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Physical Therapy provides an effective treatment option for Incontinence

Article submitted by Ceci Sittser, Kitsap Physical Therapy

For many women, incontinence is a tough subject to broach with their healthcare provider. Some feel embarrassed. Others hesitate because they believe that surgery is their only option. To cope, they typically resign to wearing pads and limiting their activities.

“I think it’s hard for them to bring up because it’s a private matter,” said Dr. Anita Alvestad-McIntyre, an obstetrician-gynecologist with Kitsap OBGYN, PLLC. “As practitioners, we try to bring this problem to light.”

Dr. Alvestad-McIntyre says the procedures addressing incontinence or pelvic prolapse are high risk, and it’s not uncommon for them to fail. The recurrence rate for prolapse and incontinence is also high after those procedures. Which is why she often suggests conservative therapy to her patients — including physical therapy.

“Physical therapy is very effective, especially if I can catch women at an early stage,” she said. “It’s conservative therapy for the long term to try to avoid surgery or having to use other devices.”

Like many women with pelvic floor weakness, Melanie Herr, 68, stopped doing many of the activities she once enjoyed. After diagnosis, she was referred to Kitsap Physical Therapy, where her treatment included stretches to improve the function of the pelvic muscles, deep breathing to engage the abdominal muscles, and other techniques.

“I haven’t had to wear a pad for weeks and weeks,” Herr said following her treatment.

Herr was so excited about her success, she now talks to other women about it, telling them they don’t have to live with it.

“I never thought I would discuss my bladder or pelvic floor issues with someone,”.

Taking a holistic approach

The exact cause of incontinence may be difficult to pinpoint because many factors can be involved. One myth is that it’s a natural occurrence for women after giving birth or menopause.

Weakness in the pelvic floor, poor nutrition and dehydration, low estrogen and even anxiety and depression can all play a role. When a patient is referred to Kitsap Physical Therapy, all those factors are considered before a treatment plan is implemented.

The treatment could then include stretching and other exercises, along with strategies such as dietary change to eliminate irritants like caffeine and recommendations for estrogen replacement.

KPT physical therapist Kara Bermensolo knows the problem first hand. She suffered from incontinence as a competitive gymnast when she was young - due to stress, poor diet and performance anxiety.

Now, Bermensolo specializes in treating women who have pelvic floor dysfunction resulting in incontinence and other problems.

She says women who undergo physical therapy need to be patient because it could take weeks, and even months, to see results.

“To change 20 years of habits in six weeks is a challenge,”

Dr. Alvestad-McIntyre says most of her patients who try physical therapy are happy with the results.

“With physical therapy, they get a much better understanding of how their body works,” she said. “They can take better care of themselves in the long run.”

Kitsap Physical Therapy offers an array of pelvic health services such as:

· Pelvic Pain

· Incontinence (urinary and fecal)

· Constipation

· Pelvic Organ Prolapse

· Sexual Dysfunction (desire, tissue pain, vaginal dryness, orgasm)

In cases where all other medical causes have been ruled out and pharmacological management, general PT or surgical management has been exhausted or proved ineffective, a referral to a pelvic health specialist would be a next conservative option for evaluation and treatment.

A pelvic health specialist can do a screening (1 visit) to determine if pelvic pt is needed or not. Examples:

SI Joint (hip pain)

Sciatic pain

Coccydynia (tail bone pain)

Lower Back Pain (50% of women with incontinence or low back pain have a pelvic floor dysfunction)

Organ Pain (pelvic floor dysfunction can often feel like organ pain)

Specialists are available at KPT’s offices in Port Orchard, Bremerton, Silverdale, Poulsbo and on Bainbridge Island. For more information, visit

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