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Pelvic Floor / Incontinence

Written By JeanAnn Fitzgerald |

Kachoo! Darn!! Your underwear is wet again–and maybe even your outer garment.

The problem lies in your pelvic floor. This is a group of muscles that form a sling or hammock across the opening at the bottom of your hip bones. These muscles keep the bladder, intestines, uterus (or prostate) in place and functioning properly.

Damage, trauma, and scar tissue can disrupt the pelvic floor muscle tone and cause incontinence of the bladder, or even the rectum. Age, pregnancy, childbirth with its muscle tearing or episiotomy, family history, and hormonal status all contribute to incontinence. Approximately one-third of U.S. women experience bladder leakage sometime in their lives.

You may have heard that part of the pelvic floor, your Kegel muscles, can control this bladder leakage. The problem is you have to remember to tighten them before you sneeze or cough, which is not always the first thought when those reflexes hit you. The better plan is to make the Kegel contractions a natural reaction that you don’t have to think about.

This natural response is accomplished through exercise. The routine is a tightening of the Kegel muscles, followed by their relaxation, and then a pushing outward of them.

“The problem with doing this on your own,” says Amie Stoddard with Barbieri Manual Physical Therapy, “is that people tend to instead contract their gluteal muscles or adductors (butt cheeks or rectal muscles).” If you cannot cut off your urine flow in midstream, you may need a professional to coach you. Sometimes the whole pelvic floor is in constant constriction so it may be necessary to do some therapeutic release work on the muscles to alleviate their cramping. This work is much like a vaginal exam and is pretty up close and personal, but its reward is obviously worth it.

In addition to, or even instead of incontinence, there are other signals that the pelvic floor muscles are constantly “frozen.” Since these muscles attach to the ilia, they can move these hip bones from their natural position. This can prevent you from having a flowing, easy walking gait, or a feeling of awkwardness, or having “two left feet.” This imbalance of the pelvis puts pressure on leg nerves, causing tightness of the leg muscles to the point of serious cramping. Pressure on these leg nerves can also result in real nerve pain. There may also be a sensation of cervical cramping between menses periods.

Men are affected with incontinence also, primarily due to prostate surgery. This operation can leave scar tissue that is inflexible and therefore the Kegels cannot “pinch off” the urinary tract. Sometimes nerves are damaged so that tightening messages are not received by the muscles.

Peter Barbieri says there are other contributing factors, such as a man’s occupation. A job that calls for prolonged sitting and twisting can cause muscle tension in the pelvic area, thus upsetting the pelvic floor’s muscle balance. Physical therapy once again includes locating the Kegels and then exercising them properly. Should pelvic floor muscle release be called for, the therapist utilizes an alternate port of entry than that used for women.

There are many qualified therapists who can help you regain confidence in public. The financial trade off is no more pads or diapers, plus the stress of wondering whether their absorption will be adequate next time.





1. Amie Stoddard, P.T. D.P.T., Barbieri Manual Therapy

2. Peter Barbieri, P.T., Barbieri Manual Therapy


JeanAnn is a free-lance writer for health and metaphysics. Her four e-books are available at and She also does handwriting analysis and numerology.