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Decoding the Symptoms: Is it Urinary Tract Infection or Pelvic Floor Dysfunction?

The article was written by Susan Tsang, physiotherapist at Momentum Health.
Does this scenario sound familiar? Pain or burning with urination? It has to be a urinary tract infection, or UTI. Call the doctor and treat with antibiotics. Symptoms subside for a bit, and then come right back. Off to the doctor we go again. And repeat.
What if I told you that you might not have a UTI, but that the real issue may be in the muscles of your pelvis? Sound crazy?
A UTI is caused by a proliferation in unwanted bacteria in the lower urinary tract – specifically the urethra and bladder. This can cause pain or burning with urination, increased urgency and frequency of urination, lower abdominal pain and the urge to pee despite just emptying your bladder (also known as incomplete emptying). Tight, or hyperactive, pelvic floor muscles can mimic these same symptoms!
The pelvic floor is a sling of muscles situated within the pelvis. These muscles are integral to bladder, bowel and sexual function. The pelvic floor muscles act like a trampoline by supporting the abdominal contents and managing pressures coming from above or below the pelvis. Much like a trampoline, these muscles must be able to relax and extend and then recoil and shorten depending on the movement or intra-abdominal pressure applied. If the pelvic floor is hyperactive or tight, it has difficulty relaxing and lengthening enough to allow the bladder to release and empty urine with a steady stream. It can also lead to incomplete emptying of the bladder.
Hyperactive muscles can also create tension or pulling on the bladder and urethra creating irritation and pain in the surrounding tissues. This pain can then lead to increased muscle tension as a reactive and protective response, thus compounding the problem.
Have you suffered from recurrent, lab-positive urinary tract infections? True urinary tract infections can actually create enough irritation to leave the pelvic muscles hyperactive and tight even after the infections have been treated with antibiotics!
If you have signs of a UTI but negative results on laboratory testing, then you might be suffering from a dysfunctional pelvic floor.
So what should you do if you have symptoms of a UTI? First, have your medical doctor test you for bacterial infection. If the results are negative then….
  • Try some deep, diaphragmatic breathing to help your pelvic muscles relax.
  • Try some mobility exercises to lengthen and relax the pelvic floor (cat-cow and child’s pose in yoga are great places to start!).
  • Relax and breathe when you go to the bathroom. No rushing, no power pees and no hovering!
  • Visit a Pelvic Health Physiotherapist for more guidance!
Other signs your pelvic floor might be hyperactive include:

About Susan Tsang, PT Pelvic Health Physiotherapist

Susan Tsang PT

With over 16 years of experience, Susan has helped a multitude of patients to get back to the activities that they are passionate about – whether that’s a 10 km run, ripping the mountain bike trails, the weekly squash game, or just keeping up with the kids! Susan graduated in 2006 with her Master of Science in Physical Therapy from the University of Alberta and has been working in private practice ever since.

Susan strongly believes that she can guide you to great results with her compassion and experience. By examining the entire kinetic chain, Susan facilitates tailored rehabilitation, proper management and the prevention of future injuries. Susan has advanced training in pelvic health physiotherapy, helping to address incontinence, dyspareunia, pelvic organ prolapse, menopause, pelvic girdle pain with pregnancy and treating female athletes. Certified in dry needling/IMS, acupuncture and manual therapy, Susan values learning and is always striving to further her knowledge base and skill set.

To easily search, compare and book an appointment with a healthcare professional near you, visit medimap.ca.

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