March Knowledge Drop
Each month for our newsletter, the Lady Blurb, we'll share answers to some pelvic health questions you've submitted. The questions below were taken directly from you! To submit a question for next month, comment below or email us at contact@ladybirdpt.com.
**The answers to these questions are not meant to be used as medical advice. These answers are not meant to take the place of a skilled physical therapist or discussion with your medical provider. If you are experiencing concerning symptoms, please contact your physician.**
This month, we’re answering:
I think that I’m drinking enough water, but my bladder is still irritated. Does it matter if most of my water intake is coming from sparkling water rather than still?
I’m planning on an unmedicated birth, but what positions could I deliver in if I do end up having to have an epidural?
Why are you working on my hips when my pelvic floor is the problem?
1. I think that I’m drinking enough water, but my bladder is still irritated. Does it matter if most of my water intake is coming from sparkling water rather than still?
The short answer, yes! While I love to hear that you are prioritizing hydration and paying attention to how much water you are drinking, the type of water does matter. Carbonation, in any form, can be a bladder irritant. Key word here being *can*. If you aren’t having any issues with voiding- great! Research shows that carbonated water hydrates us just as well as still water. If you are finding an increase in your urgency or frequency, try swapping sparkling for still to see if it makes a difference for you!
Other common bladder irritants can include:
● Caffeine
● Alcohol
● Artificial sweeteners (or sweeteners of any kind)
● Spicy or acidic foods (including vinegar)
● Tomatoes
● Chocolate
● Dairy
● Vitamins B and C
If you choose to eliminate multiple items from your diet and symptoms improve, try adding them back in one by one to see how it affects your symptoms. Also consider how you could be combining irritants in meals. You might find that you’re able to tolerate tomatoes, but not in the same meal as a margarita.
Another option is to increase water intake with irritants (aka a cup of water before and after your coffee) to help dilute in your bladder.
2. I’m planning on an unmedicated birth, but what positions could I deliver in if I do end up having to have an epidural?
Great question! It can be incredibly dissappointing when your birth does not progress as planned. Movement throughout early labor has been shown to be incredibly beneficial not only in helping baby progress through the pelvis, but also in pain management for the birthing parent. Ultimately, you’ll need to listen to your body and your medical provider, but delaying an epidural when possible can help the birthing parent and baby stay moving and take advantage of gravity for as long as possible.
If you do end up with an epidural, you still have some options. With an epidural, it’s most typical for folks to labor on their back, but with the support of your team other positions may still be accessible to you. Other positions you can consider are supported side lying on either side and sometimes (with assistance) on hands and knees in quadruped depending on the comfort of your team.Continue to communicate with your provider, your birth partner and/or doula or midwife to find positions that feel best for your body!
And check out our course Birth Preparation & Postpartum Planning to learn more about preparing your pelvic floor for birth and recovery.
3. Why are you working on my hips when my pelvic floor is the problem?
This is a question I have answered in some form or another every single day that I’ve been treating as a physical therapist. While your pain or symptoms can seem to be presenting quite locally, part of the fundamental training of physical therapists includes treating the whole patient and addressing whole systems of function and movement.
Let’s think about this question functionally. None of our muscles work in isolation, and the pelvic floor is no different. Our hip muscles, including the glutes and some of our deeper hip rotators, play roles in the function of the pelvic floor as well as the mobility and stability of the whole pelvis. When muscles function together, they also dysfunction together. While it can be beneficial to address the pelvic floor muscles specifically, best practice is to ensure that we also treat the surrounding and supporting tissues to ensure that they are not impacting the dysfunction you’re experiencing in the pelvic floor.
For example, weak or malfunctioning glutes can put extra strain on the pelvic floor muscles to contribute to pelvic stability, a job they were not designed to do. That extra strain contributes to fatigue, and could present to you as leaking with coughing and sneezing. By treating the surrounding tissues as well, our goal is to make sure your symptoms resolve and stay resolved long term!
Working with a pelvic floor physical therapist can help address sexual dysfunction, bowel and bladder concerns and help you prepare for pregnancy, birth and postpartum recovery. Contact us here to learn more about setting up an appointment with us, today!
Dr. Liz Cote (she/her) earned her Bachelor of Science in Exercise and Movement Science at the University of Vermont in 2014. She went on to earn her doctorate in physical therapy from Northeastern University in Boston, Massachusetts in 2018.
Liz moved to Austin after graduating and never looked back. She earned a Manual Therapy Certification in 2019, and went on to become a board certified Orthopedic Clinical Specialist shortly thereafter. With four years of experience in treating a variety of orthopedic and pelvic health patients, Liz is excited to use her knowledge, experience and clinical brain to support folks through their pregnancies and postpartum recoveries.
When not rocking it as a physical therapist in the clinic, Liz enjoys exploring Austin, paddleboarding, trashy reality TV, spending time with friends and family and watching her favorite sports teams- the New England Patriots and Boston Bruins!