| | Nose Creek Physical Therapy Information on Urinary Incontinence | | Physical Therapy and Urinary Incontinence | | Incontinence is an undesired leakage of urine that may interfere with one’s life. It is common, and experienced by 16% of men and 33% of women over the age of 40(1).
It is not a normal part of aging, but a sign that there is dysfunction in the body. Fortunately, in most cases it can be greatly improved with appropriate treatment. | | There are several types of incontinence: | | Stress incontinence occurs when you apply a pressure (or 'stress') o your bladder. This may include coughing, sneezing, straining, exercise, or lifting. Urge incontinence is when urine leaks and is accompanied by a strong urgency to get to the bathroom. You may get an uncontrollable feeling to go to the bathroom, for example, as soon as you put the key in the door when you get home. Sometimes urgency occurs without actual incontinence. At other times a person becomes so adept at going frequently to the bathroom 'just in case' that they avoid the urgency or incontinence. These are still symptoms of a problem. Mixed incontinence is a combination of stress and mixed incontinence. Overflow incontinence is a constant or frequent dripping of urine that occurs because the bladder is overfilled and unable to fully empty. This may be a sign of a serious medical problem. Functional incontinence occurs when people have difficulty getting to a bathroom due to restraints such as from the environment, or their physical or mental abilities. For example, this may be a problem in people who have been institutionalized, or people who have difficulty ascending the stairs to the bathroom due to arthritic pain in their legs. Nocturnal Eneuresis is a loss of bladder control at night, in adults or in children who are old enough to be toilet trained. | | What are the causes of urinary incontinence? | | Sometimes incontinence is only a temporary problem, brought about by medications, bladder infections, constipation, or drinking too many diuretics (tea, coffee). Other times, incontinence can be longstanding, and occur from multiple causes. Urge incontinence can develop because the bladder muscles contract at inappropriate times. Anxiety concerning bladder function often aggravates this sudden contraction. | | Stress incontinence often occurs because the muscles that support the bladder and hold in urine become weak or damaged. Specific ways the pelvic floor is weakened are listed below: | | -The pelvic floor becomes stretched or damaged during pregnancy and childbirth, and becomes worse with multiple pregnancies. - As we age, there are hormonal and cellular level changes to the muscles and tissues of the pelvic floor which contribute to the floor becoming weaker(2). - Increased pressure in the abdomen, such as when constipated and straining at stool, or with chronic coughing, can further stress the pelvic floor. - Chronic obesity also increases the stress on the pelvic floor and organs. - Certain types of exercise increase the stress on the pelvic floor: for example, heavy weight-lifting, high-impact aerobics, and long-distance running2. - Pelvic surgeries such as hysterectomies alter the anatomy of the pelvis, and may reduce the effectiveness of the ligaments that suspend the pelvic organs. | | How is incontinence diagnosed? | | Your doctor will help to rule out problems that might also lead to incontinence, such as urinary tract infections, or prostate problems in males. | | How can incontinence be treated? | Some types of urinary incontinence are treated medically. Your physician may prescribe medications, a catheter, or surgery. | In many cases, Physical Therapy treatment is sufficient to treat your incontinence. We begin with lifestyle modification: this includes diet and fluid recommendations, maintaining a healthy weight, and avoiding positions or activities that stress the pelvic floor. | | Behavioral treatments involve modifying bladder habits, or “bladder training”: learning when and how to go to the bathroom, and learning how to suppress urgency. These methods have been researched and shown to be very effective(3). An important component of incontinence treatment is retraining the pelvic floor muscles so that they provide a strong support to the bladder, and can retain urine when needed. These exercises have also been shown effective in research studies(4).
The Physical Therapist identifies specific muscles that might be weak, and therefore working ineffectively to support the bladder, or muscles that might be tight, and are interfering with urination. | | If you think you might suffer from incontinence, ask yourself these questions: Do you ever urinate when you don’t want to? Do you experience leaking when laughing or coughing, running or exercising? When you need to urinate, is the feeling urgent or hard to suppress? Do you go to the bathroom frequently, to avoid losing urine unexpectedly? Do you get up more than 1-2 times at night to urinate? Do you avoid certain activities to avoid incontinence? Do you need to strain to urinate, or have trouble fully emptying the bladder? | It is very likely that you or someone you know is having symptoms of incontinence. Talk to your doctor, and talk to our certified Pelvic Floor Physical Therapist, Heather Enns BScPT, about beginning treatment. At Nose Creek Sport Physical Therapy, we can help improve your quality of life. | | | | | |
