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Heather and her staff blog about all things pelvic health related

Including male, female, pediatric, transgender and nonbinary chronic pelvic pain, urinary dysfunction such as incontinence, prostatitis, sexual dysfunction, pregnancy, back pain, upcoming events and more.

Urinary Incontinence and Low Back Pain | Image Courtesy of Toa Heftiba via Unsplash
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It has long been recognized in the Pelvic Physical Therapy World that there is a connection between urinary incontinence and low back pain.

Clinically, we often see patients that come in with both symptoms. How common is urinary incontinence among people also affected by low back pain? What comes first, the urinary incontinence or the back pain? What causes this?

In a recent systematic review, a positive association of 83% was found between urinary incontinence and low back pain or pelvic girdle pain. Pelvic girdle pain is defined as the area below the low back and below the abdomen (gluteal region in the back and pubic bone in the front). The strength of this correlation depends on many factors such as type of urinary incontinence, pain severity, and length of pain.

The relationship between urinary incontinence and low back pain is seen equally in both men and women and can be applied to all folks. Low levels of low back pain were mostly associated with both, stress urinary incontinence (SUI) and mixed urinary incontinence (MUI). Whereas high levels of low back pain were associated more with urge urinary incontinence. Based on one study by Stockil et al., SUI was seen more often with sudden onset pains than with chronic pain. Unfortunately, their sample of patients was limited, consisting mostly of young women who have never given birth. To measure the correlation more accurately, studies involving a broader population will need to be conducted.

Read more: The Link Between Urinary...

Urinary Chronic Pelvic Pain and Resilience | Photo courtesy of Mark Adriane via Unsplash
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 A Recent Pilot Study Looked at the Connection Between Urinary Chronic Pelvic Pain and Resilience

A recent pilot study looked at how resilience affects patients with urinary chronic pelvic pain (UCPP) conditions and chronic overlapping pain conditions (COPCs).

Resilience can be defined as the “capacity to adapt successfully to disturbances that threaten a patient's viability, function or development.” (Southwick et al., 2014)

Resilience is now an important aspect in the treatment of pain, as it can increase psychosocial well‐being and the quality of life in patients living with chronic pain. (Casale et al., 2019)

Read more: Urinary Chronic Pelvic Pain...

Safe Sex During Covid
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Are You Wondering About Safe Sex During Covid?

Whether you're asking for a friend or for yourself it's an important question these days.

Practicing social distancing and wearing a mask can make it quite difficult to have intimate relationships. Through the last year and half, we have learned more about COVID-19 and each and every day new data helps us better understand this virus and how to practice safe sex during COVID.

How is the virus transmitted?

The virus spreads through infected saliva, mucus, or respiratory particles entering the eyes, nose, or mouth. This means it can be transmitted through kissing and close contact. Studies have also detected the virus in feces and in sperm in those infected (Diangeng et al., 2020). It is unknown at this point if the virus can be spread through sperm or feces.  Educating yourself can be the key to safe sex during COVID.  

Read more: Sexual Health Awareness...

Urinary Incontinence Cameron Smith
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Overview: Urinary Incontinence

About 13 million people in the United States experience some type of incontinence, or unwanted leakage of urine. More than 50% of women over 20 years old reported experiencing urinary incontinence at some point in their lives. Moderate to severe urinary incontinence is prevalent in 17% of women aged 20 years or older, but more commonly occurs in 38% of women aged 60 years or older.

Types of Urinary Incontinence

Stress Urinary Incontinence

Stress urinary incontinence is when leakage occurs during stress-induced activities such as exercises, coughs, and sneezes.

Urge Urinary Incontinence

Urge urinary incontinence is leakage associated with urgency, and can make it difficult to hold the bladder without leaking. This can arise from poor bladder habits or overactive bladder syndrome (OAB). About 16% of the United States population are diagnosed with overactive bladder syndrome, which causes intense sudden urgency and frequency to urinate. This can cause depression, social and work disability for many adults.

For urge urinary incontinence alone, the estimated national costs in 2007 included 1.5 billion dollars in direct nonmedical costs (for example, incontinence pads). Depending on the type of incontinence and their comfort level, some people avoid certain activities or perform more “just-in-case” peeing to avoid leakage. There are also many products people use to help them continue those activities but in a more hygienic way.

Treatments for Urinary Incontinence

Standard nonsurgical, non-pharmaceutical treatments for incontinence may include:

  • pelvic floor training
  • behavioral training
  • vaginal cones/bladder supports

There are also pharmaceutical treatments available that help improve urinary retention or affect pelvic nerves or muscles that may be the underlying cause for urinary incontinence. Along with incontinence products and/or medication to help you continue to do the things you love, it is best to have a specialized pelvic floor physical therapist by your side to help understand your bladder physiology and thus improve incontinence or prevent worsening of symptoms. This way, we can help you decrease incontinence, reduce reliance on such products, or reduce the absorbency needed so you can get back to doing the things that you love in a leak-free manner!

Read more: Urinary Incontinence |...

