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A specialized treatment plan to rebuild your pelvic floor can be just what you need if you suffer from incontinence.

Incontinence occurs when the muscles and nerves that help the bladder hold or release urine weaken. This leakage can be mild or severe, such as leaking urine when you cough or feeling the sudden urge to relieve yourself but are unable to get to the bathroom in time. No matter the severity of your issue, this condition can make it hard to function in day to day life.

Urinary incontinence is a fairly common problem if you suffer from it you are not alone 3.5 million Canadians have urinary incontinence.

• 1 in 4 women
• 1 in 9 men
• Only 1 in 12 are known to health care workers because people find it embarrassing or believe it is an inevitable part of aging. The rest suffer in silence.

For those who suffer from incontinence, it may feel like this condition is an inevitable side effect of their current physical health issues. While issues such as aging, pregnancy, and pelvic floor disorders, do increase the chances of becoming incontinent, there are things you can do to improve your condition. The common response may be to mask the problem by taking medication. But a better solution is to solve the issue at its source by improving your overall pelvic floor health.

Causes of Incontinence

While incontinence (both bladder and bowel) can stem from a myriad of health problems, much of involuntary leakage is caused by issues related to weakened pelvic floor muscles. These muscles work to support the pelvic organs; the bladder and bowel in men and the bladder, uterus, and bowel in women. But when the muscles experience trauma such as childbirth or an organ prolapse, the floor can lose some of its integrity and therefore not work effectively to support the organs. This can lead to loss in control over your bladder and bowels.  Other causes of incontinence may differ depending on one’s age and gender.

Women are more likely to experience incontinence stemming from:

• Pregnancy
• Childbirth
• Abdominal surgery
• Menopause
• Overactive bladder muscles

Whereas men see incontinence associated more with these conditions:

• Prostate enlargement
• Radiation therapy
• High impact exercise
• Obesity

Additional contributing factors can be milder in nature such as prolonged sitting and not drinking enough water, which can lead to bladder irritation and increased urination.

Common Misconceptions

• It is a misconception to think it is normal to have urinary leakage after childbirth.
• It is a misconception to think it is normal to have urinary leakage as you age.
• It is a misconception to think there is nothing you can do about urinary leakage.

 Pelvic floor dysfunction can be caused by:

• HYPOTONICITY – contributing to stress incontinence and pelvic organ prolapse.
• HYPERTONICITY – contributing to urgency, urge incontinence, chronic pelvic pain, dyspareunia (difficult or painful sexual intercourse), various other conditions including neurological conditions and prostatitis.

 Incontinence is mainly divided into the following types:

• Stress Incontinence: This is when you involuntarily loss urine secondary to an increase in intra-abdominal pressure which could be due to coughing, sneezing, laughing, exercise, lifting, etc. Usually a very small amount of urine is lost.
• Urge Incontinence: Urine loss associated with a strong, uncontrollable need to void, inability to delay voiding. It’s usually accompanied by increased frequency or over active bladder.
• Overflow Incontinence: The bladder does not empty normally and becomes very full (distended bladder). The individual may feel a constant loss of small volume of urine (dribble). The bladder may not feel completely empty.

Role and Function of the Pelvic Floor

The pelvic floor muscles help to:

• Support the basket of muscles that support organs against gravity and intra-abdominal pressure
• Control the passage of urine and feces – sphincteric property
• Stabilize assists in unloading the spine
• Sexual function

How Kegels are not always the answer.

Kegels are NOT always indicated for pelvic floor problems. Sometimes they do more harm and then good. Often, they are not performed correctly. For instance, an individual with an overactive pelvic floor will not benefit from doing Kegels and it may worsen their symptoms. Even an individual with hypotonic pelvic floor will need an internal exam to correctly perform Kegels in order for the muscles to become stronger.

The latest research has shown than physiotherapist with specialized training in pelvic floor rehabilitation (using internal examination to teach the exercises) should be the first line of defense, before surgical consultation for stress, urge and mixed incontinence in women.

How can Pelvic Physiotherapy Help?

• A physiotherapist will:
  • Perform an evaluation of the pelvic floor
  • Establish and perform a treatment plan and its progression for male and female incontinence
  • Use manual and behavioural techniques, may use biofeedback and electrical stimulation to treat incontinence
  • Educate you about bladder training and simple functional and lifestyle changes to resolve incontinence.
• Physiotherapy in conjunction with diet, lifestyle changes and exercise can reduce or avoid the need for surgery

Of course, you want to know what kinds of treatments you’ll receive, and the truth is, it varies depending on the type and severity of your issue. The main point is, don’t let embarrassment over your incontinence stop you from receiving the help you need to regain control over your body. Elite Physio has the therapists fully qualified to help provide you the effective tools for addressing your pelvic floor problems and staving off medication or surgical intervention. Start today with an initial assessment from Elite Physio.

IMPORTANT

After reading this article, please don’t self-diagnose yourself on the internet! All bodies are different and you should get an accurate assessment in order to properly address your chronic pain. Always consult your physician to be sure you’re getting the correct diagnosis and treatment. If you both decide you require the services of a physiotherapist, we can help.