A spinal cord injury can result in loss of function, feeling, and mobility. This can also include changes in sexual function, bladder and bowel control.

Natalia shares why neurological concerns can impact the bladder and bowel, cauda equina red flags to recognize, actionable tips for health professionals to use in their clinic with patients who have a spinal cord injury, how to use TENS for hyperactive bladders, and tips on catheter use. We also review a special spina bifida case study.

Pelvic health therapists can have a huge impact on improving pooping, peeing, and sex after a spinal cord injury by retraining the bladder, bowel, and sex organs.

Despite society’s assumptions around sex and disability, those who identify living with a disability or chronic illness are sexual beings with sexual curiosities, needs and desires for sexual freedom and expression as non-disabled folks. Disability and sexuality are not mutually exclusive.

Natalia shares the different classifications of spinal cord injuries and their neurological impacts on the pelvic floor:

• Complete spinal cord injury: no sensory or motor function below the level of the injury (fortunately not the majority)

• Incomplete spinal cord injury: voluntary control of the anal sphincter and deep anal sensations

• Upper motor neurons spinal cord injury: injuries that occur above the sacral nerves

• Lower motor neurons spinal cord injury: injuries that occur below the sacral nerves

As a clinician, it’s important to recognize red flags of cauda equina injuries and other key conditions.

Cauda equina is an injury below the sacral level. It can happen due to:

• Compression

• Herniated disc

• Tumors

• Traumatic spinal cord injury (fall or traffic accident)

Red flags to look out for:

• Severe pain that can be similar to sciatic type pain

• Saddle area paresthesia/anesthesia

• Bladder, bowel, sexual dysfunction

• Lack of sensation passing urine

• Urinary retention and stress incontinence

The impact pelvic health physiotherapists can have on improving quality of life is huge by retraining the bladder and bowel.
Tune into 11:10 for more cauda equina injury symptoms.

A few other key tips Natalia shared:

🔑 Self-catheterization is not terrible! Even if it seems like a bothersome thing to do, catheters protect the kidneys, pelvic floor, and keeps the patient dry in spina bifida cases.

🔑 TENS for hyperactive bladder, placing it over the bladder and playing with intensity and specific location (sometimes even placing it over the sacral), can help to help calm down the bladder. 

This episode is packed with great information for pelvic health physiotherapists and all health professionals. Here a guide to the episode:

• 3:16 pelvic reflexes after spinal cord injuries

• 7:20 basic human physiological functions

• 7:58 types of spinal cord injuries

• 11:10 cauda equina injury symptoms

• 1:01 bladder and bowel impact on spinal cord injuries

• 18:40 sexual dysfunction

• 28:01 organism without reflexive arousal

• 33:08 bladder botox

• 35:28 what physios can do in their practice

• 41:23 importance of relearning how to use bladder muscles

• 43:33 spina bifida, lumbar stenosis, multiple sclerosis, and pelvic pain

• 47:10 bladder prolapse and the importance of relaxing pelvic floor muscles when peeing

• 53:58 how to safely and efficiently use a catheter

• 58:25 TENS for hyperactive bladder 

Natalia is a passionate and committed physiotherapist with experience and great interest in pelvic health and neurological pelvic dysfunction. After graduating with a First Class degree in Physiotherapy, Natalia gained a Master’s in Clinical Neuroscience at University College London and immediately started her clinical research into neurogenic bladder and pelvic dysfunction. Following her research, Natalia has continued to take part in the academia and has presented her work in numerous national and international meetings. Her research, training and academic experience led her to successfully implement and consolidate the only Specialist Pelvic Physiotherapy Clinic at the London Spinal Cord Injury Centre, Royal National Orthopaedic Hospital where she treats a wide range of complex pelvic dysfunction cases. Natalia's experience has lead her to extend her practice to the general population in the private sector but whether in the NHS or in the private sector, Natalia has a holistic and compassionate approach and she puts everything into her practice. 

Contact Natalia

Natalia is available for virtual consultations. Please contact her at nataliavasquezp@icloud.com

Website: www.nataliavasquez.co.uk

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This information is not intended to substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a healthcare professional with any questions you may have regarding treatment, medications/supplements, or any medical diagnoses. This information is intended for educational purposes only and is in no way to substitute the advice of a licensed healthcare professional.