People living with urinary incontinence often struggle to engage in regular physical activity. Urge incontinence is also prevalent; individuals can suddenly have an urge to urinate followed by leakage of urine.
There are a variety of treatment options available, and this article will detail several such approaches, such as pelvic floor physical therapy.
Muscle Strengthening
Many people suffering from urinary frequency find themselves feeling an urge to urinate frequently and quickly, often four to eight times per day and getting up at least twice in the night to pee. Frequent urination could be caused by infections or conditions affecting kidneys, bladder or tubes or ducts where urine flows through.
Physical therapy can assist with strengthening the muscles that support bladder function. This may involve exercises targeting abdominal and pelvic floor muscles as well as strengthening hips and lower back muscles – this may reduce pain and stress on pelvic floors that contribute to bladder control issues.
Your physical therapist may prescribe flexibility exercises as part of an overall training regimen to increase joint mobility and reduce stiffness, which is key in helping prevent falls and osteoarthritis risk. They should be performed two or more times each week until muscles tire out, necessitating brief rest periods before continuing.
Studies have demonstrated the link between muscle-strengthening exercise and improved health outcomes, such as decreased urinary frequency, and muscle strengthening exercise participation. Unfortunately, however, over 80% of adults do not meet the guidelines (>two times weekly), making identification of factors that contribute to participation critical. Research should examine peer pressure, normative beliefs and accessibility of facilities/equipment impact on participation in muscle strengthening exercise activities.
Botulinum toxin injections offer one solution for patients experiencing urinary urgency who have not found relief with other therapies: This office-based procedure takes 12 weekly sessions over 30 minutes, and works to slow and soften signals between your bladder and brain, offering relief to some individuals suffering from OAB.
Physical therapists certified as clinical specialists in orthopaedic physical therapy with certificates of achievement in pelvic health may be able to offer effective solutions for your bladder issues. You can locate such professionals using the American Physical Therapy Association’s Find a PT tool.
Core Strengthening
Your core muscles are essential in supporting your spine and pelvis for movement, posture, balance and strength. They also play a significant role in controlling bladder and bowel functions; your physical therapist may suggest core strengthening exercises as part of treatment for urinary frequency.
Physical therapy with pelvic floor physical therapy (PFPT), is an effective and comprehensive solution to OAB symptoms including urge incontinence. Your physical therapist (PT) will teach you to strengthen and coordinate the pelvic floor muscles through muscle-training exercises such as Kegels. By strengthening and corralling these muscle fibers more efficiently, OAB sufferers may reduce leakage, urgency, and frequent night urination caused by OAB.
Your therapist may suggest biofeedback therapy, a device which provides feedback to increase awareness of which muscles to contract to support bladder function. It works by connecting a small sensor placed on your skin with a computer screen which displays pressure when you squeeze muscles – your therapist will decide if this approach is suitable for your symptoms.
One option for treating OAB symptoms, particularly urge incontinence, is using a device known as percutaneous tibial nerve stimulation or PTNS to deliver electrical stimulation directly into the sacral nerves that innervate the bladder. This approach typically requires 12 weekly 30-minute office-based treatments over several months.
Physical therapy is an economical and safe solution to treating OAB symptoms, and research suggests it outperforms other approaches, including medications and injections, significantly improving quality of life and overall quality of care. You are strongly encouraged to ask your healthcare provider for a referral for physical therapy sessions.
Find a physical therapist trained specifically in treating OAB by the American Physical Therapy Association (APTA), certified with a Certificate of Clinical Competence for Pelvic and Obstetric Physical Therapy. Use their Find a PT tool or ask friends, family, or health care providers for referrals in your area.
Pelvic Floor Exercises
The pelvic floor, an intricate network of muscles located at the base of your pelvis, is essential to overall health as it supports pelvic organs such as bladder, uterus and prostate while stabilizing spine and pelvis, aiding sexual function, maintaining bowel and bladder control and helping sexual function. Unfortunately, it remains one of the body’s least-developed muscles; weak pelvic floor muscles often lead to urinary frequency in women; physical therapy exercises can strengthen these muscles for improved bladder control that will reduce or even eliminate symptoms altogether.
Pelvic Floor Muscle Training (PFMT) involves contracting and relaxing pelvic muscles to strengthen them, increase endurance and foster coordination between all surrounding muscles. Your therapist may teach exercises such as Kegels to tighten and relax these muscles to improve urinary incontinence; using Kegels may even decrease need for pads, underwear with absorbent materials or other treatments, reports Healthline.
Your therapist may also instruct you in strategies to enhance bladder control, including double voiding and fluid modification. Double voiding involves emptying your bladder twice as fast rather than waiting until an urge strikes – this helps reduce urine loss after leaving the bathroom and can help avoid leakage when outside of bathroom walls. Fluid modification means drinking 48-64 oz of water per day while restricting caffeine and alcohol to less than 2 servings daily.
Sacral nerve stimulation may provide some patients with significant benefits. This procedure performed by a doctor involves implanting a small device which regulates nerves in the lower back that carry impulses to the bladder and regulates their signals to help reduce urinary frequency in certain women. Studies have also proven this treatment to be an effective means for decreasing urine volume output.
Pelvic floor muscle training may take several months before you notice its benefits; individual results may vary. If no improvement occurs, speak to your therapist about additional treatment options or medication to ease symptoms. They can also recommend bladder training, behavior modification and relaxation techniques as potential ways of decreasing urinary frequency.
Relaxation Techniques
Relaxation techniques seek to activate the body’s natural relaxation response – a state of deep rest which provides respite from stress by slowing breathing, heart rate and blood pressure – as well as returning the mind and body into balance. Relaxation techniques may be practiced alone or with help from trained professionals and can include progressive muscle relaxation (PMR), autogenic training (AT), visualization or guided imagery techniques.
Research of both old and new studies suggest that relaxation techniques may help alleviate pain from conditions like fibromyalgia and headaches. They might even reduce epileptic seizures; however, most supporting research is of low-quality quality, so more evidence needs to be accumulated before reaching definitive conclusions.
When practicing relaxation, it’s essential to focus on soothing both the body and mind with techniques such as meditation, rhythmic exercise, yoga or tai chi. Integrating a relaxation practice into daily life makes it easier to remember it and use whenever stress or tension arise.
Complementary and integrative health specialists and mental health professionals often teach relaxation techniques, or integrate them into physical therapy sessions. A popular new trend in relaxation therapy is floatation therapy; this involves lying back on a tank filled with water containing Epsom salt dissolved into it for weightlessness that’s known to induce relaxation while simultaneously releasing endorphins.
Relaxation techniques have shown promise for decreasing stress hormone levels and leading to reduced urinary frequency, but further studies are required. Exercise, good sleeping habits and healthy eating as a means of mitigating stress.
A bladder muscle stimulation device known as PTNS has been found to effectively decrease OAB urination frequency by slowing signals going to and from the bladder. A small electrode is placed under their sacrum to stimulate nerves that innervate their bladder, with 12 weekly office sessions lasting 30 minutes each taking place over 12 weeks. A clinical trial for an analogous device that sends impulses through leg muscles directly to their bladders is currently in progress.
