Understanding Incontinence
Urinary incontinence has a reputation of being something only little old ladies have. But many young people get urinary incontinence. And while more women than men are affected, men can have urinary problems too, especially after prostate surgery. Fortunately, there are many treatments for urinary incontinence.
Behavioral treatment. Some people with urinary incontinence may get relief by making simple lifestyle changes. If you have stress incontinence, for instance, in which you leak urine when you cough, sneeze, or laugh, your physical therapist may tell you to limit how much you drink. If you have urge incontinence, in which you get the sudden urge to urinate and can’t always make it to the bathroom in time, your physical therapist may tell you to avoid spicy foods, caffeine, and carbonated drinks, because they can irritate the bladder and make the problem worse. Exercises to strengthen the pelvic floor muscles, known as Kegels, can sometimes help people with stress incontinence. Kegels can also help people with urge incontinence. Sometimes, Kegels are combined with biofeedback techniques to help you know if you are doing the exercises properly. For urge incontinence, bladder training, sometimes called bladder retraining, can also help. This involves gradually increasing the interval time between trips to the bathroom, working up to longer and longer intervals between bathroom stops.
Devices and absorbent products. Protective pads and panty liners can help avoid embarrassing situations. A pessary, a plastic device inserted into the vagina, may help prevent urine leakage by supporting the neck of the bladder; it is most useful for stress incontinence.
Mild to moderate cases of common types of incontinence can be cured or greatly improved by behavioral or exercise therapy. We can also teach you habits and techniques to reduce urgency and urge incontinence (or leaking with a strong urge on the way to the bathroom). Even periodic incontinence is not something you have to deal with. We can help!
Incontinence, Chronic Pelvic Pain, & Physical Therapy
A physical therapist is highly skilled in evaluating and treating various musculoskeletal and neurological conditions affecting the body. This profession focuses on assessing any underlying factors, such as strength, neuromuscular control, balance, coordination, skeletal alignment, and endurance, which may be contributing to impaired functional mobility, activity participation, and quality of life.
Of course, most people only seek physical therapy when they’re suffering from a common injury or condition such as whiplash, tendonitis, low back pain, ligament sprains, and plantar fasciitis. Perhaps lesser known is that chronic pelvic pain and dysfunction, including incontinence, can also respond positively to physical therapy intervention.
Causes Of Incontinence And Chronic Pelvic Pain
If you have pain in your pelvis, it may not always be fully clear what’s causing it. Some common causes of pelvic floor dysfunction and chronic pelvic pain include, but are not limited to:
- Pregnancy
- Sacroiliac joint dysfunction
- Coccydynia
- Irritation of the pudendal nerve (which originates near the bottom of your spine)
- Irritable bowel syndrome
- Levator ani syndrome (increased tension in pelvic floor muscles)
- Post-surgical complications (e.g., pain following a hysterectomy, hernia repair, cesarean section, and/or prostatectomy)
Any of these conditions may lead to inadequate support of the organs contained with your pelvic cavity, increased pressure or inflammation of nerves, muscles, and other connective tissues (including your bladder), and impaired pelvic bone alignment. These symptoms can be frustrating, painful, and embarrassing, and may limit your tolerance to daily participation in desired activities, including exercise.
Other symptoms frequently appear with pelvic pain, including incontinence, bloating, abdominal pressure, reluctance to strain while defecating, and pain in the low back, buttocks, and hips. You may also have decreased tolerance to a variety of activities including sitting or standing, walking, exercise, and sexual intercourse.
How A Physical Therapist Can Treat Pelvic Pain
Every patient presenting with chronic pelvic pain is unique. If you come to see a physical therapist for your pelvic dysfunction, you’ll be taken through a thorough physical examination and patient history questionnaire. He or she will ask you specific questions about your pain, what makes it worse and better, and whether you have a history of any related issues. Based on the results of the examination, your physical therapist can then develop a customized treatment plan to relieve your symptoms and address the suspected underlying causes to prevent recurring dysfunction.
Common physical therapy treatments may include:
• Soft tissue mobilization and massage of internal and external pelvic musculature, to relieve muscle tension and provide pain relief
• Spinal and sacroiliac joint manipulations to reset the neurological pathway, relieve pain, and restore normal spinal alignment.
• Electrical stimulation modalities, such as neuromuscular electrical stimulation to provide pain relief and restore normal neuromuscular activation of pelvic floor muscles and nerves.
• Therapeutic exercises to restore the normal strength, flexibility, and endurance of stabilizing postural muscles in the low back and hips.
Struggling with pelvic pain? Frustrated and concerned about incontinence? For both short-term and long-lasting relief without the need for invasive interventions or medications, consider consulting with our physical therapists today.