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3 bladder habits you should break

Bladder control issues?  Here are three habits you should break.

By Andrea Trask, DPT OCS

You likely don’t pay much attention to your bladder habits and urinary pattern unless it’s causing you problems, such as during pregnancy, postpartum, or prostate disease (or you’re potty training a toddler, like I currently am!). Many people don’t realize that the bladder is controlled both by reflex and conscious regulation from the brain, and it includes both voluntary (skeletal) and involuntary (smooth) muscle. Thanks to this design, our bladder “learns” much in the same way the rest of our muscles do – and it can learn some less-than-ideal habits, too. Try to avoid these three common mistakes – and please, seek help from a trained pelvic floor physical therapist if you have concerns about urinary incontinence or other bladder symptoms!

  1. Going “just in case.”

We all do this sometimes, when you’re about to get in the car for a long road trip, heading into a big meeting and feeling nervous, or trying to beat the rush before a sporting event starts. But frequently emptying your bladder before it’s truly full teaches your body to “reset” its perception of fullness – and will leave you regularly rushing to empty a partially-full bladder. Try to wait until you truly have a sense of urge before you go.

  1. Hovering or squatting.

Everyone has likely had to go somewhere less than ideal, where you’d rather keep your bare skin as far as possible from the toilet seat. But regularly squatting or hovering over the seat instead of sitting on it makes it difficult to relax your pelvic floor muscles, which can contribute to dysfunction of the muscles, and potentially lead to pelvic pain. If it makes you feel better, a recent study found that the average cell phone has 10x more bacteria than an average toilet seat.

  1. Consuming nothing but bladder irritants.

You start with coffee in the morning, switch to sparkling water mid-day, and have a glass of wine in the evening. Did you know all three of these beverages – caffeine, carbonation, and alcohol – are known bladder irritants, and can give you the urge to go more frequently? If you are struggling with urge-type urinary incontinence (not “making it to the bathroom” in time before urine leakage), bladder irritants may contribute to your symptoms. Other potential irritants include artificial sweeteners, so you may want to consider that gum and sugar-free sweets, too.

 

Andrea Trask, DPT OCS

 

High Intensity Resistance Training for Osteoporosis: Are we playing it too safe?

High Intensity Resistance Training for Osteoporosis:

Are we playing it too safe?

By Carrie Hall PT, MHS

 

The CDC and Surgeon General, along with many researchers1 have proposed that exercise plays a role in prevention and treatment of osteoporosis, but the effect has been perceived to be moderate at best. Debunking this myth, a preliminary study in Australia has shown that high-intensity resistance and impact training (HiRIT) may improve bone and muscle strength in healthy postmenopausal women with osteoporosis.2

Maybe we have been playing it too safe?

It is known that bones respond preferentially to high magnitude weightbearing loads, but most physical therapists prescribing exercise are hesitant to apply high loads to persons with osteopenia (thinning bones) or osteoporosis (low bone density) for fear of risk of injury or fracture. This study aimed to demonstrate that high intensity resistance and impact loading is both safe and effective in improving bone mass and overall physical function.

What did this study do differently?

Researchers analyzed data from the larger Lifting Intervention for Training Muscle and Osteoporosis Rehabilitation (LIFTMOR) Trial on 101 postmenopausal women age 58 or older. For eight months, half of the women did twice-weekly 30-minute sessions of supervised HiRIT that included deadlifts, overhead presses, squats and jumping chin ups with drop landings. The other half formed a comparison group, and for eight months they did unsupervised, twice-weekly 30-minute low-intensity exercise at home.

The graduated loading, close ongoing supervision, and focus on correct technique were key to safety and overall adherence to the program (low drop-out rate). The 2 time per week dosage was also very appealing to this demographic leading to high compliance (participating with expected dosage).

All the participants had bone mineral density testing with a special type of X-ray called a DXA scan before and after the eight-month training program to assess changes in their bone mineral density (BMD), or bone health, at the spine and the femoral neck at the very top of the thigh bone that connects the long bone to the head of the femur.

By the end of the study, the HiRIT participants increased BMD in their spines by an average of about 3 percent and increased hip BMD by 2.2 percent. In the comparison group, women lost an average 1.2 percent of spinal BMD and lost more than 2 percent at the hip, researchers report in the Journal of Bone and Mineral Research.

