CFA

Q: I was doing a lot of running with friends and when I stopped to catch my breath, I leaked a very small amount of urine. I’m 23 and around 110kg. This has happened twice over the span of a few months. So, I was wondering who I should consult or what to do?

A: Urinary leakage of any sort—even a small amount—isn’t normal at any age and should be assessed. A higher BMI can place strain on the pelvic floor and lead to bladder and bowel control problems. I would advise you to see a Pelvic Floor Physiotherapist who will be able to assess your pelvic floor and develop an individual management plan for you.

It is good that you are trying to be fit, and exercise is very important, but you may have to change the type of exercise you are currently doing whilst you seek help for management.

I would also suggest you have a look at our website pelvicfloorfirst.org.auwhich has information on pelvic floor function and exercise.

Q: Hi, I'm a 54-year-old male and a professional drummer. As you can imagine, I sit a lot. I have very frequent urination (sometimes every few minutes while I'm trying to sleep), burning urination, interrupted stream and sexual difficulties. Can you tell me if it's due to a weak pelvic floor, or one that's too tight?

A: I would advise you see your GP as soon as possible for assessment and treatment. As a starting point, your urine and prostate need to be assessed.  It isn’t normal to feel a burning sensation when passing urine. You also may need to be referred to a urologist to manage a prostate check, sexual difficulties and erectile function/dysfunction. You also may also find a counselor who manages erectile dysfunction to be helpful.

Q: When I started going to the gym, I found that with time, my muscles got into shape and stronger. When I stopped going, my muscles became weaker. So, I’m wondering whether the same happens with pelvic floor muscles? If I start doing pelvic floor muscle exercises and stop them someday, are they then going to get weaker?

A: Our pelvic floor muscles are the same as any of our muscles—'use it or lose it’. Therefore, we need to keep doing our pelvic floor muscle exercises for life to keep the muscles strong.

It is not unusual to regress if you stop doing pelvic muscle exercises. If you were taught correctly by a continence professional, you will have a better chance of having quicker improvement. We would advise you to be referred to a Continence Nurse or Continence Physiotherapist service to check your pelvic floor and ensure that you are performing the exercises appropriately. It would also be advisable to receive some lifestyle management regarding pelvic floor function.

Q: I had my physiotherapist give me exercises for my muscle imbalances that were a result of a work injury. I had a lower back and buttock injury and problems with my sacrum.

My pelvic floor muscles are very weak, but the exercise regimen was too much for my injuries, even though I felt they may have benefited the pelvic floor. My question is the following: Would a pelvic floor therapist and a normal physiotherapist differ in their approach as to how to strengthen the pelvic floor through exercise with previous injuries such as mine?

A:  A Pelvic Floor/Continence Physiotherapist has further qualifications in pelvic floor rehabilitation and is the expert physiotherapist to see for pelvic floor dysfunction. Their expertise is very specific to the management of pelvic muscle function, and rather different to general physiotherapy. They will be able to tailor an exercise program for you to improve your pelvic floor function.

See your GP to discuss your back injury as it may be related to your incontinence.

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