Take Control of Your Bladder

by gaylehope | 5 Comments

I have been a physical therapist for twelve years and have been treating pelvic floor conditions for the last five years. It never ceases to amaze me how many of my patients have been suffering with pelvic pain, incontinence, or pelvic organ prolapse for many years and have not been educated on the benefits of physical therapy in the rehabilitation of these conditions. Many of these patients can achieve resolution of their symptoms in a relatively short period of time with physical therapy treatment.
Take Control of Your Bladder
One of the most common conditions that I treat is incontinence. An estimated 17 million women and 25 million adults in the United States suffer from urinary incontinence and only a fraction of those people are aware that physical therapy can assist them in their recovery. Incontinence can occur in people of all ages and can be due to a variety of reasons including but not limited to pregnancy and vaginal childbirth, aging or genetic factors, medical conditions, infections, and weight gain. There are several types of urinary incontinence with the most common being stress urinary incontinence, urge incontinence, and mixed incontinence.

  • Stress urinary incontinence (SUI) occurs during performance of a physical activity when the pelvic floor muscles are unable to counteract the force of increased intra-abdominal pressure. People who experience SUI have leakage with activities such as coughing, sneezing, laughing, lifting, and exercising.
  • Urge urinary incontinence occurs when the muscles of the bladder contract inappropriately causing a sudden and strong urge to urinate often independent of the amount of urine in the bladder. People who experience urge incontinence have a strong sudden urge to urinate and are unable to make it to the bathroom.
  • Mixed incontinence occurs when someone experiences symptoms of both stress and urge incontinence. In addition to leaking urine, patients with mixed incontinence may also experience painful urination, increased frequency of urination, or the need to void during sleeping hours.

When receiving physical therapy for incontinence, each patient will be evaluated to determine the type of incontinence and the contributing factors. An individualized treatment plan will then be developed for each patient. Treatment may include:

  • Biofeedback for education and strengthening of the pelvic floor muscles
  • Posture re-education
  • Soft tissue mobilization
  • Strengthening
  • Lumbopelvic stabilization
  • Behavior and lifestyle modification
  • Bladder retraining
  • Electrical stimulation

The bottom line is that urinary leakage at any age is not normal and physical therapy can allow patients to improve their quality of life.  Many people are embarrassed to discuss these issues with their physician or have even been told that this is “normal or expected” after childbirth or with aging and this is not the case!  If you have symptoms of urinary incontinence, please know that there are many therapists out there who specialize in the treatment of pelvic floor dysfunction that can help you!

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5 Comments

  1. Kenneth

    I am a 55 yr old male, 6′, 175, exercise regularly and visit primary care physician routinely. I have had an overactive bladder for the past 10+ years and have tried prescription medicine with limited results. This is impacting my lifestyle. Do you think your program would help me?

  2. gaylehope

    @ Kenneth, physical therapy may be beneficial to help you manage or resolve your symptoms. I have had success in the past treating female patients diagnosed with overactive bladder. Often times there are postural, behavioral/lifestyle, or muscular components(such as muscle spasm or weakness) that can be addressed in physical therapy. We have several therapists in the company that specialize in male pelvic floor dysfunction that would be happy to speak with you regarding your condition. With a prescription from your physician one of these therapists could evaluate you and determine a treatment plan for your specific case. Please let me know if you have any additional questions!

  3. Sharon

    I am an RN. I am in a great deal of pain from 7 spine surgeries but as well from vaginal pain. I am diagnosed with pelvic floor dysfunction and levator ani problems. I have as well long standing problems with stress incontinence. Four vag. births are responsible for this as well as advancing age.
    I am not making the connection between phys. therapy and pain relief from my vaginal pain. Maybe you could enlighten me before I spend money to come in for a formal eval. Make the connection clear to me please.

  4. Kelly Todd

    @Sharon. I would love to help you with this. So the pelvic floor is a group of muscles that go from pelvic bone one one side across to the other pelvic bone (side to side) and from the pubic bone in the front to your tailbone in the back. It is kind of like a sling or a hammock. This muscle group is a source of stability for your internal organs but also helps to keep you continent. This muscle group also has direct connections with your hips, your lower abdominals and your lower back. It is not uncommon to have pelvic pain with chronic lower back problems or pain. Also, from your post, you state that you have had 4 vagnial births which can cause trauma to the pelvic floor. A diagnosis of pelvic floor dysfunction and levatori ani problems in essence means that there is dysfunction of this muscle group. In your case, it is more than likely very weak (one of the reasons why you are leaking) and probably tight or spasmed in some areas to compensate for the weakness. A poor overall balance of this muscle group can lead to pain. The muscles are not working as they should so they cause you pain. In pelvic floor PT, we work on finding a better balance for this muscle group (the pelvic floor). We work on decreasing the tightness or any spasming then retraining the muscles on what they are supposed to do then getting them stronger so that you are continent and painfree. I hope that this helps to answer your questions. If you have more questions or would like to discuss more, please feel free to email me at womenshealth@athletico.com. Thank you! Kelly Todd, PT, DPT

  5. Laurie Pearson

    Hi Kelly,
    my issue is having to get up 2,3, or 4 times a night to urinate. i am 67 years old an assuming this has to do with my age. I’m not getting a good nights sleep and would love to mend this issue, if possible.

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