Physical Therapy Blog

Let’s Conquer Incontinence!

Incontinence, or any leakage of urine, is a very common problem.  Fortunately, incontinence is very often totally fixable, so you have no need to suffer. It begins with identifying which type you have, so we know which strategy will work best.

Stress incontinence is when urine leaks with an identifiable physical force, like coughing, sneezing, laughing, jumping, running, lifting, etc.  Coughing, sneezing, and laughing are all exhalations,- so simply by coordinating the pelvic floor muscles with exhalations, we are able to resolve the incontinence.  So if there are no barriers, we can often get full resolution in 1 to 2 sessions.  Jumping, running, and lifting is when the body can’t close off the hole where urine exits and absorb the force of impact or load at the same time.  So we have to coordinate the pelvic floor with the whole movement, ensuring alignment and muscle teamwork are occurring at the same time, leading to excellent results.

Urge incontinence is when the bladder releases urine when you feel an urge and don’t make it to the toilet on time.  Two goals here:  1. close off the hole and lift the bladder with the appropriate muscles and 2. Quiet the nervous system.  So my treatment approach is to teach you the tools to meet these 2 goals.

Sometimes other factors are placing pressure on the bladder.  If excessive pressures are placed on the abdomen, greater than the pelvic floor can counter, leakage will occur.  It’s like squeezing a balloon; you can only place so much pressure on it before it busts or leaks.  Excessive pressures in the abdomen can come from bloating, gas, or constipation.  Learning ways to decrease gas and to prevent gas buildup can place less pressure on your bladder, and result in less bladder leakage.

Another way excessive pressures are placed on the abdomen is with excessive sit-ups or incorrect technique with sit-up exercises.  Learning how to incorporate Kegel muscles and directional forces into sit up exercises can balance the forces on the bladder, thus no leakage.

Another aspect to consider is one’s emotional state and stresses; in multiple cases when discussing the onset of incontinence with a woman, we discover it began when a woman felt like her life was spiraling out of control or when the heaviness of life was too much.  Body parts can seem to take on some of the emotional junk of life and bladders are no exception.  Acknowledging the emotional connection can sometimes be enough to decrease the bladder problem, and sometimes it requires nervous system retraining.

Yes, urine leakage is very common, but remember it is not “normal” or inevitable.  In most cases, it is completely fixable without medications or surgery.