Updated September 2023
Pursuing pelvic floor therapy may be intimidating or scary; some of you may not even know that it is an option. I wanted to share my experience with using pelvic floor therapy to eliminate stress incontinence (aka: peeing when you jump, cough, laugh, etc.).
It all started at a trampoline park.
I figured, I paid my admission, I may as well get a few jumps in along with the kids. Away I went. And away went my bladder. I didn’t feel like I had to pee, but I jumped, I landed, I squirted.
Luckily, I never leave the house without my trusty Öko pantyliner, so I was spared the embarrassment of damp leggings. I even attempted a couple more jumps. Maybe it was just a fluke! Alas, it was not a fluke.
I posted a selfie of my “omg I pee when I jump” face on my Facebook page (obviously), and received a lot of commiserating comments from fellow mamas.
My post caught the attention of Mercedes Eustergerling, a local physiotherapist who specializes in pelvic floor physiotherapy. She made it clear to me that light bladder leakage (LBL) isn’t just a fact of life that moms need to accept and cope with. There might be a whole industry of disposable products designed to catch those leaks without showing through your favourite dancing skirt (Why are women in LBL commercials always dancing?), but it’s a problem that CAN be fixed.
Because my brother is also a physiotherapist, I always knew that pelvic floor therapy was a thing. I just didn’t know what this thing entailed. Mercedes encouraged me to come see her, and she enticed me with evening appointments and online booking. I was so excited I arrived an entire day early for my appointment and had to sheepishly return the next day.
What happens during a pelvic floor therapy session?
I intentionally went to my appointment without any idea of what was going to happen. I double checked with my aunt just to be sure of the one thing I needed to know in advance: was there going to be *ahem* penetration by a gloved hand? Yes, yes there likely would be!
Thankfully, childbirth has made me stunningly uninhibited. This is beneficial because Mercedes and I broke the ice with an extensive questionnaire about my vagina and my urethra and its neighbouring body parts. The interview is in-depth and covers everything from symptoms experienced during intercourse to frequency of urination to your childbirth history. A good therapist will put you at ease, and if ever you are unable or unwilling to answer any questions, you won’t get in trouble.
If an internal exam makes you uncomfortable for whatever reason, note that everything in physio is optional. Some patients choose to do external work only or hold off on an internal exam until they’re ready and comfortable with it.
Going ahead with an internal exam allows your physio to properly assess why you are experiencing light bladder leakage (or an overactive bladder, fecal incontinence, painful intercourse, pelvic pain, genital pain, low back pain, or hip pain or issues associated with menopause). The exam is done with gloves and lubricant and a sheet covering you. (I would like to point out that Mercedes’ lube was called “Slippery Stuff.”) While her fingers are inserted in your vagina, she will ask you to perform different movements with your vaginal muscles. This was much harder than I thought. In fact, I discovered I had very little control over those muscles at all. In order to “pull up” or “tighten” as she asked, I found myself contorting my face in concentration, and frequently moving my butt muscles instead of my vaginal ones …
Diagnosis: Stress urinary incontinence.
Prognosis: With commitment to prescribed exercises, I would be free to jump, sneeze, laugh and cough without fear!
At each of my subsequent appointments, Mercedes would assess the impact of the prescribed exercises. Each time, I found I was able to scrunch up my face less and clench my butt less when controlling my vaginal muscles as required.
The exercises included tightening and relaxing, tightening in a sort of “elevator” fashion up my vaginal wall and tightening while squatting and jumping. I had to practice twice a day for a few minutes. Let me emphasize that the exercises are not just Kegels. In fact, sometimes Kegels can cause problems, which is why you should always see a pelvic floor physio to make sure the exercises you are doing are helping resolve rather than exacerbating your problem. And no, I didn’t practice twice a day, every day, but I did it enough to make a noticeable difference at each check-up. Knowing she and her glove were going to test my progress was motivation enough to keep practising!
After just three sessions, Mercedes declared I had graduated from pelvic floor physiotherapy!
So am I cured? Well, yes! Thanks to Mercedes’ guidance and exercises, my vaginal muscles now respond to jumps, sneezes and chuckles by tightening on cue. I don’t even think about it anymore. When I sneeze, my muscles tighten and nary a dribble of urine escapes, even with a full-ish bladder. Now that I am pregnant, when I am historically most susceptible to light bladder leakage, I can confirm that my treatment has worked!
Pelvic floor physios can also help with post-prostatectomy care, pregnancy and prenatal issues and preparing for a VBAC (vaginal birth after caesarean).
Update:
The above mentioned experience with pelvic floor physiotherapy took place after my second pregnancy and birth. I gave birth to twins the following year and started almost immediately suffering from bouts of debilitating back pain.
Because … twins … I didn’t start dealing with the primary cause of this pain until just this year (2023).
I visited Shilpa Kumar at Vida Health only to have her confirm what I had long suspected: a very weakened core and diastasis recti.
Although my stress incontinence was not a problem, my weak pelvic floor and core were leading to excessive strain on my back. Essentially I was not engaging my pelvic floor or abdominel muscles during exercise, lifting or really any daily tasks, and I was constantly throwing my back out.
This time, rather than exercises focusing exclusively on the vagina, I learned to engage my pelvic floor and my core muscles during my stretching and strengthening exercises.
As long as I keep up with my stretches and exercises, my back pain is mostly gone. In the same way that I learned to engage my pelvic floor muscles before a sneeze or a jump, I have re-trained my body to engage my pelvic floor and core in my daily movements to protect my back.
And the most unexpected improvement has also been achieved: since my very first pregnancy, I have always peed any time I have had to vomit (which was far, far too often during my subsequent pregnancies). I had the unfortunate experience of vomiting recently, and once I had recovered, it dawned on me that I did not pee my pants!
Ready to get started?
To find a pelvic floor physio near you, consult the physiotherapy association in your province; their website will have a searchable database (just put “pelvic floor” as the search term for areas of practice). In Alberta, you can visit www.physiotherapyalberta.ca. Another resource is Pelvic Health Solutions, and their listings are primarily in Ontario.
If you’re in Calgary, I highly recommend my physio, Shilpa Kumar, at Vida Health (the original PT I saw, Mercedes, is now teaching physiotherapists and not taking clients).
And, just a note, this post is not sponsored by Vida Health … I just really wanted my readers to know about pelvic floor physiotherapy!
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