Urinary incontinence, the involuntary loss of urine, is more common than you’d think affecting multiple populations including children, new moms, athletes, and the geriatric population. The majority of bladder incontinence symptoms are linked to weakness of the pelvic floor muscles. Pelvic floor weakness happens from a myriad of reasons: pelvic injury, nerve damage, childbirth, menopause, gynecolgic or abdominal surgeries, pelvic organ prolapse, and/or recent weight gain A primary function of the pelvic floor muscles is closing the urethra during body movements to stop urine from leaking.
There are different types of bladder incontinence and bladder symptoms:
Stress Urinary Incontinence occurs when one laughs, coughs, sneezes, or sometimes during physical activity such as walking, jogging, or high intensity exercise. During all these activities there is increased pressure on your abdominals and pelvic floor. If your pelvic floor muscles are too weak, or delayed in activating, urine leakage will occur.
Urgency Urinary Incontinence occurs when one has a strong urge to urinate and urine leaks while walking to the restroom. With normal pelvic floor muscles, they activate to calm the bladder urge and prevent urine leakage before reaching the toilet. However, if your pelvic floor muscles are too weak or too tight, the signal is not sent to calm your bladder on the walk to the bathroom and leakage occurs.
Urinary Incontinence without sensory awareness can occur during any activity or during rest, from a small trickle to large volumes of urine loss. At this point the pelvic floor muscles are too weak, or too tight to close the urethra at appropriate times. A decrease in urge to urinate may signal a nerve injury or compromise.
Urinary Urgency occurs when you feel a strong urge to urinate and you cannot prevent yourself from urinating. A typical medical diagnosis is Overactive Bladder. This is urinary frequency of more than 7 times in one 24 hour period. Your pelvic floor muscles have a direct relationship to the bladder, if your pelvic floor muscles are strong they automatically contract to “quiet” the bladder until it if full. With prolonged pelvic floor weakness, or prolonged overactivity of the pelvic floor, the bladder no longer has an “off switch” creating a strong urge to urinate multiple times in a day/night.
How Can Physical Therapy Help?
Your Physical Therapist will conduct a thorough physical exam to assess your current pelvic floor strength and coordination. Strengthening the pelvic floor muscles significantly helps regain bladder control to reduce incontinence symptoms. Physical Therapy interventions include:
- Strengthening program for your pelvic floor muscles to address your specific goals and activity level
- Biofeedback training to make sure you’re working your pelvic floor muscles correctly
- Coordinating pelvic floor muscle activity with functional body movements
- Diet and fluid intake recommendations to reduce bladder symptoms
- Teaching urgency suppression techniques to regain control of your bladder and reduce urgency/frequency symptoms