Case Study: Leaking with position changes and lifting
Pelvic Floor PT Case Study
Condition Focus: Urinary Urgency, Frequency & Leakage
Client Overview
Age & Life Stage: 79-year-old female, highly active, enjoys walking and hiking most days
Primary Complaint: Urinary urgency, frequency, and leakage primarily with position changes — sit to stand, supine to sit, and lifting
Relevant Background: Gradual onset over the last few years. Medical history includes arthritis, intermittent low back pain, and two vaginal deliveries. No orthopedic surgeries. Not on any medications. Maintains a clean, low-sugar diet. Reports decreased water intake due to urinary symptoms; consumes 2 cups of coffee each morning and diet soda or iced tea with lunch.
Initial Challenges
Symptoms & Daily Impact:
Frequent urgency and daytime urination
Leakage triggered by transitional movements and lifting
Avoided drinking water to minimize symptoms
Emotional Toll:
Frustration and surprise due to symptoms despite healthy lifestyle
Concern over symptoms worsening with age
What Was Tried Before:
No formal treatment or pelvic floor PT prior to referral
Managed symptoms by reducing fluid intake
Turning Point:
Sought PT after increasing impact on daily life despite active lifestyle and dietary care
Treatment Approach
Findings:
Functional leakage with transitions and lifting due to increased intra-abdominal pressure
Breath holding observed during positional changes
Dietary bladder irritants present and reduced water intake contributing to concentrated urine
Plan of Care:
Education on bladder irritants and the importance of increased water intake to reduce urine acidity
Instruction on coordinated exhalation during position changes and lifting to support pelvic floor elevation
Urge management strategies to delay and manage urinary signals
Advice to hydrate around bladder irritants (e.g., following caffeine with water)
Initial Response:
At one-week follow-up, patient reported approximately 95% symptom resolution
Remaining symptoms (approx. 5%) linked to increased intake of bladder irritants and reduced water intake
Results Achieved
Physical Outcomes:
Dramatic reduction in urgency, frequency, and leakage
Improved bladder control with position changes and lifting
Maintained physical activity without fear of leakage
Quality of Life Gains:
Returned to full activity, including hiking, without limitation
Empowered to manage symptoms independently through diet and behavior
Client Quote:
"I didn’t expect such a big change from simple changes — I feel like myself again."
Clinical Insight
This case highlights how targeted pelvic floor education, dietary awareness, and behavior strategies can resolve symptoms in active older adults. Despite strong physical health, unaddressed bladder irritants, breath holding, and hydration patterns contributed to urgency and leakage. Empowering patients with simple, effective tools can result in rapid symptom relief without medications or invasive interventions.
https://kellyelevatewellnesspt.com
Kelly McCall Knott PT, DPT
📞 719‑416‑4039 • 📠 719‑622‑3326
