Do you know where all the clean bathrooms are in the areas you frequent? Do you use them "just in case" when you walk by? Have you ever practically dropped your bags beside the door when you return home so you can make it to the bathroom in time? If any of these scenarios sound familiar, you may suffer from urinary incontinence.
Whenever we think of this condition, it's in the context of wearing diapers and total loss of control. Most people believe leaking urine is a normal part of aging or the normal consequence of childbirth. It is NOT. The truth is the small leaks during coughing, laughing, sneezing or any physical activity are considered incontinence. Many women don't seek help in this area because they feel embarrassed or think this is normal. Only when the symptoms become out of control do they seek help. With the recent bombardment of commercials advertising drugs or panty liners, many women think these are their only options. There is another option--physical therapy.
Types of Incontinence
- Urge incontinence is the most common type of incontinence. This is also known as an “overactive bladder.” This occurs as a sudden need to urinate and you feel as though you cannot reach the bathroom in time.
- Stress incontinence happens when there is a sudden increase in pressure (stress) in the intra-abdominal area that results in increased pressure on the bladder. This can be caused by laughing, coughing, sneezing, exercising, or heavy lifting. It is essentially a weakness of the pelvic floor muscles. This is the most common type in women age 30 to 50 and can be caused by:
o Pregnancy and Childbirth
o Episiotomy (during childbirth)
o Injury or trauma
o Vaginal or Rectal Surgery
o Lack of exercise and lack of use
o Weight gain
Mixed incontinence is a combination of stress and urge incontinence
- Functional incontinence occurs when a person cannot physically get to the bathroom in time. This type of incontinence is uncommon and can only be established as a cause after other possibilities have been ruled out by a physician. Possible causes:
o Environmental (Too far to bathroom, slow ambulating because of walker or cane use, too many obstacles to navigate around)
o Joint pain or muscle weakness
o Decreased functional mobility
o Confusion or dementia
o Psychological problems such as depression or anger
- Overflow incontinence occurs when the bladder cannot empty properly. Because the bladder never empties completely, it may feel full again very quickly. Tests can be performed to determine if you have this type of incontinence.
Urinary incontinence can be the result of weakened pelvic floor muscles. These muscles attach from the pelvic bones and run from front to back to form a sling-like structure that supports the internal organs and controls the sphincter muscles. They aid in strengthening the low back, stabilizing the pelvic girdle, and help with sexual function. When these muscles become weakened they no longer perform as well. Physical therapy can help strengthen these muscles.
Physical therapy intervention can include:
Behavioral modification - Education on avoiding foods or drinks that may irritate your bladder and/or change behaviors that may be contributing to your incontinence.
Bladder retraining - Education on techniques to increase time between voiding.
Biofeedback - Visual feedback that shows you how your muscles are working.
Electrical stimulation - Used to strengthen or relax muscles.
Physiological quieting - Guided imagery for relaxation.
Personalized exercise program - Techniques to increase awareness and initiation of the correct pelvic floor muscles.
With physical therapy you can regain control over you bladder and your life. Save money by eliminating or reducing the need for costly incontinent medications and supplies. Surgery can possibly be prevented. But the biggest benefit can be a return to an active healthy lifestyle.
If you suffer from incontinence, please discuss this with your doctor and see if a physical therapy referral is right for you.
The following link offers help with discussing your problems with your doctor.
https://www.mypelvichealth.org/ToolsforPatients/TalkingwithYourDoctor/tabid/78/Default.aspx
Kegel Exercises are the most well known exercises to strengthen the pelvic floor. How do you know if you're actually tightening the pelvic floor muscles? Physical therapists trained in Women's Health can help ensure you are activating the correct muscles. The following document from the Women's Health section of the APTA (American Physical Therapy Association) can provide more information.
http://www.womenshealthapta.org/pdfs/What is a Kegel.pdf
For more information, visit the following sites:
Women's Health Section of the APTA
Herman & Wallace Pelvic Rehabilitation Institute - Resourses
To find a physical therapist trained in Women's Health in your area, click on the following links:
Herman & Wallace Pelvic Rehabilitation Institute - Practitioner's Directory