The benefits of bone density improvements at the femoral neck and spine translate into stronger hips and backs. Women in the resistance group also had a 40 percent improvement in back and leg extensor strength, which helped improve their posture and reduce their risk of falls.

Close ongoing supervision is key!

The researcher of this study felt this demographic has traditionally been held back from high intensity resistance training for fear of fracturing fragile bone with heavy loading, but that this overly conservative approach has led to stagnation in the field. This study demonstrates preliminary evidence for safety and effectiveness of a HiRIT program for otherwise healthy postmenopausal women with low to very low bone mass.

Key to the success of this program is that HiRIT training should be supervised by adequately trained and educated professionals such as a physical therapist, to ensure correct technique and appropriate progressions, as well as to minimize injuries.

WE DO NOT RECOMMEND INDIVIDUALS WITH LOW BONE MASS TO UNDERTAKE THIS PROTOCOL IN AN UNSUPERVISED ENVIRONMENT, even after notable training, because it is not possible to self-monitor technique or self-prescribe dosage.

Despite misconception to the contrary, high intensity resistance training can be safe and has proven to be effective in improving bone mass.

Consult your PT if you are interested in beginning a program such as this.

Happy lifting!

 

  1. Howe TE, Shea B, Dawson LJ, et al. Exercise for preventing and treating osteoporosis in postmenopausal women. Cochrane Database Syst Rev. 2011(7):CD000333.
  2. Warson SL, Weeks BJ, Weis LJ, et al. High-intensity resistance and impact training improves bone mineral density and physical function in postmenopausal women with osteopenia and osteoporosis: The LIFTMOR Randomized Controlled Trial. JBMR. 2017.

 

Carrie Hall PT, MHS – President

Why you should be deadlifting

Why You Should Be Deadlifting

By Corley McBeth, DPT

 

There seems to be no exercise more effective than the deadlift in instilling fear in the hearts of patients. I cannot tell you the number of excuses, hesitations, and outright refusals I have heard regarding its performance. It would seem that we still mistakenly believe that the squat is the safest and most optimal way of lifting and moving load (thanks WebMD), but I am here to tell you that just is not the case. Mechanically speaking, the deadlift, when performed correctly, is the proper way to lift – whether it be a case of wine, a heavy moving box, or a piece of furniture. It is the ultimate functional movement.

So why are we so terrified of it? Usually it’s something along the lines of “my back is weak/sore/painful” or “that’s how I hurt myself” or “but I might hurt my back”. However none of those are a good reason to avoid it – in fact, those are all reasons you should be doing it! There are many contributing causes to back pain. Back pain can stem from weak glutes and hamstrings making it difficult to effectively move the load you required of the task. It can also come from weak spinal erectors and/or weak abdominal and pelvic floor muscles. A properly performed deadlift challenges your body to maintain a specific spinal position thereby training it to remain stable when exposed to high shear forces. You will get more benefit from a properly performed deadlift than you will from hundreds of crunches or a 3-minute plank hold.

This is because deadlifts are a total body exercise. Not only does the deadlift help facilitate strong and powerful glute and hamstring muscles and effectively challenge your core, it also places greater demand on the upper body than a squat. Squats don’t have the same effect on your scapula and rotator cuff in terms of stability, nor do they require the same muscle activity from your biceps and latissimus dorsi muscles. Deadlifts are also one of the safest weight lifting exercises to perform – you aren’t going to get pinned under weight or risk getting pulled over backward. They don’t require a spotter, you simply drop the weight if you get into trouble.

That being said, deadlifts, when performed correctly, are not bad for your back. Poorly performed deadlifts, regardless of weight, can place you at risk of injury. One must first have the required mobility as well as the appropriate stability, in order to perform a deadlift with proper form. And no, it’s not just for powerlifters. Deadlifts can be and should be performed by just about everybody.  Sure, you may need instruction and supervision during the learning process. There are many variations and modifications to allow for a safe and appropriate progression to lifting and moving heavy loads with the deadlift. Your physical therapist or other trained fitness professional can help to properly assess and instruct you in the correct performance of this movement (see video below for an example, but please use feedback for practice). Keep doing your squats, but don’t neglect the deadlift – your glutes, hamstrings and core will thank you.