Q: What is Urinary Incontinence?
A: Urinary incontinence is known as the “loss of bladder control” or “urinary leakage”. The 3 most common types are:
Stress: loss of urine with activity, due to an increase in abdominal pressure.
Patients often report leakage with laughing, coughing, sneezing and/or while exercising. This may be due to the bladder and urethra being hypermobile (moving too much) or the internal sphincter (the muscular ring which stops the flow of urine from the bladder to the urethra) is deficient. Common causes of this are child birth/pregnancy and menopause. Child birth/pregnancy results in weakness of the pelvic floor, which causes leakages. While menopause, due to the reduction in the production of female hormone estrogen, weakens the urethral tissue.
Urge: loss of urine with the sudden urge to go to the bathroom.
Most often patients have leakage while quickly trying to get to the bathroom and may have a sense of incomplete emptying. There are often common triggers that your physical therapist can identify with you. Common triggers mentioned in the clinic are:
- “Every time I get home and put the key in the door, I have to go”
- “Each time I get in the car I need the bathroom”
- “When it’s really cold out I really need the bathroom”
Often the cause is that your bladder contracts when you don’t want it to because it is overactive.
Q: How common is Urinary Incontinence?A: Although both men and women often find it difficult to speak to their doctor about their incontinence, it is a lot more common than most people think. It affects around 25 million adult Americans each year. In America, around 19.5 billion dollars are spent each year on incontinence diagnosis, with only 8% of this being spent on treatments such as physical therapy.
Q: Hang on, isn’t leakage just part of getting old?A: I am sure that you have all seen the television advertisements, and the numerous aisles with incontinence pads/liners/and underwear products in your local pharmacy and grocery store, but incontinence should not be accepted as a normal part of aging. Incontinence affects all ages, and when not addressed, it increases the risk of other medical complications such as skin break down and infections.
Q: How can physical therapy help?
A: At PTW, pelvic floor treatments and assessments are an hour one-on-one with your therapist in a private room. A thorough pelvic health history is taken and your personal goals are discussed followed by an examination of your lower back, hips, pelvis and peroneal area and muscles (if indicated). From the examination findings, a treatment plan and goals will be developed by you and your therapist. Your therapist may ask you to take a bladder diary home with you to complete so that your bladder habits can be looked at in more detail.
Common treatments that may be performed:
Pelvic floor muscle training: It is NOT just doing Kegels. Your therapist will instruct you on how to correctly train both the power and the endurance of your pelvic floor muscles, and most importantly how to relax the muscles. These will be performed in positions where gravity is initially eliminated, then progressed to against gravity and finally with functional activities.
Biofeedback: This is used to help you learn how to contract and relax your muscles. Electrodes are placed over the muscles to measure muscle activity. This information then links to a computer or a hand held monitor so that you can visually see when your muscles are activated.
Hip, core and lower back strengthening
Bladder retraining: By reviewing your bladder diary, your therapist will provide strategies on how to progress voiding intervals, for correct bladder emptying and education on healthy bladder habits.
Manual therapy: Soft tissue mobilizations, visceral mobilizations, trigger point release, cupping, joint mobilizations and stretches will be performed to address any myofascial restrictions, tight or painful tissues or restricted joints.
Tips for maintaining a healthy bladder:
- Do NOT perform Kegels while peeing
- Urinate every 3-4 hours, 5-7 times in 24 hours
- Sit on the toilet, take your time and do not strain
- No “just in case” peeing when you leave the house
- Pee before and after having sex
- Drink plenty of water to keep hydrated, approximately 50% of your body weight in ounces per day
- Avoid alcohol, caffeinated, carbonated and sugary drinks as these can irritate your bladder
If you have any questions in regards to your pelvic health or would like to schedule an appointment with our Pelvic Health Specialist Katie Barnett, PT DPT you can contact her at either our Lansdale location 215-855-9871 or at our Glenside location 215-887-2001.