Incontinence can be extremely embarrassing and can dictate your life, if you let it. According to the National Institute of Diabetes and Digestive and Kidney Disease, over 13 million Americans have incontinence. But there are ways to take control, starting with Physical Therapy.
What Exactly Is Urinary Incontinence?
Urinary incontinence is the leakage of urine at inappropriate times. Often times you may experience difficulty with holding your urine when you feel a strong urge to go, or you might even have trouble starting the urine stream. The muscles responsible involve the pelvic floor. These muscles attach to the bottom of the pelvis and run front-to-back, forming a bowl-like structure that lifts to support the internal organs, as well as to control the sphincter muscles. The pelvic floor muscles are extremely important in assisting to support the lower back, provide stability to the pelvis, and assist with sexual function as well. While women are more apt then men to have urinary incontinence, men certainly suffer from it as well. There are different types of incontinence:
- Stress Incontinence–You experience small amounts of urine leakage when there is increased pressure on the bladder.
- Urge Incontinence–This occurs due to spasm of your bladder muscle–if the spasm is severe enough, you tend to leak medium to large amounts of urine. While this might only happen on occasion, it can also occur as often as every 15-20 minutes.
- Mixed Incontinence–You experience both stress incontinence and urge incontinence.
- Functional Incontinence–You experience urine leakage when you can’t make it to the bathroom in time.
Let’s take a closer look at each of the types of incontinence.
Normally due to weakness and lack of support from the muscles of the pelvic floor, stress incontinence generally occurs with sneezing, coughing, laughing, with exercise, or activities such as lifting. Women who suffer from this often have under-active pelvic floor muscles. This can be caused by many factors, including:
- Pregnancy and childbirth–this can put pressure or stress on the bladder, leading to potential trauma of the pelvic floor muscles
- Episiotomy (an incision in the tissues between the vaginal opening and anus during childbirth).
- Vaginal or rectal surgery
- Other injury or trauma
- Lack of exercise and lack of use
After delivery, some women may also experience fecal incontinence (leakage of stool) if there was any tearing of the vaginal opening that extended to the anal sphincter.
This may or may not include weakness of the pelvic floor muscles, pelvic floor muscle tension, or pelvic floor muscle spasm.
In this type, the cause is not directly related to the pelvic floor muscles or bladder. Some causes might be related to:
- Psychological issues such as anger or depression
- Muscle weakness or joint pain that results in you moving with difficulty
- Dementia, confusion, or delirium
- Environment barriers–this can be due to the bathroom being too far away, using an assistive device such as a walker that slows you down, or encountering numerous obstacles that you have to navigate around to get to the bathroom
It is also possible that you may have an overactive bladder. This is where you frequently empty your bladder throughout your day–more than every 3-4 hours–or you get up more than once during the night to urinate. There may be a number of causes here, such as sensitivities to certain foods or beverages.
How Can Physical Therapy Help If You Suffer From Incontinence?
First and foremost, your Physical Therapist should perform a thorough evaluation to determine the exact cause of your urinary incontinence. They can then advise you whether or not a physician would need to be consulted for additional testing. Based on the findings of your Physical Therapy examination, you should be provided with an individual treatment plan to strengthen your pelvic floor muscles as well as to improve their function. Your Physical Therapist should help you to:
- Gain control over your symptoms to help you regain your life back
- Reduce the need for special undergarments and pads, incontinence medications, and to avoid surgery
Your Physical Therapist should instruct you in how to identify your pelvic floor muscles in order to strengthen them and to be able to use them correctly. Instruction in pelvic floor strengthening exercises most often involves Kegel’s exercises in which you gently squeeze the muscles of the sphincter, buttocks, stomach, and thigh simultaneously. These exercises can be performed standing up, sitting, or lying down. In addition, your Physical Therapist should also help to identify other muscles in the region that are weak or tight, so you can address them as well to support proper bladder function.
In addition to working on strengthening and flexibility, there are several other ways in which your Physical Therapist can provide you with information about handling your urinary incontinence. They should provide you with information on the following as well:
- Ways to decrease urinary urge and frequency
- Changing behaviors that make symptoms worse
- Diet and nutrition so you can avoid food and drinks that might irritate your bladder
If you or someone you know is suffering from urinary incontinence, don’t wait to take action. Call my office at once at (302)691-9055 or visit my website at www.wildermanphysicaltherapy.com and schedule your FREE 30 minute consultation to see how Physical Therapy can help. Don’t delay–schedule now!