Managing and Preventing Incontinence with Physical Therapy

By: Deborah Marchese, PT, DPT, OCS, Cert. DN

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More than 25 million adult Americans suffer from incontinence. Men and women are often embarrassed to seek treatment for loss of bladder or bowel control. Urinary and fecal incontinence can cause low self-esteem, create social isolation, and impair quality of life.

What is Incontinence?

Incontinence is the lack of voluntary control over urination or defecation. There are two major types of incontinence and they are treated differently.

Urge incontinence is a form of urinary incontinence characterized by the involuntary loss of urine for no apparent reason. Urge incontinence produces a sudden feeling of needing to use the restroom and having difficulty delaying the urge. Triggers for urge incontinence may be running water, a key in the door, or excitement and/or nervousness.

Stress incontinence is due to insufficient strength in the pelvic floor muscles. These muscles may fail to prevent urine leaks from the bladder when coughing, laughing, sneezing, exercising, or other movements that increase intra-abdominal pressure. Incontinence is prevalent in post-menopausal women due to weakness in pelvic floor muscles and 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, which is why it’s important for new mothers to participate in physical therapy for six weeks after delivery.

The pelvic floor muscles are part of our 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 and hip problems, urinary and bowel issues, and descent of the bladder or the uterus. A physical therapist can educate you on proper exercises, provide dietary and behavior modifications, and use biofeedback and electrical stimulation to help you strengthen or relax your pelvic floor muscles as indicated.

Good Habits to Prevent or Decrease Incontinence:

  • Using the restroom 5 to 7 times a day, going every 3 to 4 hours
  • Sitting on the toilet, NOT hovering
  • Going to the restroom when you need to go and not “just in case”
  • Drinking plenty of fluids (at least 64 oz. a day)

Addressing these issues early can help prevent many of these problems in the future. Sheltering Arms Institute has physical therapists specialized in pelvic health. To schedule an evaluation, contact us online or call (804) 764-1000.

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