6 Easy Solutions for your Lady Issues (without surgery or kegels)

Hey lady!

Have you been experiencing some bladder leaking or pain during intercourse?  Or feeling like things aren’t quite right “down there”? Perhaps you are concerned about diastasis recti or damage from childbirth.  Well, I want you to know that while all of these issues are very COMMON, they are NOT NORMAL.  

So kudos to you for taking the first step in fixing these issues and not ignoring them any longer!  I’m glad you are refusing to believe the lie that these problems are a normal part of becoming a mom or getting older.  

This guide will give you six really easy steps to get you started on the path to resolving your issues so that you can return to the activities you enjoy most without having to deal with embarrassment, worry, or pain.  I’d love for you to try to implement at least two of these steps right away and see if you notice a difference. I really think you will!

And as always, if you have questions, aren’t sure what you are doing, or need a little more guidance, feel free to reach out to us at Contact@Revitalize-PT.com. We are happy to help!

Pelvic Floor Tip #1: Breathe Deeply

Now, I know what you are thinking.  “Breathing? Really?”  But hear me out…

Diaphragmatic breathing (AKA belly breathing) is one of the most important components of restoring proper pelvic floor function in order to help resolve your lady issues.  The reason for this is that the diaphragm lowers down as you inhale in order to let air in, then lifts as you exhale to push air out. The pelvic floor follows this same movement: lowers (relaxes) as you inhale and lifts (contracts) as you exhale.  This allows the pressure within the space between the diaphragm and pelvic floor to remain fairly constant. It also helps the pelvic floor to relax and contract. And a functional pelvic floor needs to be able to do both!

Often times, women have two big issues when it comes to their pelvic floor: 1) Poor coordination of the pelvic floor muscles and 2) Overactive pelvic floor muscles.  This means that the pelvic floor muscles do not lengthen and lift properly.  Over time, this can lead to many different lady issues.

So how do you belly breathe properly?  Lie on your back or sit comfortably. Place one hand on your chest and one hand on your belly.  As you inhale deeply, you should feel your belly press out into that hand.  Then as you exhale, the belly comes back in to it’s starting position.  The hand on your upper chest should remain still throughout and not have much movement. Practice proper belly breathing several times throughout the day.

Pelvic Floor Tip #2: Make it easier to “GO”

When women are constipated, the pelvic floor muscles undergo more pressure.  Because constipation also makes it more difficult to go to the bathroom, women tend to strain while attempting to “push it out.”  This straining causes pressure to increase inside the abdomen. Over time, this increased pressure can lead to issues such as pelvic organ prolapse and diastasis recti.  It can also contribute to incontinence issues, so it is best to try to get more regular.  Follow these tips to help avoid constipation:

• Increase water intake to at least 64 ounces per day, more if exercising

• Increase fiber intake to approximately 40 grams per day with sources from fresh fruits and vegetables as well as healthy grains

• Use a “squatty potty” which is a specially designed step stool that fits nicely under your toilet. This helps the pelvic floor muscles relax to make it easier to “go.”

• Relax when going to the bathroom and do not strain or push when voiding

Pelvic Floor Tip #3: Hydrate with water, not bladder irritants

As I mentioned above, increasing your water intake can help you avoid constipation and stay more regular.  But it also has several other benefits for your pelvic floor as well!  First, staying well-hydrated will keep all of your muscles hydrated and working properly.  Your muscles need water in order to contract and be strong, and the pelvic floor muscles are no exception.  Water also helps your muscles stay strong if you are experiencing hormonal changes in the perimenopause or menopause stage of your life.

Adequate water intake will also help decrease stress incontinence and urge incontinence.  My clients often tell me that they limit their water throughout the day because they think that the less they drink, the less they will leak. While I can understand the logic behind this, the truth is that drinking less water can actually make you leak more.  

