Pelvic pain and urinary incontinence in women are things that, even though they are widespread, are seldom discussed, says physical therapist Kimberly Tonovitz.
“It’s extremely common,” Tonovitz says. “I know they say about two-thirds of women struggle with some form of urinary incontinence at some point in their life. And I think it’s more prevalent than that. I think that’s an underestimate.”
Incontinence is most common after childbirth and after menopause, but that and pelvic pain can happen to any woman at any time. That’s why she’s made it her mission to help women address these problems.
“As hormone levels change, especially the loss in estrogen after menopause, it changes our soft tissue and its ability to maintain its tone,” she says. “Loss of muscle strength and the position change by the bladder can lead to incontinence.
“I treat young women who maybe haven’t had children yet. They may be into physical fitness and have done a tremendous amount of work strengthening their abdominal muscles and core, but neglect their pelvic floor. And, I actually have a couple patients now who are in their upper 80s.”
Kegel exercises, the tightening and relaxing of pelvic muscles, are a part of the therapy.
“But knowing how to do that correctly, properly and effectively is really important,” Tonovitz says. “There’s so much more to it than that, to balancing your muscle strength and flexibility to get the most out of those muscles. So, it’s more than just kegels.”
When she meets a new client, Tonovitz takes time to ask plenty of questions about medical history. “Many women will tell me they have other issues going on, problems with their hips or their lower back,” she says. “I find that correlates a lot with how their pelvic floor muscles are doing.”
Tonovitz speaks from experience: She conquered incontinence after the first of her three children was born.
Another problem, pelvic pain, is very complicated.
“No two stories are the same,” she says. “Often, the pelvic muscles are not relaxing well, and it may have to do with other tissue in the pelvis. There’s relaxation training, breathing, and stretching (exercises) as part of the therapy process.”
Her goal is to help women with pelvic pain and/or incontinence to return to their everyday lives where they don’t have to worry about going out in social situations fearing they may be too far from a restroom.
Elaine, a 69-year-old woman from a small town in western New York, is one such woman. She’s able to socialize comfortably now and no longer wakes up five times a night to use the bathroom. Therapy with Tonovitz was the key.
“She’s phenomenal, absolutely the best, a hidden secret,” Elaine says.
Those sleepless nights due to incontinence resulted in her falling asleep behind the wheel and being told she could not drive. Thankfully, she’s driving again and sleeping in bed, not her car.
Elaine says she’s learned the proper exercises and they have become part of her everyday life. She’s down to waking up perhaps twice each night to use the bathroom. “I do think the exercises I’ve been doing have made a difference for the better.”
Elaine has also learned that some foods can irritate the bladder. For her, that includes strawberries. Drinking alcohol can do so, as well. “I gave up the red wine, but I may try it again," she says.
She advises any women with pelvic pain or incontinence book an appointment with Tonovitz — and says they won’t regret doing so. This service requires a referral.