Amanda Wilde (Host): We don't talk about it much, but pelvic floor
issues affect a great many women.
So we are talking about women's health and pelvic floor therapy with
physical therapist Catherine Middleton.
This is Woodlawn Health Doc talk, and I'm your host, Amanda Wilde.
Catherine, thank you so much for being here to get in depth on something that
we can all benefit from learning about.
Katherine Middleton, PT, DPT: Yeah, no problem.
Amanda Wilde (Host): Well, pelvic floor issues, as I mentioned, are
not uncommon, but is pelvic floor therapy, which is what you do?
Katherine Middleton, PT, DPT: So, pelvic floor therapy, um, we treat anywhere from
anything that goes on with the pelvis.
So bowel issues, bladder issues, pain with sex.
Any of that kind of stuff.
Pain, just generalized pain.
we do that through, you know, hands-on therapy.
We may bring in some different tools.
We, do strengthening.
We work a lot on breathing and just body mechanics and posture and it's,
there's a lot that goes into it.
Amanda Wilde (Host): So having these issues can be normal, but treating them
is not something people generally do.
They are treatable.
Katherine Middleton, PT, DPT: Yeah, most of them are.
And we may not be able to completely get rid of it like a prolapse, especially
a prolapse That is, like a grade four, which is a pretty bad prolapse.
We may not be able to get rid of that, but there's things that we can do to help.
Lessen the symptoms and maybe make it a little better.
and same with pain and incontinence.
And, we can even treat, if you have like diverticulitis or things like
that, like after surgeries, know, I'm not doing the surgery part, but
we can do a little bit of rehab to help prevent this from getting worse.
Amanda Wilde (Host): I was going to ask who would benefit from this service?
It sounds like anyone who has any of the issues you just
mentioned, who do you normally see?
Katherine Middleton, PT, DPT: I primarily only see women right now who
are referring men to different places.
I am willing to see some children if they're, old enough to follow
directions and things like that.
But primarily women.
Most of mine have been, you know, menopausal age.
Some of 'em have been younger where they're pregnant.
Some have been, you know, post-pregnancy.
So between that like menopause and pregnancy ages.
So there's a whole wide range of ages that I treat.
Amanda Wilde (Host): That's interesting because I think a lot
of us tend to associate pelvic floor issues with having given
Katherine Middleton, PT, DPT: Mm-hmm.
Yes,
Amanda Wilde (Host): So what causes pelvic floor issues generally?
Katherine Middleton, PT, DPT: That's a tricky question because there's
so many things that can cause it.
it could be part of, it could be our diet, part of it could be just different
diseases that we might have, birth can cause it, being pregnant because that
puts a lot of pressure on those tissues.
just being human,
unfortunately.
Amanda Wilde (Host): So you see all kinds.
Katherine Middleton, PT, DPT: Yes.
Amanda Wilde (Host): What are some of the signs of pelvic floor issues?
Katherine Middleton, PT, DPT: some of 'em would be like pain.
It is not normal to have pain in your pelvic region, especially if you're
having constant pain, where it's not necessarily normal to need pain relievers
for your period and things like that.
Have noticed some leaking, especially with like coughing or sneezing or having
trouble getting to the bathroom on time.
Pee more than once or twice a night.
or going more than like eight times a day is really not normal.
having stools that are, being constipated or having diarrhea,
so stools that are super loose or stools that are really, really hard.
another one is just having to strain and push and, having difficulty with pooping.
Amanda Wilde (Host): No wonder we don't talk about these things, but I am so
glad we're having the conversation women.
In age, it does become increasingly common to have some form of incontinence.
Is this something pelvic floor therapy could help with?
Katherine Middleton, PT, DPT: Absolutely.
Absolutely.
So as we age, especially women that once we hit menopause, our estrogen decreases.
So our muscles, you kind of lose muscle mass.
the tissues also kind of, you know, shrink the pelvic tissues shrink.
When we lose estrogen, And that could cause some, some dryness,
some irritation, And also cause result in that incontinence.
And especially as we've, you know, developed habits throughout our
lives, some of those habits may not be very good habits And that
could be contributing to it too.