Certain foods and beverages are what we like to call “bladder irritants” that aggravate the bladder and make it try to get rid of those fluids as quickly as possible. Ever drink a big cup of coffee and notice you have to use the bathroom more frequently afterward? That’s because caffeine is a bladder irritant.  Dehydration also irritates the bladder and can result in more urge incontinence (overactive bladder) or stress incontinence (unexpected leakage). To avoid irritating the bladder, you’ll want to do the following:

• Drink at least eight 8-oz glasses per day, more if you are exercising

• Minimize bladder irritants like soda, juices, alcohol and caffeine

• If you are drinking a bladder irritant (hello, Wine Wednesday!), drink water with it to help minimize the irritation on the bladder

Pelvic Floor Tip #4: The real truth about core exercises

In my opinion, one of the most confusing areas for women dealing with pelvic floor issues is knowing what exercises they should and shouldn’t do.  There is so much information on the internet with advice about exercise, and most of it is conflicting, especially when it comes to core exercises.  So I want to clear things up and give you a simple list of core exercises to avoid.  But first, I want to talk about the most important core muscle called the transverse abdominus (TA).  

The TA is the deepest layer of the ab muscles. When you contract the TA, your core pulls in like a corset.  The TA muscle is also the main stabilizer of the spine and pelvis, and it works together directly with the pelvic floor.  This muscle is our main focus in pelvic floor physical therapy in order to solve your issues because the muscle often times is not functioning properly.  So we always start with the basic TA exercise in order to get the muscle working again before progressing to other exercises.

Directions: Lie on your back with knees bent. Draw your belly button in towards your spine like you are zipping up tight pants and then flatten the back into the ground. Hold this, then slowly lift one foot slightly off the ground (only about an inch or two). Pause, then lower the foot back down. Alternate legs. The hips should not rock or shift while you life the foot and the back should not lift up off the ground. Perform 10 reps.

Once you can do this exercise well, then it would be safe to progress to harder exercises.  You can find some core exercise ideas on our YouTube channel: http://bit.ly/coreexvideos

Core exercises to avoid long-term:

• Crunches

• Sit-ups

Core exercises to avoid short-term (you may be able to progress to them with proper help):

• Planks

• Side planks

• Muscle-ups

• V-ups

• Row boats 

• Russian Twists

Pelvic Floor Tip #5: Stop hovering on the toilet

I know the thought of a public bathroom and all of the germs potentially lurking on the toilet seat can really freak people out.  However, hovering over the toilet seat can be one of the causes of your incontinence.

When you hover over the toilet, you are essentially in a squat position and the pelvic floor muscles are active. When you squat, the pelvic floor contracts in order to stabilize the pelvis and spine. While this is a good thing during exercise, the toilet is not the place to practice pelvic floor contractions. When you are voiding on the toilet, the muscles need to be relaxed in order to let the bladder effectively empty.  If you are squatting and going to the bathroom at the same time, you are voiding through contracted muscles.  When you do this repeatedly, the bladder then learns that it’s “okay” to pee when the muscles are contracted.  Then you start to pee at other times when the muscles are contracted, like when you’re jumping or running. See the pattern?

So the lesson here is to sit down on the toilet, relax your pelvic floor muscles and pee. :)

Pelvic Floor Tip #6: Ask for help and don’t do it alone

If you really want to fix your issues and get back to whatever “normal” means for you, then I would highly recommend pelvic floor physical therapy.  Chances are, you’ve maybe tried to fix your issues by doing some kegels and it hasn’t helped.  And if you follow these tips and are still having issues, then you likely need professional help in order to fix them and return to all the activities you enjoy.  

We get asked all the time if things will get better with more time or with more exercise.  And our answer is usually if it hasn’t gotten better already or with trying a few exercises, more time probably won’t help.  So it is a good idea to at least talk with a pelvic floor PT about your issues and find out what it would take to resolve them.

At Revitalize Physical Therapy, we offer a free 30-minute consultation with our patients in order to answer women’s questions about how long will it take to get better, what type of treatment they need, and what is the best home exercise program for them.  We truly believe that women should be able to do all the activities they enjoy without leaking, pain, or limitations.  These issues are not a normal part of becoming a mom or getting older.  And we want you to know that you have options!