One common symptom treated in pelvic floor physical therapy in our Boulder and Lafayette clinics is urinary urgency and frequency. These symptoms can be due to a number of musculoskeletal or nervous system dysfunctions: hypertonic pelvic floor or abdominal muscles, irritated pudendal or genitofemoral nerves, a high sympathetic nervous system state, learned behavior, etc. Patients will often report, “I’ve been trying Kegels and that hasn’t helped”. Indeed, Kegels are not always the answer. New research confirms this by showing that those with urinary urgency and frequency do not have weaker pelvic floor muscles than those without urinary dysfunction. 

In a study by Foster et al in 2021 participants were measured via dynamometry for hip external rotator and hip abductor strength as well as measured via vaginal mammography for pelvic floor muscle strength and endurance. Those with urinary urgency and frequency were compared with matched controls. The findings were that those with urinary urgency and frequency had statistically significant weakness in hip external rotators and abductors, but no difference in pelvic floor strength or endurance.

This study confirms the importance of a thorough hip exam for any patient with complaints of urinary urgency and frequency. Pelvic physical therapy cannot simply be focused on only the pelvic floor. Examination and treatments for urinary dysfunctions must include the hip and other surrounding areas.

Schedule an appointment with our pelvic physical therapists at Mend in our Boulder and Lafayette clinics to get a more thorough exam that looks outside the pelvis.

Foster SN, Spitznagle TM, Tuttle LJ, et al. Hip and Pelvic Floor Muscle Strength in Women with and without Urgency and Frequency Predominant Lower Urinary Tract Symptoms. J Womens Health Phys Therap. 2021;45(3):126-134.