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Urinary incontinence affects approximately 25 million adult Americans according to the National Association for Continence. Unfortunately, urinary incontinence is often considered a “norm.” Some women are even told to expect leakage after a certain age or after having children.
What most do not realize is that incontinence is easily treatable with pelvic floor physical therapy. In many cases, simple strengthening, relaxation exercises and/or bladder re-training can be enough to alleviate symptoms depending on the type of incontinence.
There are three subcategories of incontinence: stress, urge and mixed. With stress incontinence, one will experience leakage with physical exertion, such as coughing, sneezing or lifting. In general, those with stress incontinence have weak pelvic floor muscles that prevent proper closure of sphincters. The pelvic muscles are simply too weak to counteract pressure on the bladder with exertion. In this case, strengthening exercises such as Kegels can improve pelvic floor strength and prevent leakage. Physical therapists even have specialized tools including biofeedback machines and electrical stimulation for use on the pelvic floor to stimulate these weak muscles for an enhanced strengthening effect.
With urge incontinence, one is unable to reach the bathroom before experiencing leakage. Those with urge incontinence also typically experience urinary frequency, the urge to urinate more frequently than normal. Pelvic floor muscles may be functioning properly; however the bladder is in a habit of emptying prior to completely filling. Consuming a healthy amount of fluid and avoiding bladder irritants including but not limited to citrus, caffeine, chocolate, alcohol, cranberries, etc. can reduce urinary frequency and urgency. Bladder retraining with scheduled voiding is also extremely helpful in decreasing frequency and urgency. In some instances, the pelvic floor muscles might even be too tight, which can cause unnecessary pressure on the bladder.
Some individuals have a combination of both stress and urge incontinence, also referred to as mixed incontinence. In this case, incontinence is multifactorial and can be addressed with a combination of strengthening, relaxation techniques and bladder re-training.
A physical therapist trained in pelvic floor rehabilitation has the all of the tools necessary to address all types of urinary incontinence. We can determine the underlying causes of incontinence through examining lifestyle, medical history and orthopedic assessment of the pelvis both externally and internally. Most patients find this form of rehab extremely empowering and helpful. It is important to realize that incontinence is a very common condition for which help is readily available.
Tina Thornhill, PT, DPT is a physical therapist with Sheridan Memorial Hospital’s Wyoming Rehab Department.