Urinary Incontinence: Take Control of Your Bladder

By Deborah W. Marchese, PT, DPT, OCS

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More than 33 million American adults struggle with urinary incontinence. While ads on television are raising awareness, many people are still embarrassed to seek treatment for loss of bladder control. If not addressed, incontinence can negatively impact self-esteem, create social isolation, and impair quality of life.

What is Urinary Incontinence?

Urinary incontinence is the lack of voluntary control over urination. There are two major types of urinary incontinence and they are treated differently.

Two Types of Urinary Incontinence Scenarios:

  1. Urge incontinence is a form of urinary incontinence characterized by the involuntary loss of urine for no apparent reason while feeling a sudden urge to go, leaking urine before reaching the toilet. Triggers for urge incontinence may be running water, a key in the door, or excitement/nervousness. This type of incontinence is often addressed with behavior modification techniques.
  2. Stress incontinence is due to insufficient strength in the pelvic floor muscles to prevent urine leakage from the bladder with coughing, laughing, sneezing, exercising, or other movements that increase intra-abdominal pressure. Re-education and muscle strengthening are helpful in addressing stress incontinence.

Incontinence is particularly prevalent in post-menopausal women due to weakness in pelvic floor muscles as a result of estrogen loss. Also, after giving birth, it’s common for women to deal with issues like urinary incontinence, separation of the abdominal muscles, and pelvic pain. That’s why it’s helpful for moms to get referred to a pregnancy recovery specialist six weeks after delivery.

How Do You Treat Urinary Incontinence?

A pelvic floor physical therapist can evaluate the type and cause(s) of your issues. Once a historical record of your complications is documented, they will be able to provide instruction on pelvic floor exercises specifically designed for your unique problems.

Here are some great examples of pelvic floor exercises that can be done in the privacy of your own home. We always suggest consulting with your doctor or your therapist first before starting any new exercise programs.

A study in the journal Female Pelvic Medicine & Reconstructive Surgery found that 23 percent of women who said they knew how to do Kegel exercises (pelvic floor exercises) did not do them correctly. The pelvic floor muscles are part of your core stabilizers and are important to activate during your regular exercise workout. If problems are left untreated, over time they can lead to low back pain, hip problems, urinary and bowel issues, and descent of the bladder or the uterus.

In addition to guidance on exercises, a physical therapist can recommend dietary and behavior modifications, and use biofeedback and electrical stimulation to help you strengthen or relax your pelvic floor muscles as indicated. Addressing these issues early may help you cope and prevent additional problems in the future.

Good habits to prevent or decrease urinary incontinence:

  • Voiding your bladder 5-7 times/day
  • Urinating every 3-4 hours
  • Sitting on the toilet, rather than hovering
  • Going when you need to go and not going “just in case” – Going just in case can shrink the bladder muscle and retrain it to urinate more often.
  • Drinking plenty of fluids (32-64 ounces per day) – If you don’t drink enough water, the pH of the bladder decreases and the bladder becomes acidic and more irritable. This may cause you to have pain or need to go more frequently.

Sheltering Arms now offers physical therapy to address issues with fecal incontinence as well.

Want to speak with one of our pelvic health experts? Request an appointment with a physical therapist who specializes in pelvic floor therapy.

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