Pelvic Floor and Urinary Incontinence Rehabilitation
Urinary incontinence — the loss of bladder control — is a common and often embarrassing problem. The severity ranges from occasionally leaking urine when you cough or sneeze to having a sudden and strong urge to urinate so that you don’t get to a toilet in time.
Types of urinary incontinence include:
- Stress incontinence. Urine leaks when you exert pressure on your bladder by coughing, sneezing, laughing, exercising or lifting something heavy.
- Urge incontinence. You have a sudden, intense urge to urinate followed by an involuntary loss of urine. You may need to urinate often, including throughout the night.
- Overflow incontinence. You experience frequent or constant dribbling of urine due to a bladder that doesn’t empty completely.
- Functional incontinence. A physical or mental impairment keeps you from making it to the toilet in time. For example, if you have severe arthritis, you may not be able to unbutton your pants quickly enough.
- Mixed incontinence. You experience more than one type of urinary incontinence.
Urinary incontinence isn’t a disease, it’s a symptom. It can be caused by everyday habits, underlying medical conditions or physical problems. It may be caused by an easily treatable medical condition, such as an urinary tract infection and bowel constipation. It can also be temporarily caused by certain drinks, foods and medications that may act as diuretics (alcohol, caffeine, carbonated drinks, chocolate, spicy and or sugary foods, vitamin C, certain blood pressure meds, sedatives and muscle relaxants).
Urinary incontinence may have a significant impact in an individual’s life. It increases the risk of repeated urinary tract infections. It can affect one’s social, work and personal relationships.
Furthermore, it can contribute to accidental falls in several ways. Here is how incontinence and accidental falls are connected:
- Incontinence episodes may lead to slips on wet floor surfaces.
- Urge incontinence may increase fall risk when a person hurries to the toilet, especially in unfamiliar, cluttered or dark areas.
- Episodes may be related to acute illness, such as urinary tract infections that can cause incontinence, delirium, drowsiness and hypotension.
- Medications used to treat incontinence, such as anticholinergics or alpha blockers, can cause postural hypotension causing a person to feel dizzy when rising from sitting or lying down.
- Waking up to urinate at night can result in poor sleep, which is associated with increased fall risk. Making frequent bathroom trips at night, through a poorly lit or obstructed pathway, is a high fall risk.
Though Urinary Incontinence occurs more often as people get older, it isn’t an inevitable consequence of aging. For most people, simple lifestyle changes or medical treatment can ease discomfort or stop urinary incontinence.
Physical Therapy can be very effective in treating Urinary Incontinence and decreasing its associated risk for falls.
The Pelvic Floor muscles support the uterus, bladder, small intestine and rectum. Having strong Pelvic Floor muscles gives us control over the bladder and bowel. They are also important for sexual function in both men and women. In women, they also provide support for the baby during pregnancy and need to be relaxed during the birthing process.These muscles also work with the abdominal and back muscles to stabilize and support the spine.
The pelvic floor is hidden from view and difficult to be visualized. These muscles are also difficult to be isolated during exercises. However, with the right program, they can be consciously controlled and therefore trained, much like our arm, leg or abdominal muscles. It is very important to correctly identify your pelvic floor muscles before moving into a regular pelvic floor muscle exercise program. Performing your exercises poorly can lead to an increase in the risk of an urinary tract infection and to an exacerbation of your incontinence symptoms.
At Movement and Flow Physical Therapy our program can help you to identify and isolate your pelvic floor muscles. We will guide you through the correct exercise routine and help you perfect your technique with the Kegel exercises. We then add some challenges by incorporating these exercises into progressively challenging positions and physical activities.
Our program can also improve posture, which helps keep pelvic floor muscles function. We utilize Bladder training as part of our interventions. Bladder training retrains the way the brain and bladder interact to give you more bladder control. It helps you gradually increase the amount of urine you can hold.
Another benefit of our program is weight management and physical activity which can help women who are overweight or obese. It is known that extra weight puts extra pressure on the bladder and pelvic muscles therefore losing weight may help relieve urinary incontinence.
At Movement and Flow Physical Therapy we help our patients regain control of their bladder so they can carry out daily activities without bothersome and embarrassing urinary incontinence.