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Opening Up About Urinary Incontinence

Urinary incontinence is condition people seldom talk to their physicians about despite the fact that millions of people in the U.S. experience urinary leakage. It’s something people are fairly embarrassed to talk about but it really affects people’s quality of life. While it’s not a normal thing that’s happening, it’s really common and we definitely have ways to treat people.

The good news is that setting aside the embarrassment and talking to a medical professional can help you get the treatment you need to be leak-free.

There are two main types of urinary incontinence: stress urinary incontinence and urgency incontinence. Both types can exist simultaneously in the same person but each type is caused by something different and needs to be treated differently.

Stress urinary incontinence is leakage with coughing, laughing, sneezing, or anything that increases pressure in the belly.

SUI happens when the muscles that support the urethra and part of the bladder are weakened. Without enough support, the bladder and all the muscles in the urinary tract are unable to contract like they normally would to start and stop the flow of urine, which results in leakage.

There are several reasons the muscles may become weak and cause incontinence:

  • Chronic coughing or sneezing: Any condition that causes chronic coughing or sneezing, or lifestyle habits like smoking that can cause persistent cough, can over time lead to leakage.
  • Obesity: If you’re overweight or obese, your body puts more pressure on the bladder, which can lead to incontinence. The more pressure you put on the urethral sphincter, which squeezes and holds urine in, the more likely you are to leak.
  • Hormonal deficiency: The big one here is estrogen, since it helps keep the muscles around the bladder and urethra strong. After menopause is a common time for women to experience SUI because lower estrogen levels cause the vaginal tissues to weaken and become thinner.
  • Age: Along with weaker vaginal muscles, the bladder muscles can also become weaker as you get older.
  • Hysterectomy: If you’ve had any surgery on your reproductive system, some of the surrounding muscles may become compromised.
  • Pregnancy and childbirth: We’d be remiss if we didn’t go into a little detail on these, since they are such common causes of urinary incontinence. During pregnancy, hormones and extra weight on the uterus can cause SUI. Pushing during a vaginal delivery can further weaken the muscles and tissues that support the bladder and urethra, and even cause prolapse, all of which can result in incontinence.

Urgency incontinence is when you get a sudden urge to go and can’t hold it, so you leak. Urgency incontinence is a symptom not an anatomical condition. For example, when combined with other issues like excessive urination, urgency incontinence can be a sign of overactive bladder.

How Can Physical Therapy Help?

Physical therapy can provide significant improvement in symptoms caused by urinary incontinence. The first line of therapy is pelvic floor muscle training.

The pelvic floor consists of muscles, ligaments, tissues and nerves that act like a hammock to support the bladder, uterus, vagina and rectum. When the pelvic floor is weak, these areas are unable to function as well as they should.

A normally functioning pelvic floor can help with core strength and stability to allow for better bladder control. This can help prevent as well as relieve the symptoms of urinary incontinence.

Based on evaluation results, a physical therapist will individualize treatments to strengthen your pelvic-floor muscles and improve their function. Pelvic floor physical therapy can help you:

  • Gain control over your symptoms.
  • Reduce the need for pads and special undergarments, incontinence medications, and possibly surgery.

Strengthen Your Muscles and Make Them Work Better for You

A physical therapist will show you how to “find” the right muscles and use them correctly. Using pelvic-floor exercises, the therapist will help you strength those muscles so that you can better control your bladder.

A physical therapist will:

  • Show you how to “find” the right muscles and use them correctly.
  • Use pelvic-floor exercises to help you strengthen your muscles so that you can better control your bladder.
  • Instruct you in exercises to stretch and strengthen other important muscles, so that they can support proper bladder function.

Remember: Knowledge Is Power

A physical therapist can provide information about:

  • Diet and nutrition to avoid food and drinks that may irritate the bladder.
  • Changing behaviors that make symptoms worse.
  • Ways to decrease urinary urge and frequency.

For anyone who lives with urinary incontinence, I recommend seeking medical treatment. Physical therapy truly can provide a life-changing difference for many.

kim gladfelter physiofit 1 ABOUT THE AUTHOR

Kim Gladfelter, MPT, OCS, FAAOMPT
Women's Health Physical Therapy Specialist at PhysioFit Physical Therapy & Wellness

Kim Gladfelter is a physical therapist, Pilates instructor, educator, author, and co-founder of PhysioFit Physical Therapy & Wellness. She is known as a keen, well-rounded expert of healing through movement and women’s health specialist in the Silicon Valley area.

Kim has helped men and women of all ages to stay active and feel their best. She also writes about managing pain in her health columns, blogs and the local Los Altos Town Crier newspaper as well as reaches out to the local community, support groups, schools, libraries, and sports centers to advise and educate on body awareness and therapeutic exercise.

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