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Therapist stresses importance of keeping your pelvic floor healthy

Sarah Capodagli has grown to learn that life as a physical therapist who treats bathroom issues can make you a big hit at parties.

Over drinks and chatter, the questions start to spill out.

How can I stop going to the bathroom so often at night?

As a new mom, how come I leak after I urinate?

When I use a public restroom, is it healthier for me to squat over the toilet seat?

“Invite me to a party,” said Capodagli, 29, a Wheatfield native who runs CorrEra Physical Therapy (correrapt.com) in Williamsville. “People always have questions. They say, ‘Oh my gosh, you do what?’ And then they always want to know more.

“No one wants to talk about it, but everyone wants to know about it – because everyone has a pelvic floor, and it’s important to keep it healthy. You go to your gynecologist yearly, your primary care physician or urologist. Why would you blow past the muscles that are there to support you?”

Capodagli holds a bachelor’s of science and doctorate in physical therapy from Nazareth College in Rochester. She and her husband, Greg, who works in marketing at Fisher-Price, live in West Seneca.

She started in pediatrics PT after college working in homes with parents of newborns and toddlers. “That is how I met a lot of new moms and they would share, fairly openly, some of the symptoms they had. And they would say, ‘That’s normal after childbirth.’ I always feel that symptoms of pain and symptoms that disrupt normal urinary function are not normal. They’re just really common.”

She went on to work at Roswell Park Cancer Institute, helping men address urinary and other symptoms after prostate surgery, and opened her own practice in late 2013 after seeing the need for people of all ages to try conservative, nonsurgical ways to prevent and address incontinence, frequent urination, pain with intercourse and related issues.

Q. Talk about your patients.

I’ve had patients from 12 to 85. I range about 60/40 women to men. I see more postpartum. In terms of pain, it’s probably 50/50. In terms of urinary systems, I do so mostly with women. For men, it correlates to the best time to have prostate surgeries. … I take a lot of time with patients. My evaluation is close to an hour and a half. I don’t treat shoulders or knees. I only do pelvic floor. I want to be known as the specialist for this in the area.

When patients come in and have these symptoms that they’re embarrassed about, sometimes they’re confused and made to feel this is all in their head. There really is something going on physiologically. I have so much empathy. I can share that there was once a period in my life where I had pelvic pain and my physician basically said to tough it out. That was something I had to navigate. I’m aware of what to do but I know there are people out there who don’t know what to do. It’s almost an injustice in our health care system.

It’s musculoskeletal but also neurological in terms of how our muscles can work and how our muscles can change. I really believe that we’re well made and there’s a backup system for a backup system. When we can really get the body going in the right direction, there’s so much potential for healing.

Q. Explain the pelvic floor.

If you were looking down at your pelvis, you have a pubic bone and tailbone. It’s really the whole pelvis, the pelvic bowl. If these muscles were not there, we would have a big hole in the bottom of our pelvis. The muscles serve as support. There’s a lot of pressure in this area. Everything in the abdominal cavity is essentially putting some pressure on these muscles.

Q. Talk about common urinary issues.

If it’s urinary leaking, a lot of times it’s stress incontinence and urge incontinence. We end up doing a lot of figuring out where the muscles are starting, if we need to strengthen them or if we need to get them more coordinated and work on some behavioral or habitual things that people do. So a ton of what I do is coaching to get your body going in the right direction.

Q. Can you talk about preventing future problems?

I had an 84-year-old woman who preventively did squats and other exercises to protect her pelvic floor. If you’re going often during the night, provide some consistency about how often you go during the day. Avoid GJICing. It’s an acronym for “Going Just in Case.” Normal frequency is between two and four hours, so if you’re going every 45 minutes, it’s not a good plan to jump to two hours right away. Gradually add time.

Another thing that women are notorious for doing: If we’re in a public place, we’re afraid to sit on the toilet, so we hover. Do your pelvic floor a favor and make a nest and sit on it.

email: refresh@buffnews.com

On the Web: Sarah Capodagli demonstrates kegel exercises at video.buffalonews.com; learn more about her practice here.