Prevention interviews clinicians including me!! While working as a pelvic physical therapist in the Department of Physical Medicine and Rehabilitation, I was interviewed for an article regarding Kegel exercises. This article details the right way to perform Kegel exercises, as well as who should and should not try them.

I treated a young patient last week with abdominal pain, night time urination x3/night, anxiety and asthma. After evaluating her, I saw that her trunk was shifted Right, her pelvis was mal-aligned, her pubic ridge was uneven and had trigger points, her abdomen had great tension and her left leg had poor caudal glide. After I applied MFR (Myofascial Release) to her trunk in side lying, I addressed her fascia in the lower abdominal region and her respiratory diaphragm, her right psoas, balanced her pelvis, and treated her tension near her bladder. I then addressed her cranium for tension near her eyes in the sphenoid bone. After 45 min, my treatment was finished for the day. She arose from the table, ran 5 laps around the table and exclaimed,” I feel all stretched out!” That night, she slept 9 hours and did not awake until 5:30 am to urinate. The next night, she did not awake at all to urinate. She had no pain either day. The bladder is anchored to the pubic bone by the uracus ligament. When the pubis is mal-aligned, the bladder is pulled into a torsion and cannot function properly It is imperative to release this restriction and to align the pelvis for the bladder mobility in the body and for proper urge sensation. My sense is that the patient would settle down for the night in her bed and the fascial tension would pull, gripping her abdominal region. She would awaken in pain, causing anxiety. All of the deep breathing and prayers could not release this tension. It is not until myofascial release was applied, that the system can stop being in hyper alert, settle down and allow for the body to relax. #health #mfr

New research is demonstrating that chronic pain causes changes in the brain. “The longer pain persists, the more your brain becomes sensitive to it,” says Jane O’Brien Franczak, MSPT, founder of SerendipPT . According to O’Brien, the brain responds more rapidly and effectively when experiencing the same pain stimulation over time. “Your best defense against chronic pain is to deal with acute pain now.” Studies show that the amount of pain you experience does not necessarily relate to the amount of tissue damage you have sustained. The neurons develop a memory for responding to pain signals and can cause one to perceive an area of pain as larger than it truly may be. Think of when you bite your lip and it becomes swollen. As this pain persists, your brain causes you to perceive that the injured area of your lip is larger than it really is. O’Brien’s message: “Don’t just put up with pain. A headache will propagate more headaches. Back pain leads to more back pain. One should not just deal with it and expect that it will go away with time. Deal with it and see a professional for help.” The body and mind are connected. Minimizing pain requires a combination of methods that O’Brien has been recommending to her clients for years. First, address the body. Aerobic exercise can increase parasympathetic response (endorphin release) and decrease the sympathetic response (the fight or flight). Then, receive care from a healthcare professional such as a Physical Therapist who can address the musculoskeletal system. Third, change the mindset. Positive thoughts, laughter, socializing, changing the negatives into positives has a pain minimizing effect. Reduce one’s reaction to pain. Finally, decreasing your heart rate and slowing the breathing can lessen pain. “To succeed in decreasing pain, address your whole being. Seek help, stay positive, and breathe,” says O’Brien. #massage #naturalhealingways #MFR

Have you ever leaked urine when you run, laugh, sneeze or cough? Stress Urinary Incontinence (SUI) is the name for this issue. When pressure outside of the bladder exceeds the limits of control, a person may not be able to control leakage. Often, someone attempts to go for a run and ends up with an embarrassing wet spot in their exercise pants. Leakage when bending over to lift or when hitting a golf ball are examples of SIU. Leakage when laughing is yet another example of SUI. It's quite the spoiler to the fun. Although Urinary Incontinence is common, it is not how the body normally works. Under normal circumstances, the bladder should be able to contain urine until we are settled at the potty and relax the pelvic floor muscles (PFMs). These muscles help control continence, support the bladder and help with sexual function. The bladder is a storage organ. As the bladder fills, a muscle inside of it, called the detrusor, detects the pressure of the liquid as it is filling. The detrusor signals the brain regarding the volume. The muscles and sphincter tighten to maintain continence, or dryness. Eventually, the volume becomes large enough to trigger the brain with a strong urge. One heads to the potty, relaxes the PFMs and relieves the pressure. A disruption in the normal process can alter the cycle and wreak havoc on one's lifestyle. Issues can arise from an injury to the pelvis, abdominal or pelvic surgery, giving birth and being pregnant. Often, the pelvic floor muscles become weak after a surgery. Carrying a large developing baby is a tremendous strain on the pelvic floor muscles. In these cases, the PFMs are not strong enough to support the pressure of a full bladder. They cannot clench enough to close the urethra (aka the pee tube) so urine may leak out. Strengthening, by way of Kegel exercises, can correct the strength deficit and resolve the leakage. Sometimes, the muscles of the pelvic floor are too tense. Power is a function of force and distance. If the muscles are tense, from clenching, they are short. (Distance). It would take a tremendous amount of force to create the power needed to compress the urethra and control leakage from the bladder. If a muscle is overly tight and short, it cannot contract any farther. The muscle cannot generate any more force and is therefore, ineffective in its job. To correct this, the muscle needs to be lengthened. Kegel strengthening will only serve to make the muscle shorter, not stronger. So how does one determine if they need to lengthen or to strengthen? Some signs of short muscles are pelvic pain, painful intercourse, abdominal and back pain. People who tend to clench their jaws or shoulders also tend to clench the pelvic floor. Being aware of tension in the body is the first step to improvement. Performing a body scan every hour to determine if the jaw is tense, the shoulders are elevated or if the PFMs are gripping is helpful in changing these behaviors. Relaxing these areas by dropping the shoulders, opening the jaw and dropping the PFMs on a regular basis can lead to great changes. Seek out the help of a pelvic floor therapist to evaluate your issues and determine a plan for treatment. A pelvic floor PT can help you to take back your life allowing you to run and laugh again without wetting yourself. Go to https://pelvicrehab.com/ to locate a therapist. Jane O'Brien Franczak, PT, MSPT, WCS Women's Clinical Specialist, Board Certified CAPP Certificate of Achievement in Pelvic Physical Therapy