Thanks for tuning in to the Armor Men’s Health Hour Podcast today, where we bring you the latest and greatest in urology care and the best urology humor out there.
In this segment, NAU Urology Specialists' partner and pelvic floor physical therapist Dr. Angela Treadway talks female incontinence with our very own Donna Lee. Dr. Treadway explains the types of incontinence that most women experience as well as the anatomy of the pelvic floor and surrounding muscles and how they can be strengthened through physical therapy. If you or someone you love has ever experienced incontinence from everyday activities like coughing, sneezing, running, or jumping, or for any other reason, please give us a call today and let us help you restore your pelvic floor!
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Dr. Mistry is a board-certified urologist and has been treating patients in the Austin and Greater Williamson County area since he started his private practice in 2007.
We enjoy hearing from you! Email us at armormenshealth@gmail.com and we’ll answer your question in an upcoming episode!
Round Rock Office 970 Hester’s Crossing Road Suite 101 Round Rock, TX 78681
South Austin Office 6501 South Congress Suite 1-103 Austin, TX 78745
Lakeline Office 12505 Hymeadow Drive Suite 2C Austin, TX 78750
Dripping Springs Office 170 Benney Lane Suite 202 Dripping Springs, TX 78620
Speaker 1:
Welcome back to the Armor Men's Health Hour with Dr. Mistry and Donna Lee.
Donna Lee:
Hello there and welcome to the Armor Men's Health Hour with Dr. Mistry and Donna Lee. And I happen to be Donna Lee. Dr. Mistry is the co-host for the show and he stepped away, so I wanted to bring back in Dr. Angela Treadway. Welcome back!
Dr. Treadway:
Hello.
Donna Lee:
Dr. Angela Treadway has been with us for 12, 13 years since we opened the practice in 2007ish. You have a doctorate of physical therapy.
Dr. Treadway:
Yes, I do.
Donna Lee:
Gotcha. So when I refer to Dr. Treadway, I want to make sure that everybody knows you're our magical pelvic floor physical therapist.
Dr. Treadway:
Emphasis on the magical!
Donna Lee:
Magical, and beautiful pelvic floor physical therapist. We also have Dr. Kendel Lipe with us. She's joined us recently and she's also a pelvic floor physical therapist.
Dr. Treadway:
She's amazing. I trained her. But it wasn't just me. No, she came that way.
Donna Lee:
She's pretty awesome. But, yeah, so everybody check out our website and you can see our providers at our website is armormenshealth.com. That will take you through our main website through Urology Specialists. We are NAU Urology Specialists. We're in Round Rock, North Austin, South Austin, and Dripping Springs, Texas, Dr. Treadway. Have you been there lately?
Dr. Treadway:
No.
Donna Lee:
It's so cute.
Dr. Treadway:
I hear I'm supposed to I'm supposed to check it out since there's none of us unicorns out there.
Donna Lee:
Right? We need pelvic floor physical therapy out there with our clinic, for sure. It's kind of like Wimberly, but bigger. Like it's just beautiful out there. So anyway...
Dr. Treadway:
They have a winery?
Donna Lee:
They do, they have a vodka-ry.
Dr. Treadway:
Okay.
Donna Lee:
They have lots of those things out there. There's lots of beer places and wine places... Anyway, you can reach us during the week at(512) 238-0762. You can also visit our website like I mentioned, armormenshealth.com, and you can send us questions to any of our providers and Dr. Treadway as well, of course, to armormenshealth@gmail.com and we will get those questions answered anonymously. What would you like to talk about today, Dr. Tredway?
Dr. Treadway:
Well, we were starting on the track of women's health. I know we'd had a lot of questions coming in from ladies. And so I want to continue on that line of thinking with the thing that happens probably the most often around here, and that is incontinence. So what is incontinence easily defined? It's urine escaping the bladder without your permission.
Donna Lee:
Like when you jump or sneeze or giggle or just walk.
Dr. Treadway:
Or lift, or work out, or run...
Donna Lee:
Or just exist?
Dr. Treadway:
Sometimes that too. Sometimes that too.
Donna Lee:
Right? Help us not wear the Depends.
Dr. Treadway:
Yeah, we're getting you out of that right now.
Donna Lee:
OK, good.
