Another example is that one’s muscles may weaken as their hormone levels change, which may result in some urine leakage with exercise. This may result in premature emptying of the bladder, in order to avoid filling to a level that is a challenge to hold, which, in turn, may result in decreased bladder filling capacity and an increase in urinary frequency. Or, she may respond in excessive “clenching” of her vaginal muscles in an attempt to prevent the leakage, which can, in turn, cause muscle irritation which results in urinary frequency and urgency. In our evaluation we investigate the root cause of your symptoms, and devise strategies to deal with your specific presentation.
What to do:
it is a good idea to schedule a preventative physical therapy session before any major changes in habit, such as a change in your exercise routine, to make sure that you implement your program in a way that will not challenge your capacity to remain continent down the road. In this session we will evaluate your muscle firing patterns and teach you to properly recruit your trunk musculature as well as teach you which behaviors to implement in order to best preserve your ability to maintain continence over a lifetime of exercising, including through transitions through lifespan phase changes (e.g. childbirth, menopause).
Many girls and women experience some difficulty initially with penetration. Their first attempt at tampon insertion is not successful, or their first pelvic examination is painful. This is very different from ongoing difficulties with penetration, for example never being able to insert a tampon, pain with subsequent attempts at penetration or vaginal examinations. The entry point to the vagina is covered with the hymen in many girls or women who have not experienced penetration. In cases where the hymen is intact, penetration may be painful due to tissue tearing. This should heal fairly quickly (within a few days), and tissue should stretch and accommodate with successive episodes of penetration.
Some women experience ongoing pain with penetration, for a variety of reasons (e.g. repeated catheterizations in childhood). This may occur from her first attempt at penetration, or may begin after a period of painless penetration. Often the reason for this is unknown. These individuals are often led to believe that this is a result of an anatomical challenge- they are simply “too small.” Anatomical abnormalities, however, are rare, and one must consider that these tissues are designed to stretch to accommodate the passage of a full-term baby through them (albeit with hormones present that help relax the tissues further).
In the vast majority of cases, women must learn to consciously relax their pelvic floor muscles to allow for easy penetration. Most of our clients learn quickly to relax and stretch their vaginal muscles to allow for easy, painless penetration.
What to do:
If you are having trouble with penetration of any kind, it is a good idea to schedule a preventative physical therapy session, rather than to continue painful penetration or avoid it altogether. We will evaluate the status of your vaginal muscles, and teach you to relax and stretch them as appropriate.