Stephanie Hahn PT, DPT

03/12/2023

I just returned from a wonderful long weekend in Monterey, CA from Balanced Body’s “Pilates on Tour” event where I feasted on all things Pilates! Having the opportunity to learn from incredible experts in human movement and fitness greatly expanded my appreciation for what it takes to be a top-notch Pilates instructor. It was most inspiring to see so many women teaching well into their 70’s and beyond. Balanced Body’s exceptional support for physical therapists integrating Pilates into their rehab settings reinforced my decision 20+ years ago to do that very thing. I am looking forward to integrating new information and equipment into my teaching repertoire!

03/12/2023

Happy New Year, Healthy New Year!

My first Pilates session in 2023 teaching one of my "experienced" clients reminded me of something I learned during my doctoral studies. Physical activity and movement can absolutely slow down the hands of time. Research has shown that the effects of disuse can be reversed by engaging in endurance training for the cardiovascular system and strength training to help with improving muscle tone and balance. I was excited to add a new term this last year to my physical therapy/Pilates vocabulary - movement longevity! My two 90-year-old Pilates clients are perfect examples of this!

Here's to a happy, healthy and active year ahead!

03/12/2023

03/12/2023

03/12/2023

Why You Need a Custom Pelvic Floor Exercise Program
By Stephanie Riley Hahn, PT, DPT and Elizabeth E. Houser, MD

If you are considering starting a pelvic floor exercise program, we congratulate you! Your pelvic floor muscles, like any other muscles in your body, need exercise on a regular basis. Doing correct exercises for your pelvic floor can help with pelvic conditions like women’s urinary incontinence, pelvic organ prolapse, and decreased sexual sensation.

But did you know that not just any pelvic floor exercise program will do? You actually need a program that is customized to your pelvic floor muscle… more specifically, the level of fitness of your pelvic floor muscles.

Here’s why…

Why You Need a Custom Program for Your Pelvic Floor

Not having a customized exercise program is like going to the gym and starting a weight-lifting program… with whatever weights happen to be on the bench press bar. Not having a customized program may mean that you are doing pelvic floor exercises that are either too easy or too difficult for your current level of pelvic floor fitness.

What happens when you do pelvic floor exercises not suitable to your current level of pelvic floor fitness?

1. Too Easy
When you use an exercise program that is too easy for your level of pelvic floor fitness, you will not get much benefit from doing these exercises. Exercise fitness studies indicate that you need to exercise your pelvic floor muscles at maximum intensity for your current level of fitness for a short period of time to gain maximum results. Doing many repetitions at a lower intensity will not yield beneficial results.

2. Too Difficult
On the other hand, if you attempt to do exercises that are too difficult or too intense for your current level of pelvic fitness, you may end up engaging the wrong muscles. Studies show that when women attempt to do pelvic floor contractions too intense for their level of pelvic floor muscle fitness, these women tend to engage their buttock or inner thigh muscles instead of their pelvic floor muscles.

Designing a Program “Just Right for You

Like Goldilocks, having a pelvic floor exercise program that is “just right” for your level of fitness is the key to success. When you exercise your pelvic floor muscles at your current maximum level of intensity, for just 15 minutes per day or less, you will gain the maximum benefit.

How do you know what level of exercise is just right for you? You need to use a program based on these factors:

*strength of your current pelvic floor muscles contraction
*length of time you can hold a correct pelvic floor muscle contraction
*number of repetitions you can do correct pelvic floor muscle contractions

A correct pelvic floor muscle contraction is one that engages only your pelvic floor muscles, not overflow muscles such as your inner thigh or buttock muscles. To design the perfect at-home pelvic floor exercise program for your current level of fitness, first test your level of fitness, then design a program based on that level of fitness. For complete instructions on how to test yourself and design your custom program, check out A Woman's Guide to Pelvic Health. We give you complete step-by-step instructions for testing and designing, plus advanced directions on how to integrate these exercises into your daily life easily and with maximum results!

Send a message to learn more

03/12/2023

Got Women’s Urinary Incontinence? Tests You Can Expect

If you have women’s urinary incontinence and are finally ready to discuss your condition, we congratulate you! One of the best ways that you can prepare for your doctor’s appointment is to understand the tests your doctor will likely perform to assess your condition. These tests are designed to help your doctor discover which form of urinary incontinence you experience: stress, urge (or overactive bladder), or mixed urinary incontinence. Learn about the three different types of women’s urinary incontinence here. In addition, these tests will inform your doctor about your symptoms, whether you have urinary urgency, leakage, or frequency (or all three)!

Tests for Women’s Urinary Incontinence
Don’t worry, none of the tests your doctor will perform to assess your urinary incontinence is painful. At the most, these tests are slightly embarrassing, but then, most women already feel embarrassed discussing their urinary incontinence with their doctors. If you have overcome that embarrassment and actually have an appointment with your doctor, these tests will be a breeze.

Initial Tests
Your doctor or specialists (urologist or ob/gyn or gerontologist) will first discuss your symptoms and condition. In addition, your doctor will perform some initial tests, which usually include a physical examination, a urinalysis, and a post-void residual. Here’s what each of those tests involves:

– Physical Exam: The physical examination will include a pelvic evaluation, so you may wish to take extra care with your hygiene prior to your appointment. This physical exam helps your doctor determine the anatomy associated with your incontinence. During this evaluation, the specialist will determine whether any of your pelvic organs have pr*****ed or fallen out of place, which may contribute to your urinary incontinence issues.

– Urinalysis: This initial test helps your doctor rule out infection or blood in the urine as the cause of your urinary incontinence. You will be asked to provide a urine sample for testing. If the specialist suspects that you have a urinary tract infection, he or she will recommend a specific treatment plan to resolve the infection and send the sample for further testing. If blood is found in your urine, further testing may be needed to determine the cause.

– Post-void residual: This test confirms whether you are fully emptying your bladder when you urinate. A catheter or ultrasound machine is used to measure the urine remaining in your bladder after urination. A normal post-void residual is less than 100 ml

Further Testing
If your doctor is unable to fully determine the cause of your urinary incontinence, he or she may perform further tests. These can include a cystoscopy, urodynamic testing, and asking you to keep a bladder diary. These tests will include the following:

– Cystoscopy: A cytoscope is a thin, lighted viewing instrument that is inserted into the urethra and bladder. Your doctor will use this instrument to examine the interior lining of the bladder and urethra for issues, other than weakened pelvic floor muscles, that may be affecting your continence.

– Urodynamic Testing: This minimally invasive test focuses on your bladder’s ability to fill and empty. It measures how much your bladder can hold, how much pressure builds inside your bladder as it stores urine, and how full it is when you feel the urge to urinate. Urodynamic testing helps your doctor determine how well you might respond to certain treatments.

– Voiding Diary: Your physician may ask you to keep a voiding diary as part of your evaluation. This diary will allow you to communicate clearly with him or her about the status of your bladder, including how frequently you urinate during the day and at night, how much fluid you drink daily, and the volume of urine leakage you experience. The voiding diary will most likely also educate you about your own condition, too. Many women who keep a voiding diary are surprised at how frequently they urinate or have leakage accidents.

So there you have it. Now you have a better understanding of the tests your doctor or specialist may run to fully understand the causes of your women’s urinary incontinence. Knowledge is power, and at this point you are armed with the knowledge to confidently go to your doctor’s appointment to get on the path the relief!