Incontinence is certainly common. More than half of people have incontinence after a baby, it can accompany pelvic pain, prolapse, low back pain or following a surgery.

But it’s never normal, and never something you have to live with.

Sometimes this is normalized - we joke about it with friends, or hear about it from our mothers. But we often don’t recognize the profound effect of incontinence on our lives.

We often abstain from exercising (which has life-long health effects). We don’t feel comfortable doing certain activities with our kids. It dictates what we can wear. Many people find they are making a lot of sacrifices because of their incontinence they didn’t even think about.

Fortunately, it’s absolutely something that can be resolved by a qualified pelvic PT - and generally without Kegels!

Fundamentally, incontinence is the inability of the pelvic floor muscles to perform their job of holding back urine.

But this doesn’t mean they are weak! In fact, many times incontinence is actually due to overly tight and irritated muscles incapable of performing their normal job.

Incontinence is not normal and not something you have to live with. I’ve never had a patient not find improvement with pelvic PT, and the vast majority can completely eliminate incontinence without surgery, medication or a lifetime of pads

Local to Southern California?

We'd love to work with you to completely resolve your incontinence and pelvic floor issues. If you're local to Southern California, please give our PelvicSanity team a call - we'll be happy to answer any questions and get you started!

Whether we're your first call or you've been to multiple other pelvic PTs and physicians, you can absolutely find lasting relief!

About Us

Dr. Nicole and Jesse Cozean are the founders of PelvicSanity Physical Therapy (www.pelvicsanity.com) in Southern California. The clinic has helped thousands of patients in the Orange County, CA area and hundreds from around the world with a remote consultation and Out of Town Program.

They co-authored The IC Solution and Nicole created The IC Roadmap online course to provide the most accurate, up-to-date information for those with interstitial cystitis. They run the Finding Pelvic Sanity Facebook group for a supportive online community for anyone dealing with pelvic health issues.

Nicole has also created courses and trained thousands of pelvic PTs to provide better care through her work with Pelvic PT Rising (www.pelvicptrising.com).

• Subscribe to the podcast
• Follow @pelvicsanity for great info!
• Join the Finding PelvicSanity support group
• Check out www.pelvicsanity.com for additional help!

And as always, we hope this has helped you find just a bit of pelvic sanity!

For many people (almost 90% of those diagnosed with IC) tight muscles in the pelvic floor irritate the nerves running through the area. One of the most important of these is the pudendal nerve.

So what symptoms might be caused by pudendal nerve irritation? One is urethral burning or pain. One branch of the pudendal runs right to the urethra, so it is often responsible for urethral pain or burning.

The pudendal can also be the cause of urinary urgency and frequency. It connects to the bladder. Usually these nerves are ‘silent’, but with IC they are often activated and continue to send signals to the brain. When the brain interprets these as the urgent need to urinate, we get urinary urgency and/or frequency.

(Just a note - Often when we hear ‘pudendal nerve’ we do a Google search and see information about pudendal neuralgia. This is obviously a scary diagnosis. But what we are talking about here is pudendal nerve irritation. We actually compare it to something we’re more familiar with - sciatica)

So it’s definitely possible pudendal nerve irritation is driving symptoms. There are many other nerves in the area which can be causing symptoms as well, so that’s where a pelvic PT can both figure out what is going on and work to address the issue.

This also explains why many people with IC-like symptoms are given bladder-focused treatments (bladder instillations, Elmiron, hydrodistensions, etc.) without benefit.

Finding Pelvic Sanity Facebook Group

If you haven't already, make sure you join the Finding Pelvic Sanity online support group (www.facebook.com/groups/findingpelvicsanity). It's a supportive group and moderated by the PelvicSanity team, so you know you're getting high-quality information.

If you're local to Orange County (or can come here for treatment), we would love to work with you directly!

About Us

Dr. Nicole and Jesse Cozean are the founders of PelvicSanity Physical Therapy (www.pelvicsanity.com) in Southern California. The clinic has helped thousands of patients in the Orange County, CA area and hundreds from around the world with a remote consultation and Out of Town Program.

They co-authored The IC Solution and Nicole created The IC Roadmap online course to provide the most accurate, up-to-date information for those with interstitial cystitis. They run the Finding Pelvic Sanity Facebook group for a supportive online community for anyone dealing with pelvic health issues.

Nicole has also created courses and trained thousands of pelvic PTs to provide better care through her work with Pelvic PT Rising (www.pelvicptrising.com).

• Subscribe to the podcast
• Follow @pelvicsanity for great info!
• Join the Finding PelvicSanity support group
• Check out www.pelvicsanity.com for additional help!

And as always, we hope this has helped you find just a bit of pelvic sanity!

Have you heard or been told you 'just need to Kegel'? Here's why that's never the answer to pelvic health issues.

Kegels (or the voluntary squeezing of the pelvic floor muscles) are often one of the only areas of pelvic health we’ve heard about. It’s often surprising to people to learn Kegels are often ineffective, antiquated and can cause flares or actually exacerbate symptoms. Here’s why they are rarely used at all at PelvicSanity.

1) The majority of people with pelvic floor symptoms already have overactive pelvic floor muscles.

This means we want to be working to calm down the pelvic floor. Help it to relax and stretch out. Not adding a bunch more work for it to do!

Not only are Kegels ineffective, but can often flare symptoms for those with an overactive pelvic floor. This is why Kegels are never recommended for those dealing with pelvic pain.

2) Even if you are weak, Kegels aren’t the best way to strengthen the pelvic floor.

Even for the small subset of people who truly do have pelvic floor weakness, Kegels are only one small part of the pelvic floor.

If your goal is to run without leaking, how is laying on your back and staring at the ceiling the best way to train for that? We need to get you up off the table and get your pelvic floor working in a functional manner again.

3) Kegels don’t find or resolve the underlying ‘why’

At PelvicSanity we’re always about trying to find and address the root cause of your issue so it doesn’t return.

The underlying why is usually outside the pelvic floor - in how you’re moving, in your back, or glutes, or hips, or ankles. Unless we find and resolve the underlying why, symptoms will either return or crop up in a different way in the future.

So if your pelvic PT was only doing Kegels or biofeedback, make sure you find a great pelvic PT for a second opinion. And if you haven’t been to pelvic PT yet, let this be your call to action!

Local to Southern California?

Our expert team in Orange County would love to help resolve your pelvic floor issues for good - without a bunch of Kegels or biofeedback! Give us a call or send us a message and we'll be happy to answer any questions and get you started!

About Us

Dr. Nicole and Jesse Cozean are the founders of PelvicSanity Physical Therapy (www.pelvicsanity.com) in Southern California. The clinic has helped thousands of patients in the Orange County, CA area and hundreds from around the world with a remote consultation and Out of Town Program.

They co-authored The IC Solution and Nicole created The IC Roadmap online course to provide the most accurate, up-to-date information for those with interstitial cystitis. They run the Finding Pelvic Sanity Facebook group for a supportive online community for anyone dealing with pelvic health issues.

Nicole has also created courses and trained thousands of pelvic PTs to provide better care through her work with Pelvic PT Rising (www.pelvicptrising.com).

• Subscribe to the podcast
• Follow @pelvicsanity for great info!
• Join the Finding PelvicSanity support group
• Check out www.pelvicsanity.com for additional help!

And as always, we hope this has helped you find just a bit of pelvic sanity!