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Exercises for pelvic floor strengthening

INCONTINENCE

Incontinence: Leaking and How to Resolve it For Good!

Pelvic Floor Physical Therapy is very effective at treating various symptoms and causes of incontinence. The most commonly thought of, and most prominent type of incontinence in women and men, is urinary incontinence. Although less commonly experienced, Pelvic Floor Physical Therapy can also treat fecal incontinence and decreased control of flatulence. While these different types of incontinence are common in a lot of individuals, especially the pregnancy and post partum populations, it should certainly not be considered normal or persistent.

 

There can be many causes of urinary incontinence and the outcomes with Pelvic Floor Physical Therapy treatment are outstanding at about 90% improvement in incidence of leaking urine overall. Plenty of individuals experience full resolution of leaking. Even the more complex and chronic cases can expect improvement and increased ability to manage symptoms and improve overall function. Urinary incontinence can be divided into two main categories: stress urinary incontinence and urge urinary incontinence. Both are very treatable with Pelvic Floor Physical Therapy.

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Stress incontinence is usually a little more straight forward to explain. This type of incontinence is when an individual leaks urine with activities that increase intra abdominal pressure such as coughing, sneezing, laughing, or vomiting. Jumping, heavy lifting, transitioning, and falling also increase intra-abdominal pressure and can cause leaking. Typically this type of incontinence will cause leaking anywhere from a drop or two, to tablespoons, and occasionally full bladder loss. Pelvic floor physical therapy treats this through internal and external assessment of the pelvic floor musculature, as well as assessment of breathing, coordination, and reactivity of the core musculature. Core and hip strength directly correlate to pelvic floor strength which is more likely to predispose an individual to have incontinence if there is weakness in these areas. While different in nature and presentation, stress urinary incontinence has similar assessment and treatment as urge urinary incontinence with a few differences.

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Urge urinary incontinence is different from stress in regard to the brain and body connection being dis-regulated. The individual does not feel like they have control over the bladder when they get the urge to urinate. The urge will usually come on very suddenly and unexpectedly. This can lead to leaking urine when the urge comes and they are unable to get to the restroom in time. This could occur in various locations and circumstances such as at the grocery store or at home right before they reach the toilet. Sometimes there will be "triggers" such as hearing the sound of water, pulling into their driveway, or right when turning the key to their home when they know the bathroom is close. Pelvic floor therapy can help by using the same physical assessment as for stress incontinence, but additionally helping to retrain toileting habits and re-establish control of the bladder through the brain-body connection. There can also be bladder irritants and potential triggers for urgency that can be discovered through patterns when keeping a bladder diary for a minimum of 3 days. This bladder diary will be provided by your Pelvic Floor Physical Therapist where you will keep track of frequency of urination as well as what you eat and drink. This will help you to discover if there are factors that can be changed to reduce bladder irritation and urgency. The final type of incontinence after these two types of urinary incontinence is fecal incontinence which Pelvic Floor Physical Therapy can also be very effective at treating. 

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Fecal incontinence is overall less common than urinary and usually occurs when an individual has decreased control over their pelvic floor in combination with loose stools. This type of incontinence can really affect quality of life and should be addressed with Pelvic Floor Physical Therapy as first line of care. Onset of these symptoms can occur in various populations for different reasons. This can happen in the post partum phase, as well as after certain surgical procedures where the nerves and sensation around the anus and rectum can be affected, decreasing control of the pelvic floor. Pelvic floor physical therapy can provide very similar treatment to that of urinary incontinence by regaining control of the pelvic floor and improving function in the structures surrounding the pelvis. Like urinary incontinence, a diary can be kept with fecal incontinence to pick up patterns of when this occurs as well as what foods cause loose stools which can increase likelihood of incontinence. 

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Incontinence is typically not known to have any type of treatment except for some medications which can help somewhat with urinary urgency. However, these medications typically have side effects and only help minimally with leaking. It is very unfortunate that incontinence is considered to be "normal," especially in the post partum population where most think it is just part of having children and that every mother who gives birth experiences leaking as something to live with. This is far from true and can be treated very effectively with Pelvic Floor Physical Therapy. If you have experienced any the symptoms described above, Pelvic Floor Physical Therapy can help! In fact, it should be your first line of treatment to help avoid any unnecessary medications or surgeries.​ Using your own body to address your symptoms is the most effective way to resolve incontinence and should also be empowering as your Pelvic Floor Physical Therapist helps to facilitate your process in resolving your symptoms. 

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Reach out to a Pelvic Floor Physical Therapist today for your evaluation to resolve leaking for good!

Get in touch so we can start working together.

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