Urinary incontinence can be a serious problem that affects your quality of life. Fortunately, physical therapy can help relieve your symptoms and prevent future issues.
Although pregnancy, childbirth, menopause, aging, and pelvic surgeries can make urinary incontinence more likely, it is not a normal part of aging and can be treated.
Stress incontinence
Affecting more than 25 million people, urinary bladder control issues — including urgency, frequency and incontinence — cause shame, embarrassment and a decrease in quality of life. Although these issues are largely associated with aging, they can often be corrected through physical therapy. Your physical therapist can help you strengthen your bladder muscles and manage your symptoms so you can live life to its fullest.
Stress urinary incontinence is a common condition that happens when the structures that hold urine in your bladder get weak. This can occur due to things like pregnancy, childbirth or surgery and may cause urine leaks when coughing, laughing, exercising or sneezing. This type of incontinence is more common among females and it can be especially frustrating for women who are unsure what to do about the problem.
If you have this issue, pelvic floor physical therapy is an excellent solution. Your physical therapist can teach you how to do Kegel exercises, which are an effective way to help strengthen the muscles that support your bladder. They can also educate you on lifestyle adjustments that can improve your bladder control. For example, your diet can play a significant role in the severity of your symptoms. Eating a diet rich in fruits, vegetables and whole grains and avoiding caffeine, carbonated beverages, alcohol and spicy foods can help reduce your bladder control issues.
During treatment, your physical therapist can use other techniques to manage your symptoms and boost your confidence in managing your urinary bladder dysfunction. Bladder training involves extending the time between bathroom visits, which can relieve your urge to urinate and decrease incontinence episodes. Functional movement training is a broader approach that incorporates pelvic floor muscle workouts into real-life activities, such as standing, walking and sneezing. This will increase the strength of your muscles and allow you to participate in more of your favorite activities without worrying about your bladder control.
Whether you have mild to moderate symptoms or are experiencing them after having children, pelvic floor physical therapy is an empowering alternative to medications and surgery. Your therapist will provide you with tools that you can take with you into your daily routine to help ease your symptoms and regain your independence.
Urge incontinence
Urge urinary incontinence (UII) is when you feel a sudden urge to urinate, followed by urine leakage before you can get to the bathroom. Like stress incontinence, it occurs when your bladder muscles are put under pressure from activities, such as exercising, coughing, sneezing or heavy lifting. This type of incontinence also can be triggered by pregnancy, certain medications, urinary tract infections, obesity and a weak closure of your urethral sphincter muscle.
Women with this type of incontinence often feel embarrassed and believe their problems are a normal part of aging or childbirth. It is important for these women to know that they can treat their symptoms with physical therapy and reduce urinary frequency, leaking and overactive bladder problems that interfere with their quality of life.
According to the Office on Women’s Health, urinary incontinence can affect women after birth, during pregnancy, with chronic constipation, after surgery, or as a result of age-related changes in the pelvic floor connective tissues and muscles. It can be caused by weakened closure of the urethral sphincter, bladder spasms, pelvic injury or cancer, urinary tract infection and certain neurological conditions such as multiple sclerosis and Parkinson’s disease.
Pelvic floor physical therapists use various techniques to help improve continence in both men and women. These can include exercise to strengthen the pelvic floor muscles, including Kegel exercises, and biofeedback training to learn how to relax and control the bladder. Bladder retraining, which involves gradually increasing the time between trips to the restroom, is another option for improving urge incontinence.
A combination of a variety of therapies is the best way to manage urinary incontinence. Some of these therapies take time to work, but they can reduce your need for pads or panty liners and increase your confidence and self-esteem. They can even avoid or delay the need for surgical intervention in mild to moderate cases of urinary incontinence.
Although urinary incontinence may seem embarrassing to discuss with a healthcare provider, it’s important for your overall health. You can manage urinary incontinence effectively and improve your quality of life with physical therapy, especially if you are committed to the exercises and other treatments recommended by your doctor.
Mixed incontinence
If you have experienced leaking urine during activity or waking multiple times at night to urinate, it may be time for a pelvic floor physical therapy evaluation. Although it can be embarrassing to admit you are struggling with urinary incontinence, you do not have to live with it. Noninvasive treatment options are available, and your incontinence will improve with time and practice.
Your bladder and urethral sphincter muscles work together to control the flow of urine. They can be weakened by factors such as childbirth, ageing, chronic coughing and sneezing, obesity and diabetes. As a result, the muscles can weaken and become ineffective, which causes involuntary leakage. Symptoms of urinary incontinence can be divided into two types: stress and urge incontinence. Stress incontinence occurs when increased abdominal pressure (from coughing, sneezing or exercise) causes the bladder to lose control and leak urine. Urge incontinence is characterized by the sensation of needing to urinate right away and can be caused by bladder contractions or urgency. It is common to experience a combination of both, which is called mixed incontinence.
Physical therapy for urinary incontinence focuses on strengthening and retraining the pelvic floor muscles. These muscles support the bladder, urethra and other pelvic organs. They can become weakened by pregnancy, multiple pregnancies or vaginal births, and can also be weakened by menopause.
Your physiotherapist can guide you through exercises that will strengthen and tone these muscles to improve your bladder control. They can help you learn to delay urination and increase the time between bathroom visits, which can decrease urinary frequency. They can also teach you how to perform the Kegel exercise properly, which can often be difficult to do correctly. Having a strong pelvic floor can significantly improve incontinence symptoms.
Other treatment approaches include bladder training, which involves scheduling bathroom visits and gradually increasing the amount of time between them. This can reduce urge and urgency, as well as urine volume. Functional movement training is another approach that teaches you to engage the pelvic floor muscles during daily activities, such as lifting and bending. This can reduce leakage and enhance your quality of life. Depending on your individual needs, your physiotherapist will recommend the best treatment option for you.
Bowel-voiding dysfunction
Affecting about 2% of the population, bowel incontinence can be very debilitating. It causes a sudden, intense urge to go, followed by involuntary leakage from the bladder. Many times, this is caused by conditions that affect nerve signals like bladder infections or underlying neurological issues such as multiple sclerosis and stroke. It is important to treat incontinence as it impacts quality of life, social interactions and self-esteem.
Symptoms of bowel incontinence include a feeling of urgency, abdominal pain and uncontrollable diarrhea or constipation. Many people are embarrassed by this condition, so they avoid seeking medical attention. As a result, the problem persists and patients often resort to using adult diapers or medications to manage their symptoms.
Physical therapy can be a highly effective treatment for urinary incontinence and bowel incontinence, as it provides holistic treatment that addresses the muscles involved. A pelvic physical therapist can perform gentle manual therapies and release techniques to the restricted muscles and fascia of the abdomen. They can also use visceral mobilization to encourage proper abdominal movement and function.
A pelvic physiotherapist can also teach you breathing and other stretching exercises to stimulate the parasympathetic nervous system which is responsible for rest and digestion. In addition, they can teach you a simple massage technique that can reduce bloating and improve bowel movement.
For many women, incontinence is caused by weakened or damaged muscles that control the bladder and urethral sphincter. This can be caused by childbirth, aging or disease. Depending on the type of incontinence, a physical therapist can prescribe specific exercises to help retrain these muscles. A pelvic physiotherapist can also recommend lifestyle changes to reduce incontinence episodes, including diet and exercise.
Despite the common misconception that urinary and bowel incontinence is only for older adults, it can affect men and women of all ages. If you are experiencing incontinence, talk to your doctor for more information. They will ask questions about your symptoms and may perform a pelvic examination or rectal exam. They may suggest that you keep a urine diary to monitor frequency and quantity of your leaks.