Sexual Function After Cancer | Unsplash
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This article introduces common unwanted side effects that affect sexual function after cancer and discusses strategies to counteract these symptoms. 

Sexuality can be a big part of who we are as individuals.

Sexual functioning can be defined as “specific physical, physiological, neurological and emotional behaviors expressed by an individual response” (Wood, 1984).

Certain cancers can unfortunately affect our sexual health, including cervical, ovarian, bladder, kidney, colorectal and breast cancer to name a few.

Some cancer treatments can cause unwanted side effects that affect our sexual health such as decreased sexual arousal or desire, vaginal stenosis (narrowing of the vaginal canal), dyspareunia (painful sexual intercourse), and bladder/bowel dysfunction. Issues with sexual function after cancer can affect our relationships with ourselves and with our partners, and reduce quality of life. Hopefully a physical therapist is part of your team to help guide you during this challenging time and minimize these aforementioned side effects. Otherwise, ask for a pelvic floor physical therapist to join your team during your recovery!

Read more: Sexual Function After Cancer

Tarlov Cyst - Unsplash neONBRAND
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This article will go over what a Tarlov cyst is, what symptoms can arise from having a Tarlov cyst, how it is diagnosed, and common conservative and surgical treatments. 


What is a Tarlov Cyst?

Tarlov cysts are sacral perineural cysts that consist of cerebrospinal fluid (CSF) close to the dorsal root ganglion on our sacral spine (the triangle shaped bone that connects to our tailbone). Tarlov cysts are often incidental findings on MRI’s, meaning most people with no symptoms may have Tarlov cyst(s). Paulsen, et al, looked at 500 MRIs of the lumbosacral spine and found an incidental rate of 4.6%; of which 20% were symptomatic. Approximately 1% of the cysts are large enough to cause compression, thus requiring prompt treatment.

Read more: All About: Tarlov Cyst

mens pelvic pain
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Highlight on Mens Pelvic Pain

June is Men's Health Month

Pelvic health is not only tied to females; males also experience pain in their pelvis including their bladder and rectum, but may also extend to their testicles, penis, prostate, etc. Common mens pelvic pain diagnoses include (but not limited to):

Read more: Highlight: Mens Pelvic Pain

Man running representing Mens Health Incontinence
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In this Blog Post We Highlight an Important Aspect of Mens Health: Incontinence

Although it is more common to experience urinary incontinence in females compared to men, men can still experience urinary incontinence.

Just like females, males also have a pelvic floor that controls the sphincters to either contract or release (for holding in urine or releasing urine, respectively). When there is dysfunction or coordination issue (whether it is weakness or too tight) in the pelvic floor, incontinence can occur. The CDC estimates that almost 44% of men in the US who are not in an institution struggle with urinary incontinence. 

Read more: Highlight on Men’s Health:...

curved spine depicting Scoliosis and the Pelvic Floor
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Scoliosis and the Pelvic Floor - A Primer

Part 2 of our Series on Scoliosis Awareness

June is Scoliosis Awareness Month! If you recall from part 1, scoliosis is a 3-D curvature of the spine. Some people get it in early childhood or adolescence, and others get it as an adult. This can lead to low back pain, breathing difficulties, and … affect the function of the pelvic floor muscles!

Read more: Scoliosis Awareness! | Part...

Functional Scoliosis and Structural Scoliosis
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An Overview of Functional Scoliosis and Structural Scoliosis

Scoliosis is a 3-D curvature of the spine. According to the American Association of Neurological Surgeons, 2-3% of the US population currently have some form of scoliosis.

There are many different types. There is juvenile scoliosis starting at a young age, or adult-onset scoliosis. It can be categorized as congenital (some type of deformity causing irregular alignment), neuromuscular (neurological disease leading to asymmetries), or its most common form, idiopathic scoliosis (unknown).

Read more: Functional Scoliosis and...

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We wanted to share this article that we found published by the New England Journal of Medicine. We all have a lot of ongoing questions about the ongoing COVID-19 vaccine, and this is a great resource that answers nearly every question we’ve had regarding testing, vaccines and more.

Covid-19 Vaccine — Frequently Asked Questions

Image courtesy of NEJM

A collection of resources on Covid-19 vaccines, including frequently asked questions, continuing medical education, published research, and commentary.


Read more: New England Journal of...

Histamines and Chronic Pelvic Pain

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Research draws a connection between histamines and chronic pelvic pain

Also linked to histamine response, inflammation disorders, and chronic nonbacterial prostatitis.

What is Chronic Pelvic Pain?

Chronic pelvic pain is generally defined by chronic pain in the region of the pelvis (Lai, 2015).

It is a common symptom that can be caused by several different structural and functional dysfunctions/disorders that affect the anorectal area, urinary bladder, reproductive system, and pelvic floor muscles. Unlike pelvic pain caused by structural diseases like endometriosis, pelvic pain linked with functional disorders cannot be explained by an organic or other specified pathological reason (Clemens, 2008).

Functional disorders that can cause pelvic pain are classified into three general categories:

Read more: Histamines and Chronic...

**This information is for educational purposes only and is not intended to replace the advice of your doctor.

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