The Muscles No One Talks About

Did you know that the concept of joint movement being controlled by muscles and ligaments applies to our bladder and bowel movements as well? These activities are controlled by a group of muscles conveniently called the pelvic floor muscles. They sit between the coccyx and the anterior pelvis and have a role in our normal micturition, excretion, and sexual functions. These muscles are susceptible to under or over activity just like any other muscle and can alter the normal flow of our bowel and bladder movements causing incontinence, constipation, leakage, and perineal pain. Dysfunction of these muscles are often seen after childbirth, surgical/traumatic/emotional events, pelvic organ prolapse, and diabetes. More so, pelvic floor dysfunction can be caused by repetitive tasks involving heavy lifting, straining, and advanced age.

Treatment for pelvic floor dysfunction does not have to involve surgery or medications; physical therapists are able to specialize in the treatment of pelvic floor dysfunction and assist those with varying diagnoses stemming from the pelvic floor muscles. Research has confirmed that conservative, physical therapy interventions demonstrate the best possible outcomes for those suffering from pelvic floor symptoms more so than surgical or pharmaceutical interventions. Male or female, there is no reason someone should continue suffering from leakage, incontinence, or pain within their perineum and a Doctor of Physical Therapy is the best professional to help you overcome these dysfunctions and improve your quality of life!

Jennifer Santamaria PT, DPT

1.Bo K, Herbert RD. There is not yet strong evidence that exercise regimens other than pelvic floor muscle training can reduce stress urinary incontinence in women: a systematic review. J Physiother . 2013;59:159-168. (a)

2. Bernards A, Berghmans B, Hove M et al. Dutch guidelines for physiotherapy in patients with stress urinary incontinence: an update. Int Urogynecol J. 2014;25:171-179.

3. Bo K, Hilde G, Jensen J, Siafarikas F, Engh ME. Too tight to give birth? Assessment of pelvic floor muscle function in 277 nulliparious pregnant women. Int Urogynecol J . 2013:24;2065-2070. (b)SOWH PH1B4 Physical Therapy Treatment of Underactive Pelvic Floor Muscles and Prolapse.E Miracle©Section on Women’s Health, American Physical Therapy Association 2016.131

4. Braekken IH, Majida M, Engh ME, Bo K. Can pelvic floor muscle training reverse pelvic organ prolapse and reduce prolapse symptoms? An assessor-blinded, randomized, controlled trial. Am J Obstet Gynecol .2010;203(2):170e1-7.

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Hydration, Physical Performance & Recovery

With the warmer months rapidly approaching it is important to remember the significance of our daily water intake. Especially combined with physical activity, hydration can play a huge factor in performance and muscle recovery. Approximately 1-2 Liters of water are required to replace obligatory losses for even sedentary adults in a temperate climate. Therefore, almost double that should be consumed for modest amounts of exercise. That means increased activity during sport, a gym workout or even a physical therapy session can further dehydrate our bodies.

Proper hydration can help ensure optimal muscle function and prevent muscle cramps as well as excess fatigue. Along with enough rest, staying properly hydrated can aid in muscle recovery and repair after an injury or workout. Water intake also directly contributes to heat exchange and the demands of body temperature increases with physical activity or environment. This means that when we sweat due to exercise or hot temperatures, we are losing valuable fluids and we should drink extra water to make up for the loss. Studies show that the average male and female should have a water intake of 3.7 and 2.7 L per day, respectively. Although, considering factors such as metabolism, diet, climate and clothing, additional water should be considered for daily consumption.

We also must pay attention to some of the food we eat or the beverages we drink as either helping or hurting our hydration status. When in doubt, enough water can always help meet our bodies’ needs for hydration, peak physical performance, and recovery!