Myth Busters: Pelvic Floor Therapy

Physical therapists can treat symptoms involving my bladder, bowels, or sexual function? True! Many have been doing this for several years. As this area of practice continues to advance, more providers are recognizing physical therapy as an effective and conservative treatment intervention for these diagnoses. However, every patient is different and everyone has a different experience. So with so much information available on healthcare, especially online, how do you know what is correct? Medical Associates Clinic physical therapist Britt Gosse, DPT, shares her experience and training below to help you sort the facts from the myths.

“Physical therapists can’t do anything to address this.”
Physical therapists are experts in treating the musculoskeletal system. There are 14 muscles, several joints, ligaments, and nerves making up the pelvic floor.  Not all physical therapists are trained in treatment of the pelvic floor, but there are some who have completed further training to become experts in this specific type of therapy.

“I’ve already done kegels, physical therapy can’t help me.”
Physical therapy can help. Many kegel programs can be beneficial but not for all symptoms. Additionally, a balance of muscles that engage for activities is required. Finding someone who can assess all your symptoms and the balance of your body will give you the optimal outcome.

“Only women who have had a baby go to pelvic floor physical therapy.”
Yes, post-partum women are a group that commonly benefit from pelvic floor PT, but everyone has a pelvic floor. Therefore anyone could have symptoms of pelvic floor dysfunction and benefit from pelvic floor physical therapy.

“I had surgery on my (ex. bladder, uterus, etc.) for these symptoms and it didn’t help, so physical therapy won’t either.”
Sometimes surgery isn’t the answer or it’s not the whole solution to the underlying issue that is creating your symptoms. Physical therapy may be a great non-invasive option for you as well. Discuss this with your doctor and physical therapist. Even after surgery you can benefit!

“I don’t have any pelvic floor symptoms but I just had surgery on my (abdomen, bladder, uterus, bowel, etc.).”
Even if you are not experiencing symptoms, a result of surgical procedures is scar tissue. Scar tissue can restrict normal tissue function and impair daily activities. Maybe not now, but possibly in the future you might exhibit symptoms. Being proactive with therapies to strengthen your pelvic floor muscles is a great idea for preventive health.

“My diagnosis is related to genetics. Physical therapy won’t address that.”
If this is the case, physical therapy likely won’t change the driver of your symptoms but it CAN help you manage the secondary issues occurring because of your symptoms, such as urinary urgency, constipation, abdominal pain, pelvic pain, pain with intercourse, etc. You can learn new strategies and ways to help you manage symptoms you experience.

“Other people I know said they leak when they workout. It must be normal.”
It is not normal to leak when you lift, run, jump, sneeze, sit…the list goes on. Leaking may be common but it is not normal. You can learn new recruitment strategies, balance your muscular system, and optimize overall function by working with a skilled physical therapist.

“I just had a baby; isn’t leaking or prolapse normal?”
Again, I want to stress that while these are common symptoms for many women, it is not normal. Just because something is common does not mean you have to live with it. Pelvic floor physical therapy can help you.

“I have the separation of the abdominal muscles. They said I’d have to avoid core work forever.”
This separation occurs as a natural part of pregnancy but it can create symptoms following delivery, such as feelings of instability, abdominal pain, low back pain, pelvic pain, urinary leakage/urgency. You may not have to avoid the exercises or activities you love. Many women benefit from learning recruitment strategies to protect the core, optimize function, and not create further symptoms.

“I already went to pelvic floor physical therapy and it didn’t work.”
Therapists treating the pelvic floor are all trained differently. They may have a different focus, see a different number of patients per week, or have a different type of experience or approach. Seeing another therapist just gives your symptoms another set of eyes. Research and consider a new therapist that specializes in pelvic floor therapies. Be open to your therapist and be honest about your previous experience. They will use their expertise and knowledge to address your needs with a new approach.

If you are experiencing symptoms of pelvic floor dysfunction, you may be a candidate for pelvic floor physical therapy. Contact your primary care provider and receive an appointment referral or contact the Physical Therapy Department at Medical Associates directly at 563-584-4465. For more information or to submit an electronic inquiry, follow this link.


Gosse_B_2017_ultiproBrittany Gosse, DPT
Department of Physical Therapy
Medical Associates Clinic




What is Pelvic Health and how can I Benefit From it?

The term Pelvic Health refers to treatment for men and women of all ages who experience symptoms affecting bladder, bowel, and/or sexual function due to pelvic floor muscles that may be tight, weak, or spastic.

At the bottom of your pelvis, there is a group of muscles that work to control and coordinate bladder and bowel function, aid in sexual function, and provide stability to the pelvic girdle and your core. This group of muscles is called the pelvic floor. Your pelvic floor can become affected during or after pregnancy/delivery, after surgery, due to other injury/trauma, or due to lifestyle factors or disease processes, especially those involving the bladder, bowel, or reproductive systems.

You may benefit from pelvic floor physical therapy, if you have answer “yes” to any of these questions:

  • Do you have an increased frequency of urination?
  • Do you experience leakage or loss of control of urine, stool, or gas?
  • Do you have difficulty emptying your bladder or bowels?
  • Are you constipated or need to strain with bowel movements?
  • Do you have pain with bowel movements?
  • Do you experience pain during or after intercourse?
  • Are there any changes in sexual function?
  • Do you have pain with gynecological exams or tampon use?
  • Are your periods painful?
  • Do you have worsening pain or feelings of instability during pregnancy or after delivery?
  • Do you have pain in the abdomen, hip, low back, or tailbone?

Are you living with any of these conditions? While they are common, these symptoms are not normal and you do not have to endure them each day.

How can Physical Therapy Help?

