Pelvic Floor: Key Questions to Ask Yourself

Due to my short break from writing because of the chagim, I thought I would go back to the pelvic floor muscles before I move on to a host of different topics that some of you may not have heard of.

The onset of incontinence is gradual but never unnoticed. It is the body’s way of telling us that things are not quite as they should be. Leaking urine can bring on a downward spiral with loss of self respect as well as anxiety and depression. 

The initial leaking is called stress incontinence, caused by weakening of the muscles that keep urine stored inside the bladder. These muscles, called the pelvic floor muscles, fail to fight forces which push down from the abdomen when you laugh, sneeze, run or jump.

If left untreated, stress incontinence can lead to urgency and frequency. An example of this could be when running to the bank before closing time you suddenly feel dampness between your legs. You take a quick diversion to the toilet to check that this is not obvious to the outside world, you don’t really feel the need to go but as your mother probably told you better to be safe than sorry and you go to the toilet. Anxiety can begin to set in out of fear of a re-occurrence, causing you to take a trip to the toilet just in case, to really make sure your bladder is empty, thus establishing a pattern of frequency. 

Before you know it you are a confirmed toilet hopper, you know all the ladies toilets in town and which petrol stations along your driving route have conveniences too. You will then start to cut down your fluid intake (don’t ever do this) and before you know it you are laughing this situation off with all your friends, they are laughing in a supporting sympathetic way or are laughing because they have these same problems.

The three main symptoms are stress incontinence, urgency and frequency.  Stress is when leaking from a high impact movement. Urgency is the really strong need to pass urine that if ignored you feel you will probably end up with wet knickers. Finally frequency, which is how frequent you are going to the toilet. A combination of any of these three can be present.

Most people consider their toilet habits normal, however if the answer to any of the following questions is no, then your habits are not normal and it is time to really step up your exercises to your pelvic floor muscles to more than 3 times a day, which is the prescribed amount for people who do not suffer from this. It might also be the time to seek physiotherapy help as there are much higher success rates when treatment is started earlier on.

• Do you go to the toilet 4 to 6 times each day only?

• Do you sleep through or get up only once through the night?

• Do you have dry knickers all the time?

• Do you pass 300-400mls each time? 1 mug is approx 250mls

• Do you pass water easily, without straining or stopping and starting?

• Do you find urinating is painless and quite a comfortable thing to do?

If you suffer from any type of incontinence and would like to book an appointment, please contact me on 0544485086 or by email to tamaramay.physio@gmail.com.  I can arrange to see you in Bishvilaych Women's Comprehensive Medical Centre in Givat Shaul, Jerusalem or a home visit if you live in Gush Etzion.  

Sciatica: Don’t Let It Get On Your Nerves

This condition is so named as it is caused by your sciatic nerve. The course the nerve takes runs from your lower back travelling down the back of your legs and branching out into your feet. This is also where the pain is felt, following the course of this nerve. The job of this nerve is to help you feel sensation and move the muscles in your legs. 

Although seemingly quite common during pregnancy – especially in the third trimester – it is not necessarily directly caused by anything to do with pregnancy, although it can be aggravated by your posture during pregnancy. You can also suffer from sciatica without being pregnant. 

Sciatica happens when there is inflammation or pressure from your back on the nerve, often caused by a slipped or injured disc. It can also be caused by the growing uterus putting pressure onto the nerve. When suffering from sciatica you will feel a burning shooting pain, quite often in just one of the legs. It can be constant or it can come and go. Although coupled with inflammation, it is important to remember that while pregnant you cannot take Ibuprofen, even at over-the-counter strength.    

Treatment can include exercises to strengthen your pelvic floor, stomach and back muscles.  You may also be advised to wear a support belt. Flat shoes are also an essential. In bed it is important to support your bump using pillows. Keeping mobile is also very important as well as a sufficient amount of rest and getting off your feet.  One can also use heat and ice on the painful area for 10 minutes at a time.  

It is also important to discuss with your physiotherapist different birthing positions for labour as you may be more limited due to your sciatica. Labouring in water is often preferred in this case as moving in water can feel easier. 

If you suffer from any type of back pain or leg pain during pregnancy and would like to book an appointment, please contact me on 0544485086 or by email to tamaramay.physio@gmail.com.  I can arrange to see you in Bishvilaych Women's Comprehensive Medical Centre in Givat Shaul, Jerusalem or a home visit if you live in Gush Etzion.