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.
Electrical stimulation: This is used
to supplement Kegels to further strengthen the muscles.
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.