Pelvic floor physical therapy assesses the pelvic floor muscles, and other closely related structures, looking for reproduction of symptoms, restrictions, tightness, or weakness. From this assessment, an individualized treatment plan will be created to address your specific needs. The source of your symptoms will be targeted to improve quality of life. Pelvic floor physical therapy may also assist in many phases of healthcare from preventative measures, conservative management of a diagnosis, post-operative care, or post-injury/symptom onset.

If you are experiencing symptoms of pelvic floor dysfunction, you may be a candidate for pelvic floor physical therapy. Contact your primary care provider and receive an appointment referral or contact the Physical Therapy Department at Medical Associates directly at 563-584-4465.

At age 65, are you Better off on an Employer Plan or Medicare?

Whether or not you continue to work after age 65, you can still get Medicare. Most people should enroll in Medicare Part A when they become eligible, even if they are covered under an employer sponsored plan. Medicare Part A (hospital) covers institutional care in hospitals and skilled nursing facilities, as well as certain care given by home health agencies and care provided by hospices. Part A is free for most people. Medicare Part B (medical) covers most medically necessary doctors’ services, preventive care, durable medical equipment, hospital outpatient services, laboratory tests, x-rays, mental health care, and some home health and ambulance services. Part B has a monthly premium that may change each year (currently it is $134.00 a month). Part B premiums may be higher for some people if their yearly income is above a certain amount as reported on their tax returns.

If you are Medicare eligible, it may be helpful to perform an analysis to determine if it would be more cost effective to drop your group plan and take Medicare (Part A and B), along with a Medicare supplement or cost plan, and a Medicare prescription Plan (Part D). Although you can remain on your employer group health plan, it might just make better financial sense for you to be on Medicare.

Here are some things to consider when deciding if you should stay on your employer group health plan or enroll in Medicare.

  1. Average out-of-pocket costs. These include the premiums deducted from your paycheck and the member liability you pay when incurring medical or prescription drug claims.
  2. Max out-of-pocket costs. While your current medical needs may not be requiring them to pay much out of pocket, all plans have a maximum out-of-pocket cost which you could be facing in future years in the event your medical needs change.
  3. Effects on dependents covered under their plan. If you choose to elect Medicare instead of our employer group health plan, you will no longer be able to cover your spouse or dependent children, if applicable.
  4. Tax effects. While your employer group health plan premiums are pre-tax, premiums you pay for Medicare are not.
  5. Benefits Medicare does not cover. Some employer group health plans may cover additional benefits that Medicare does not cover, like eyeglasses.

To learn more about our top-rated plan, click here for a schedule of our monthly Medicare meetings, where a plan representative will be available to present you with plan information and applications. Walk-ins are welcome at our Dubuque office, located at 1605 Associates Dr., Monday through Friday, 8:00 a.m. to 5:00 p.m.


Y0045_MAHP_892 CMS Accepted 08272017

Living with Diabetes: What Can I Eat?

Grains and Starchy Vegetables

If you are going to eat grains, choose whole grains. Whole grains are high in fiber. Foods high in fiber take longer to digest and therefore affect your blood glucose more slowly (i.e. whole wheat bread, prunes and other vegetables). Reading food labels can help you with making the best choice.

What is a Whole Grain?

A whole grain is the entire grain—which includes the bran, germ and endosperm (starchy part). “Refined” flours like white and enriched wheat flour include only part of the grain. They are missing many of the nutrients found in whole wheat flour. Examples of whole grain wheat products include 100% whole wheat bread, pasta, tortillas, and crackers. For cereals, pick those with at least 3 grams of fiber per serving and less than 6 grams of sugar.

Best Choices of Starchy Vegetables

Starchy vegetables are great sources of vitamins, minerals and fiber. The best choices do not have added fats, sugar or sodium. Try a variety such as parsnip, plantain, potato, pumpkin, acorn squash, butternut squash, green peas, and corn.

Best Choices of Dried Beans, Legumes, Peas and Lentils

Try to include dried beans into several meals per week. They are a great source of protein and are loaded with fiber, vitamins and minerals. Examples include dried beans (such as black, lima, and pinto), lentils, dried peas (such as black-eyed and split), fat-free refried beans, and vegetarian baked beans.

What you need to know about Cholesterol

LDL (Bad) Cholesterol

LDL cholesterol is called “bad” cholesterol. Think of it as less desirable or even lousy cholesterol, because it contributes to fatty buildups in arteries (atherosclerosis). Plaque buildup narrows arteries and raise the risk for heart attack, stroke and peripheral artery disease.

HDL (Good) Cholesterol

HDL cholesterol is “good” cholesterol. Think of it as the “healthy” cholesterol, so higher levels are better. HDL acts as a scavenger, carrying LDL cholesterol away from the arteries and back to the liver, where it can be broken down and passed from the body.

A healthy HDL cholesterol level may protect against heart attack and stroke. Low levels of HDL cholesterol increases the risk of heart disease. HDL cholesterol does not completely eliminate LDL cholesterol. Only 1/4 to 1/3 of blood cholesterol is carried by HDL.


Triglycerides are the most common type of fat in the body; they store excess energy from your diet. A high triglyceride level combined with low HDL cholesterol or high LDL cholesterol is linked with fatty buildups in artery walls. This increases the risk of heart attack and stroke.



The Medical Associates Department of Internal Medicine provides a Fellowship-trained Endocrinologist, who specializes in diabetes, thyroid disease, and osteoporosis. The staff also includes two certified diabetes educators with board certifications in advanced diabetes management. They see patients for diabetes education appointments and medication. Call 563-584-3310 to schedule an appointment.