Incontinence Archives - Pelvic Rehab

There are many conditions that can afflict the pelvis, pelvic floor muscles, and pelvic girdle. The following pelvic floor disorders affect hundreds of millions of women globally. As awareness of pelvic floor dysfunction continues to increase, the ability to find a pelvic rehab therapist becomes more important. This list is not comprehensive, and trained pelvic floor rehab therapists will be able to diagnose and treat conditions not listed here.

Diastasis Recti Abdominis

Female Pelvic Floor Anatomy Often colloquially called “mummy tummy”, “baby belly”, etc, diastasis recti abdominis occurs when the abdominal muscles are separated vertically, along what’s called the linea albia. Clinically you would be diagnosed with diastasis recti if you have more than 2cm of separation while doing a hook lying curl exercise.

Typically diastasis recti abdominis is the result of a growing fetus putting pressure on the abdominal muscles and causing them to separate. Of course, there are other ways that this type of pressure can happen, so we shouldn’t only associate the condition with pregnancy. While the majority of sufferers are postpartum women, DRA can also occur in men. It’s related to aging, weight fluctuations, weight lifting, or other circumstances that result in high pressure within the abdominal wall.

The condition is treatable, and women who experience diastasis recti abdominis can get pelvic rehab by finding a trained pelvic rehab practitioner.

For more, see our post “What’s the Deal with Mommy Tummy?” on The Pelvic Rehab Blog.

Vulvodynia

Vulvodynia is chronic pain in the vulva with an unknown cause. Vulvodynia can be localized to specific locations in the vulva, or it can be generalized pain that impacts the whole vulva and is more constant. Pain in the vulva can be caused by touch (prolonged sitting, tightly-fitted pants, touch, medical exams, etc.), or the pain can occur chronically without a direct stimulus.
The National Vulvodynia Association is an excellent resource for women suffering from this condition, and you can find treatment for vulvodynia on our practitioner directory on www.pelvicrehab.com.

Dyspareunia

Dyspareunia is the experience of pain while engaging in vaginal intercourse, and it occurs in at least 8% of American women by age 40. Some potential causes of vulvar pain can be infectious, inflammatory, neoplastic, neurologic, trauma, iatrogenic, or hormonal deficiencies. Vaginal pain during intercourse can be frequently misdiagnosed, making it important for women who suspect they may have dyspareunia to find a pelvic rehab practitioner who is trained to recognize the condition. More information is available in our post “Why is it hard to get treatment for painful sex?” on The Pelvic Rehab Blog.

Urinary Dysfunction

Female urinary incontinence (the unintentional loss of urine) is very common, and it is often associated with weak pelvic floor muscles. Stress Urinary Incontinence is leakage resulting from any physical activity. Oftentimes women experience leakage when coughing, sneezing, laughing, or participating in more rigorous physical activity like exercising.

Endometriosis

Endometriosis occurs when tissue that should line the inside of the uterus forms on the ovaries, fallopian tubes, and other areas outside of the uterus. Endometriosis can lead to inflammation, scar tissue and adhesion formation and myofascial dysfunction throughout the abdominal and pelvic regions, and it can cause infertility in some cases. It affects up to 15% of women of reproductive age, and the severity of symptoms can vary greatly. Because endometriosis can be difficult to diagnose, it is important to find a pelvic health practitioner who is trained to treat pelvic rehab conditions.

Dysmennorhea

Dysmennorhea is the condition of experiencing pain with menstruation, and it afflicts as much as 50% of reproductive age women. Primary dysmenorrhea is related to menstruation, and often begins within a short period of time once menses occurs, whereas secondary dysmenorrhea is often related to a condition within the reproductive tract such as endometriosis or fibroids. There is strong evidence that pain with menstruation can be diminished with pelvic rehabilitation, making it all the more important that patients are able to find a pelvic rehab clinician near them.

When it comes to wetting the bed, it can be hard for parents to know when they should consult a pelvic rehab professional. Most of us have dealt with bedwetting one way or another, so it can be hard to identify when it goes from being a part of growing up to something more serious. Here are some quick facts:

Bedwetting affects 15% of girls and 22% of boys, or 5 – 7 Million US children
Boys are 50% more likely than girls to wet the bed
10% of 6 year olds continue to wet
Spontaneous cure rate 15% per year thereafter
1-3% of 18 year olds still wet their beds
The majority of bedwetting children also experience daytime “accidents” or constipation.
Bedwetting is genetic – if one parent was a bed wetter the child has a 40% chance of wetting the bed and if both parents were bedwetters the percentile goes up to 77%

It’s important to know that bedwetting is not behavioral; your kid isn’t lazy and they aren’t just trying to get attention. Sometimes it can be caused by hormone deficiency, sleep apnea, or issues with bowel incontinence. Let’s dive into that a bit.

The Effects of Anxiety and Stress

In a 2016 study, Salehi et al. found that children who wet the bed have a high frequency of generalized anxiety disorder as well as panic disorder, school phobia, social and separation anxieties, maternal anxiety, and a high body mass index.

Impacts of Bowel Difficulties

Dr. Steven Hodges has researched and written extensively on the topic of constipation causing pressure from the rectum against the bladder making it irritable during sleep. His research indicates that emptying the bowels regularly will reduce bedwetting. His book, “See It’s No Accident” is an excellent resource for parents looking for practical advice on children’s toileting issues.

Sleep Troubles

Dr. Neveus and colleagues reported that 43.5% of bedwetting children who also snore or have obstructive sleep apnea became dry after having their tonsils and adenoids removed (this operation is called an adenotonsillectomy).

Hormone Deficiency

Our bladders empty about every 2-3 hours during the day however at night we can hold for over 8 hours! This happens because our bodies produce an antidiuretic hormone when we sleep to slow kidney function and produce less urine to empty into the bladder. If this hormone is not being produced, the kidneys produce as much urine at night as they do during the day. In this case, it’s good that the bladder empties out in our sleep, otherwise our bladders would be dangerously large and possibly reflux urine backward into the kidneys. A synthetic hormone has been created, called Desmopressin acetate (DDAVP), that can be used to slow kidney function while we sleep. Bedwetting is a condition that affects millions of children throughout the world, and there is help available.

If your child is still wetting the bed by the age of 6, it’s time to consult a pediatric pelvic rehabilitation practitioner.

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Tag Archives: Incontinence

Common Female Pelvic Floor Disorders