Dr. Treadway:
Yeah, don't buy stock in those. So there's two different types. Well, actually there's more than two, but we're going to talk about stress incontinence and urge incontinence. There are two more types. Since I've mentioned it, I won't keep you hanging. One is incontinence that has to do with not being able to get to the toilet in time. In other words, if you're on a walker or in a wheelchair or something like that--so that's more of a mobile, a mobility problem. And then there's another kind that's called overflow incontinence. And that has to do with you have waited so long, your bladder's like,"I'm taking over," and it will empty, it doesn't want to explode. Right? So, but we're not talking about those kind today. We're talking about stress and urge. I'm going to, so stress incontinence is the coughing, sneezing jumping, that kind of thing. And urge is a little different, and if we have time, I'll talk about that, or maybe in another segment. So stress incontinence. So think about pressures. Think about physics. Probably not something you think about every day. But let me make it more like tinker toys for you. So if you think about the breathing diaphragm and the pelvic floor--the pelvic floor are the muscles that you're sitting on and they're inside of your pelvis. They control bowel bladder and sexual function. So they're like a basket at the bottom. So you have breathing diaphragm on top, basket at the bottom. Those are the top and bottom of a pressure chamber, a pneumatic chamber. And it's very important that they're both working at the same strength level. The rest of that chamber is the abdominal wall and your back muscles. So it's like a soda can. And if you imagine a soda can, that's got a problem at any one of those areas, you're going to start losing fizz, right? You're gonna start losing liquid. But what we're talking about here is when the bottom area, the pelvic floor, is not functioning well. And now all the pressure from the top pushes on the pelvic floor and it's a bad physics equation. Whatever's in the bladder is going to get pushed out, especially if you add the pressure of a cough, a sneeze, a jump, a run--whatever. So what we do here is assess which part of that situation is messed up. It can be the pelvic floor, it's most often the pelvic floor. It can also be the abdominal wall. Think about in pregnancy, sometimes the abdominal wall, the abdominal muscle, the one on the outside, the rectus abdominis will split a little bit above the navel. That's called the diastasis recti. Well, that messes up the walls of your soda can.
Donna Lee:
Sounds like a dinosaur.
Dr. Treadway:
Okay. The"dinosaur recti." Yeah, the dinosaur is making a mess with that whole soda can.
Donna Lee:
Bad dinosaur!
Dr. Treadway:
So see, you will all remember this now because of the dinosaur. So I have to assess, you know, what's going on with the tummy, what's going on in the abdominal wall, and what's going on with the pelvic floor and see which part of that is contributing.
Donna Lee:
Is it primarily when women have children that these issues happen, or is it age or...?
Dr. Treadway:
Babies are a big part of it because the abdominal wall gets pushed out so far and it gets pushed down a lot. And so, yes. And then vaginal deliveries can be a drastic mess if there's tearing and things like that. But that said, we've got some people that do CrossFit like mad, and sometimes I hear that, possibly, a little incontinence is like a badge of courage, you know, a badge of honor? So there are other, other things. Think about forces, it's all about physics. What could contribute to it? So anything that could be that disruptive in the forces, right? May the force be with you--but not pushing...
Donna Lee:
And also your bladder.
Dr. Treadway:
And also your bladder. Anyway, so what we do is assess those pelvic floor muscles, and generally they are at fault, and find out about the strength and the movement capability of both the slow twitch fibers and the fast twitch fibers. The slow twitch fibers, think about them as marathoners. They have the endurance and they make up 70% of the pelvic floor. So they're pretty important. And the fast twitch fibers make up 30%, but they're the coughing, sneezing...they're the minute men, you know, they come in quick, so they both need to operate. The slow twitch fibers, if you think about they make up the 70%, they can be grown like any other muscle with some girth and some size to actually physically, you know, shore up the bladder. And when they contract, they mean business, because now they're thicker. And then the quick ones need to be able to react quickly to when a cough, a sneeze, a lift, whatever, happens. And we work on those using biofeedback, which is a way that I hook up, hook them up to an EMG, which is an electromyography--just like an EKG, but a lot less complicated. I hook that up to the pelvic floor so they can see it in real time what they're doing and...
Donna Lee:
It's not painful?
Dr. Treadway:
It's not, nothing I do is painful. That's a good point. Nothing I do is painful.
Donna Lee:
She does not hurt you.
Dr. Treadway:
I don't hurt you. And I will make sure that they can do that in functional positions. So I start them laying down and then they'll go sitting, standing, and then perhaps trying a little bit of jumping to see if we can get them back running.
Donna Lee:
Okay. So then you can assess the incontinence issues right there on the spot?
Dr. Treadway:
Right there on the spot.
Donna Lee:
That's amazing. What are, what are the other types of issues that cause incontinence? Like I know you have, you've had horrific accidents that have happened to patients like car wrecks and their pelvic floor area's pretty brutalized from the tragedy of being in a car wreck.
Dr. Treadway:
Sure, if there's been any pelvic fracture. Now the bones that the muscles are attached to might not be aligned properly. It's a length tension thing.
Donna Lee:
(512) 238-0762 is our phone number. Our website is armormenshealth.com. You can see Dr. Mistry's smiling, happy face. We're in Round Rock, North Austin, South Austin and Dripping Springs, Texas. Call us during the week, like I said, or you can email us anonymously armormenshealth@gmail.com. And listen to our podcast. Thanks so much!
Speaker 4:
The Armor Men's Health Hour will be right back. If you have questions for Dr. Mistry, email him at armormenshealth@gmail.com.