other muscles. 

After spending some time on that, we began adding pelvic girdle strengthening exercises accompanied by appropriate core control to prevent leakage with simple movements. And let me tell you, she was getting STRONG! Towards the end of her treatment, some of her exercises included weighted Bulgarian split squats, which are not the easiest to perform correctly.

Once she became stronger, we began incorporating impact exercises such as jumping and running in place. Although she did experience some leakage during these exercises in the clinic, we were able to fine-tune her technique to discover what worked best for her body to keep her leak-free.

We're thrilled to report that Sally is now able to attend workout classes without experiencing any leakage. She even went into a bounce house and came out completely dry!

While Sally’s journey may differ from others, such as those where we prioritize lengthening the pelvic floor muscles before progressing to other exercises, her story is incredibly successful and relatable. Just because someone has given birth doesn't mean they have to live with lasting stress urinary incontinence, pelvic pain, discomfort during intercourse, or any other related issues. This is just one example of how effective communication with your physical therapist about goals, tailoring treatment to the individual patient, and refining exercises along the way can help achieve the outcomes you've been envisioning (as cliché as that may sound).

Thank you, thank you for reading! Our goal is simply to help people with these issues, so if this resonates with you or anyone you know, don’t hesitate to inform them that there is help available!

To your pelvic health,

The Pelvic Model Team