Regain control with pelvic floor therapy

When you experience pelvic pain or functional problems with urinating, it can be hard to tell what's going on "down there." Bladder, kidney, and other urinary tract illnesses often share overlapping symptoms. Sometimes, it takes a visit to your medical provider to tell you what's wrong. Although clinicians typically prescribe antibiotics for infections, other issues may benefit from pelvic floor therapy — a noninvasive form of physical therapy for urinary problems, pelvic pain, and more. First, you need to know what is happening.

Pinpointing the problem

Maybe it hurts when you urinate, or you have trouble going. Or perhaps you can't get to the bathroom fast enough. Sometimes the symptoms of kidney, bladder, and other infections overlap because they apply to a single body system called the urinary tract. This is how it works in three steps:

1. Your kidneys filter waste products from your blood.
2. The resulting urine flows down your ureters to your bladder, where it's held until you feel the need to urinate.
3. The urine leaves your body through your urethra.

Together, this system is known as your urinary tract, and people can get urinary tract infections (UTIs) at any point.

Signs and symptoms of a UTI

Often, people with a UTI in their urethra or bladder will experience a variety of signs and symptoms.

UTI signs and symptoms include:

• Blood in the urine — especially in younger women
• Burning or pain when urinating
• Confusion or weakness — especially in older people
• Frequent need to urinate but not being able to
• Urine that looks dark or clouded or smells bad
• These infections can also move upstream to one or both kidneys.

When an infection has moved to your kidneys, you may experience:

• Fever and chills
• Nausea or vomiting
• Pain in your groin
• Pain in your kidney area — your back and side

Preventing a UTI

Sometimes, you get a UTI, and there's nothing you can do to stop it, especially if you experience recurrent infections (ones that keep coming back). Hormone changes after menopause can make some women more susceptible to UTIs. However, a few strategies can help prevent UTIs.

Women should :

• Avoid 'feminine hygiene' products such as douches or scented sprays
• Clean your genital area daily
• Drink six to eight glasses of water each day
• Limit bath time and take showers instead
• Urinate before and after sexual intercourse
• Urinate when you need to - don't hold it in

Seeing a provider for a UTI

Some people recommend home remedies, such as drinking water or cranberry juice, but these home remedies are not proven to help. It's important to see a medical provider for UTI symptoms because if not properly treated, UTIs can keep coming back or lead to more serious problems.

Your provider will conduct a physical exam, take a urine sample, and ask about your bladder and bowel habits. If you have regular UTIs, they may perform an internal exam known as a cystoscopy to look for bladder problems such as stones, interstitial cystitis, or tumors. Typically, one or more rounds of antibiotics will be needed to treat a bladder, urethral, or kidney infection.

When it's not an infection: Pelvic floor physical therapy

What if your provider says your problems with urination or pelvic pain aren't caused by an infection? What then? If your issues are functional in nature, you may be referred for pelvic floor physical therapy .

Pelvic floor physical therapy can help men and women with:

• Pain during intercourse
• Discomfort or prolapsed (fallen) organs following pregnancy and childbirth
• Pain following prostate cancer treatment
• Problems urinating — painful urination, urgency or leaking
• Problems with bowel movements — constipation or leaking

During pelvic floor physical therapy, a physical therapist will make an initial assessment to evaluate the strength and look for tension in your pelvic muscles and connective tissues. They'll also assess your abdominal, back, and hip muscles; check your posture; and note any other factors that might be affecting your pelvic function.

Based on what they find, the physical therapist will offer individualized treatment. Goals of treatment may include relieving muscle spasms, reducing pain, improving strength, and coordinating the muscles in your pelvic area. Your physical therapist will teach exercises you can do at home. Occasionally, they will use trigger point therapy (pressure in a specific spot), biofeedback, or mild electrical stimulation to help you become more aware of what your pelvic muscles are doing.

We don't think about our pelvic floor muscles or ligaments that much. But pelvic awareness can help with bowel, sexual, and urinary function and reduce pain. In fact, pelvic floor problems can worsen over time without treatment. There's plenty of support for this underappreciated area of the body, including both pelvic floor physical therapy and pelvic floor yoga classes.

Schedule an appointment to see if pelvic floor therapy at Reid Health holds the answer to your urinary tract concerns.