Colleen Ryan DPT, is a Doctor of Physical Therapy who specializes in women’s health topics.  These include:  prenatal and postpartum care, and urinary incontinence.

Pre-natal and Postpartum

The pre-natal and postpartum phases of child rearing are times of great physical, emotional and hormonal changes for a woman.  As the fetus grows, the mother’s musculoskeletal system is challenged by altered posture, shortened muscles, potential muscle imbalances, as well as changes in spinal mobility.  In the postpartum phase, fluctuating hormone levels combined with additional physical changes brought on by delivery may also result in musculoskeletal problems such as excessive joint mobility, weakness of the core stabilizers, and altered spinal mobility and function.

How to recognize what’s normal, and what’s not:

Discomfort throughout the prenatal and postpartum phases is normal. However, if you are experiencing pain in the joints of the pelvis or spine, muscular pain in the hips or lower extremities, or incontinence, physical therapy may be helpful.

If you experience these symptoms or feel you need extra help strengthening the abdominal muscles in the postpartum phase, ask your doctor for a referral to Physical Therapy.

Referrals for Physical Therapy are appropriate for individuals with:

• Back, neck, sacral, hip, pelvic or rib pain
• Headaches
• Sciatica, carpal tunnel, thoracic outlet  or other nerve symptoms
• Decreased ability to do normal daily activities
• Weak or tight muscles
• Pelvic pain during sexual intercourse, use of tampons or gynecologic exams
• Desire to start or continue an exercise program
• Urinary incontinence
  

Men’s and Women’s Urinary Incontinence

How to recognize what’s common, and what’s not:

There are several kinds of urinary incontinence, but in general the term refers to the leakage of urine at inappropriate times.

Stress Incontinence is leakage of small amounts of urine when there is increased pressure on the bladder.  This can happen with exercise, sneezing, coughing or lifting.

Urge Incontinence is the leakage of medium to large amounts of urine when a person feels a sudden strong urge to urinate.

Mixed Incontinence  includes symptoms of both stress and urge incontinence.

Functional Incontinence is urine leakage that occurs when a person cannot get to the toilet in time.


What causes urinary incontinence?

Stress incontinence usually results from weakness in the pelvic floor muscles. The pelvic floor muscles also work to strengthen the low back, stabilize the pelvic bones, and help with sexual function. Women with stress incontinence often have “under-active” pelvic floor muscles.  Causes of under active pelvic floor muscles include:

• Pregnancy or childbirth
• Injury or trauma
• Surgery in the vagina or rectum
• Episiotomy
• Lack of exercise or use

Urge incontinence often results in pelvic floor muscles that are weak and over-active, whereas mixed incontinence can include any combination of causes of stress and urge incontinence.

Functional incontinence can be caused by:

• Joint pain or muscle weakness
• Problems with mobility
• Confusion, dementia or delirium
• Environmental barriers (use of walker, cane, etc.)
• Psychological problems such as depression or anger

Ask your doctor for a referral if you experience any of the following:

• Trouble leaking urine during normal daily activities
• Urine leakage with sneezing, coughing or laughing
• Trouble starting the urine stream
• Trouble with frequent urination (more than every two hours)
• Trouble holding urine when feeling a strong urge to go