No need to worry

Problems with the structure and functioning of the pelvic floor is one of the most common complaints for women of all ages.

Pelvic Diagram (photo credit: Courtesy)
Pelvic Diagram
(photo credit: Courtesy)
I am a 67-year-old woman who has been diagnosed with problems of the pelvic floor. The main symptom is that I cannot hold in my urine and have repeated urinary infections. It made me very nervous, as I am afraid of surgery. What can I do? -T.C., Rehovot.
Dr. Benny Feiner, head of the urogynecology service at Hillel Yaffe Medical Center in Hadera, comments: Problems with the structure and functioning of the pelvic floor is one of the most common complaints for women of all ages, including those who have recently given birth. Research has shown that only some of them tell their husbands/partners about the problem, and even fewer consult a doctor. The problem is that they’re embarrassed, but also they may not be aware that the problem can be treated and their quality of life significantly improved.
There are a number of common symptoms. A woman may urinate involuntarily many times a day (more than in the past) or even wake up at night and have to get out of bed and go to the bathroom more than once. Just hearing the flow of water may induce an urgent need to urinate. Others may lose urine when laughing, coughing, raising a heavy weight, jumping, exercising or dancing.
Urination may be urgent, but when going to the bathroom, a woman may have difficulty holding it in or have difficulty starting the flow. The flow may be weak or intermittent. Frequent urinary infections are also common in such women, and the condition may also involve fecal incontinence.
Other sufferers notice chronic pelvic pain, pain during sex or weakness of the sides of the vagina or disfigurement of the vaginal area.
Any woman who identifies one or more symptoms should to go a urogynecologist to determine whether she has pelvic floor problems. There are all kinds of treatments, including exercise, surgery and other means to repair the pelvic floor.
I am a 24-year-old woman who likes to jog and exercise. I have time on my hands and thought I might get involved in competitive amateur sport. I worry, however, of sports injuries, as I have several friends who are professional and amateur sportsmen who have gotten hurt. Is there any way to prevent sports injuries from intensive activity, or is inevitable? -V.P., Ramat Hasharon
Dr. Ron Arbel of the orthopedic division of the Center for Sports Medicine at Tel Aviv Sourasky Medical Center, replies: Sports injuries can be minor and treated on-site, but the more serious ones may require operations and longterm rehabilitation. It is not only professional sportsmen who can be injured but even amateur bicyclists who ride on the weekend. It is commonly believed that injuries are an inevitable part of all physical activity, but the truth is that they are caused by improper training.
Injuries result from either overuse of the body, or from physical trauma during a game or practice.
The most common cause of sports injuries is improper training; if the warm-ups are not done right and the player is not prepared correctly. As a result, pressure on the body during training is too great, leading to overuse of a specific part, such as a shoulder, hand, muscle or ankle. The surface on which you function is also important. Runners who work out on pavement will get injured more than those who practice on “bouncy” grass that absorbs the shock.
If sports equipment is not suited to the sportsman, significant damage may result. A cyclist has to ride a bike specifically prepared for him, otherwise injury can result to the palms, neck, hand joints and back – nearly the whole body. Even shoes need to be matched to the bike.
Overuse of the body can damage the soft tissues, including the muscles and ligaments, but also the bones, which can develop stress fractures. Muscles function as shock absorbers, but when they are not well developed or not developed properly, the burden falls on the bones themselves, and these can fracture.
Thus the general rule is by training with expert advice and following the rules, sports injuries can be prevented. ■
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