Treatment of Urinary Incontinence

Urinary incontinence is defined as the involuntary loss of urine, having both social and hygienic implications. There are different kinds of urinary incontinence with urge (loss associated with the strong uncontrollable need to void) and stress (involuntary loss of urine due to an increase in intra-abdominal pressure i.e. from a cough, laughing or a sneeze) being the most common.

Up to 3.3 million Canadians suffer from some form of urinary incontinence but the private and embarrassing nature of the topic causes many people to pause before discussing the problem with their healthcare professionals. Up to 50% of women at some point in their lives will experience urinary incontinence, with 33% of those going on to develop regular problems. Not only does urinary incontinence burden the Canadian healthcare system with physician care expenditure as well as hospital and drug expenditures but it can have significant social consequences for the individual.

Incontinence can impede social and physical activity which in turn can lead to decreased self-esteem, depression and social isolation.

True or False…

1. It is normal to have permanent urinary leakage after childbirth
2. Loosing bladder control is a normal part of the aging process
3. Once you have incontinence there is nothing you can do about it

The answer to all of these statements is FALSE!

These are common misconceptions that have been fostered as truth because of the lack of conversation around incontinence.

What Causes Urinary Incontinence?

Urinary incontinence can be linked to the health of one’s pelvic floor, a series of muscles, ligaments and fascia that provide support and stability for the pelvis and play a role in sexual function and continence.

If these muscles are too weak you may experience stress incontinence, urge incontinence and pelvic organ prolapse. This is common in the pre and post-partum population.  If theses muscles are too tight they may be contributing to urge incontinence, pelvic pain, prostatitis and interstitial cystitis.

How can Pelvic Health Physiotherapy help?

Pelvic floor dysfunction leading to incontinence can be diagnosed by specially trained physicians and physiotherapists who use an external and internal exam to determine the health of your pelvic floor.

Externally they will look at the movement and function of the low back, pelvis and hip joints to understand how their function may influence your symptoms.

Then they will perform an internal exam through the vagina and anus in women and the anus in men.

Currently the literature states that pelvic floor strengthening and retraining taught by a specialized physiotherapist using internal assessment and treatment techniques should be the first line of defense against incontinence.

This means that pelvic floor physiotherapy should be trialed before someone considers surgery.

A pelvic floor physiotherapist uses manual therapy, education, postural awareness and exercise to improve the health of your pelvic floor and improve continence.  Your pelvic floor physiotherapist may also recommend rehab Pilates if this is right for you.

Check out our blog on how Pilates can help with incontinence.

What are the Best Exercises for Incontinence?

Depending on what type of dysfunction is occurring in your pelvic floor there are going to be two exercise strategies.

1. Strengthening: The commonly known “Kegel” exercise. However, there is a large misconception about how it is performed. A pelvic health physiotherapist will help you understand the proper technique and give you individualized cues to think about. With internal pelvic physiotherapy, you will really be able to connect with the right muscles and know how to isolate them properly.
2. Relaxation exercises: which uses breath and mental imagery to relax the pelvic floor.

If you are suffering from incontinence or urinary leakage know you are not alone and you can do something about it! Speak to your family physician or book an appointment with one of our skilled pelvic floor physiotherapists today.

Written by: Tiffaney Marlow, Pelvic Physiotherapist