Urinary incontinence means involuntary loss of urine. There are several types, the most common ones include stress incontinence and urge incontinence. With stress incontinence, you may lose a few drops of urine when sneezing, coughing, jumping (under physical stress). Urge incontinence means you have frequent, strong urges to rush to the toilet and you may not get there on time.
When can physiotherapy help with incontinence? Should I see a doctor first?
Physiotherapy can be helpful in treating the symptoms of both stress and urge urinary incontinence (sudden strong urge to urinate resulting in loss of urine), however, if you have urge symptoms, you should get assessed by a urologist first. The reason for this recommendation is that there can be many causes of urge incontinence such as an infection or more serious pathology and these must be excluded first. In order to start physiotherapy for urge incontinence symptoms, a doctor’s diagnosis should be made first. If you have sudden, unexplained involuntary loss of urine, seek medical help immediately, especially if you have lower back pain, feel weak in your legs or have numbness in the pelvic area.
Weak pelvic floor muscles often cause urinary incontinence. Women’s health physiotherapy can help improve pelvic floor muscle strength, endurance, coordination, and elasticity, allowing the muscles to react well to increased intraabdominal pressure such as when coughing or forces occurring due to gravity like jumping on a trampoline.
Tightness or overactivity in the pelvic floor muscles can also create incontinence. Ensuring your hips, low back, cesarean or other abdominal scar, perineal scar etc. are mobile is therefore important. Bladder training can be useful when urgency is an issue. A strong contraction of the pelvic floor muscles reflexively relax the bladder muscle, the detrusor. This allows for further storage of urine, until appropriately arriving to the toilet.
So what are the pelvic floor muscles?
Why is it important to have physiotherapy treatment tailored specifically to you in case of incontinence?
There are multiple types of dysfunction that occur in the pelvic floor muscles: weakness, tightness/overactivity, spasm or pain. Even when symptoms are similar, the causative factors may be different, therefore no one-size fits all ‘Kegel’ exercise will help everyone. It is not true that everyone with incontinence should just do Kegel exercises. Pelvic floor exercises done only in groups and unsupervised settings increase the risk of incorrect muscle activation and even worsening of symptoms. Before commencing online or group exercise for the pelvic floor, it is highly recommended to have an assessment of the muscles beforehand. Thorough assessment allows for a better, more personalized treatment plan to match your situation and help you reach your goals.
What examination is necessary?
Palpation of the pelvic floor muscles with gloved hands is the most accurate way to assess muscle function. This type of examination is never mandatory. However, it gives the most detailed information such as muscle tone, strength, range of movement, automatic reactions or delayed relaxation.
What does treatment consist of for urinary incontinence?
Women’s Health Physiotherapy assists women through different cycles of life