Pregnancy, vaginal delivery, pelvic surgery and hormonal changes all put women at a greater risk than men for developing urinary incontinence at some point in their adult lives. One in four women over the age of 18 has episodes of involuntary urine leakage. This problem can be embarrassing and prevent people from getting out and participating in the activities they enjoy for fear of being too far from the ladies’ room or losing urine during exercise and activity.
But women do not need to accept this problem as “just part of the territory.” Physical therapy for the pelvic floor is often an effective treatment option to help women regain control of their bodies.
The pelvic floor is a highly enervated and muscular region that supports the bladder, urethra and bowels with sling-like muscles that run from the pubic bone in the front to the base of the spine in the back. These muscles and nerves may become stretched, weakened or injured during childbirth, trauma and aging. Holding urine too long during the day and ignoring signals from the bladder that it is time to empty, may contribute to problems voiding appropriately as well. Dietary considerations should be taken into account, as caffeine, carbonated beverages, artificial sweeteners, acidic and spicy foods may act as bladder irritants and thus should be avoided.
There are a few basic types of urinary incontinence. Stress incontinence is a loss of urine caused by force put on the muscles of the pelvic floor generated by laughing, coughing, sneezing, heavy lifting, jumping or running. The force created by these activities can overwhelm weakened muscles that work to hold urine in. Urge incontinence, on the other hand, occurs when a sudden urge to urinate becomes intense quickly. Bladder muscles may go into spasm, causing urine to leak, not allowing for enough advance warning to reach a bathroom in time. Overflow Incontinence is characterized by running to the bathroom often, never quite feeling like one’s bladder is fully empty even right after urinating. Mixed Incontinence is a combination of two or more of the above types of incontinence. Functional incontinence is caused by a physical or cognitive impairment that prevents a person from reaching the bathroom in time.
If you are experiencing symptoms of incontinence, the first step is to consult your physician. Once your physician determines that there are no underlying medical issues, a trained physical therapist should be consulted. Physical therapy provided by a therapist trained in working with urinary incontinence will help you learn to decrease your symptoms, and improve control. A trained physical therapist will focus on helping you locate the muscles that support the bladder and teach you to correctly engage and strengthen these muscles to better control your pelvic floor muscles. Physical therapy will arm you with the tools to both decrease urinary urges and frequency, as well as make behavioral changes to decrease these symptoms.
So go ahead, jump for joy, with proper therapeutic intervention, you may hold the keys to drier days ahead.
By Rivki Chudnoff PT, MSPT