So we can absolutely treat that.
we might work a lot on diet and changing habits and things like that.
Amanda Wilde (Host): Can you talk a little bit more about the part nutrition play?
Is in keeping a healthy pelvic floor.
Katherine Middleton, PT, DPT: Yes.
So when we're dehydrated, especially for the bladder when we're dehydrated or we're
eating a lot of acidic foods or drinking a lot of caffeine, whether that's coffee
or pop or tea, any of those, they are really, really irritating to the bladder.
So when we're eating those foods and we're not drinking enough water with
it, Then it will really make us go pee more often and almost make our bodies
more sensitive to having to go pee.
And then that causes more issues.
So having enough water is so important.
So we often say half of your body weight and ounces.
So if you weigh like 200 pounds, you should be drinking at least
a hundred ounces of water.
now if there's for some reason you're on a fluid restriction, you know.
Obviously we need to adhere to that, but if you're not on a fluid
restriction, there's, we really wanna aim for lots of water.
for the bowels, we want lots of fiber.
So getting that 20 to 35 milligrams depending on if you're male or female.
Fiber is super important.
It helps, you know, move our stool through the system helps make our
stool either solid or a little looser, whichever way we want it to go.
It helps both of those.
Nutrition is a huge part in it.
Amanda Wilde (Host): For those who are having the revelation right
now, that there is help for some of these things that we often come to.
Expect, what can one expect from our first pelvic floor therapy session?
Katherine Middleton, PT, DPT: so usually for your first physical
therapy session, I have patient's, fill out just a little form.
It is just kind of like an intake form.
And then a questionnaire before I bring them back just makes things a little
bit scope, a little bit smoother.
We just talk about a lot about what's going on.
tell me your symptoms, things that kind of cause your
symptoms, all that type of stuff.
We talk about how many, if you've had births, how many births you've had.
What type?
Any complications, anything, like all of that stuff.
'cause all of that also plays a part into it.
if you're still having menstruation, if you're postmenopausal.
If you're menopausal, we talk about all of that.
Um, also talk about, you know, your kind of, a little bit about your
diet, more about your fluid intake.
Um, we talk about how often you're going.
Poop and pee.
Um, maybe what type of stools you're having, um, and all of that.
And then we, um, start doing, I'll test your muscles, make sure, you
know, we'll do some different tests.
So we'll do muscle strength.
We'll make sure that you're able to stand on one leg.
Normally.
Um, we'll check your breathing.
We'll make sure that you don't have any splitting of the abdomen, um,
which is very common after birth.
We check to make sure the core is strong And the back muscles are strong.
So we look, kind of look at everything on the first visit, um, externally anyway.
And then usually for the second visit, I, um, as long as my
patient's comfortable with it and they feel, you know, ready and.
Um, with, we do an internal assessment.
So, um, depending kind of what the issue is, we'll either go vaginally or rectally
and kind of palpate the muscles, make sure the muscles are nice and strong, or
they're tender, or any of those things.
Kind of figure out internally what's going on.
I can get a pretty good picture from the outside, but sometimes you miss
things if you don't go internally.
Amanda Wilde (Host): It's so reassuring to know that help is available.
How does someone.
go about setting up an appointment?
Do they need a referral?
Katherine Middleton, PT, DPT: so unless you're Medicaid,
you do not need a referral.
Um, but it is usually easiest to just get a referral?
from your physician.
Um, they can just send it over like they normally do for
any other physical therapy.
And then, yeah, then we'll call and set up an appointment.
Amanda Wilde (Host): I love how sensitive you are to the needs of each and every
client that you have, and I think a big takeaway from this conversation for me is.
Uh, because we don't talk a about it a lot doesn't mean you have
to accept this as part of life.
You can see someone like Kat Middleton and she will assess you in a very thorough
way and be sensitive to your needs.
So Catherine, thank you so much for sharing your insights and expertise
and education on pelvic floor therapy.
That was physical therapist Catherine Middleton.
For more information on pelvic floor or physical therapy,
got to woodlawn health.org.
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