Tip Of The Week: It is never too late to reassess & restart.
I remember a few years ago I ran into a former patient at the store. She had worked with me to help her bladder leakage, and when we last saw each other, she was going to be working on her program independently at home as she was no longer leaking at all during her daily life. When I asked her how she was doing, she said, "Well, I did really well for a while...but the past few months, it's started back again. I just don't know what to do" I immediately said, "ahh, you should have e-mailed me!! I can help you see what's going on!" She was confused. Hadn't we worked together in the past? Didn't this recurrence mean her body needed something different?
Sometimes it can feel like our bodies just aren't doing what we want them to do. Symptoms can seem to be getting better...then poof...they're back again? Or perhaps you were having no pain for a while, then suddenly you're hurting again. Does that mean you need a new plan? Maybe...but maybe not.
What it does mean is that we need to take a fresh look at things and explore what could be going on.
What could be causing pelvic health symptoms to worsen or recur?
Here are some of the common ones:
Changes in patterns: The body typically loves routine... so if habits changed (ie diet, vacation, exercise routine, etc) this can cause change.
Stress: I know, I know...but stress can truly impact the pelvic floor. Research has shown the pelvic floor muscles to be a threat responder... so if stress is high, pelvic floor tension can occur, and this may lead to certain symptoms being exacerbated.
Bowel and bladder changes: The pelvis is the intersection of our musculoskeletal system with our GI, urinary and reproductive systems. So- if there are changes in these areas (ie constipation or diarrhea, UTIs), it can be common for the muscles to be impacted.
Injury or illness: This one is a big one too. Remember, the pelvic floor muscles are coordinated with other muscles in our lumbopelvichip complex. An injury (ie ankle sprain, low back injury, hip issue, etc) can lead to changes in the muscles that might be enough to cause symptoms. And illness? Well, this one can be a factor too, especially if that illness included coughing, sneezing or urinary/GI changes).
So. what do we do in these cases? Well, the key is to partner with your pelvic PT and multidisciplinary team to figure out what might be causing the change, then to modify the plan to address it. This may mean modifying home exercises, shifting toward pelvic floor relaxation for a while instead of activation, or reassessing and restarting an entirely new program.
If this story sounds like you, know you're in good company. Our expert physical therapists are happy to help point you in the direction needed to get back on track!
Weekly Tips Pelvic Health Tips By Dr. Jessica Reale PT, DPT, WCS