Author Archives: Medical Associates

What is a Kegel? Are they right for you?

Your pelvic floor muscles act as a hammock at the bottom of your pelvis that supports all your abdominal and pelvic organs. Strengthening these muscles can help with problems such as urinary leakage, fecal leakage, prolapse, general weakness, pressure, pain, post-partum pain, or instability. Many physicians or therapists, friends or family members may recommend Kegels as an intervention to address your symptoms, but what are Kegels and are they right for you?

First, let’s define a Kegel. A Kegel is an isolated contraction of the pelvic floor muscles. This means that those pelvic floor muscles are the only muscles contracting in your body (lifting up towards your head and squeezing around). No other muscles come to aid in this isolated contraction. It should be a “secret” squeeze; in other words, no one else would know you are flexing them.

But when you reach for your grocery bag, move that heavy couch, lift the baby, have a bowel movement, or even sneeze – the pelvic floor doesn’t work alone. Yes, you do need to be able to isolate these muscles to help build their strength, but it needs to work together with the inner core. This allows you to anticipate movement, respond, and create a support system for stability to decrease the strain or workload to one individual group of muscles. All the muscles of the inner core need to be balanced in strength to appropriately perform actions such as these.

Kegels do have their place in Pelvic Floor therapies, however every patient is different and not everyone should do Kegels. For example, sometimes the pelvic floor is tense or in spasm, meaning the muscles are already engaged or in a contracted position. Another type of intervention or home program may be more appropriate in this case. If tension is the source of the symptoms being experienced, those muscles likely need to be lengthened and taught to relax instead. This is why it is critical to be evaluated by someone who is specifically trained in pelvic floor therapies. Knowledge of how your pelvic floor presentation relates to your symptoms and the ability to assess what the rest of the system is doing are crucial.

If you’ve tried Kegels and they haven’t helped, please contact us. There might be modifications we can make, different muscles to address, or an altogether new therapy tactic to try. Call 563.584.4465 to schedule an appointment or ask your doctor for a referral to pelvic floor physical therapy. You can also fill out our intake form here and someone from our office will reach out to you.

Gosse_B_2017_ultiproBrittany Gosse, DPT
Department of Physical Therapy
Medical Associates Clinic

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