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Physical Therapy for Incontinence – Information, Exercises, and More

You are struggling with incontinence. 

Laughing, coughing, and sneezing have all become stressful bodily functions for you. 

You’ve stopped doing activities that you love out of fear of having an embarrassing moment. 

Some treatments can help you — physical therapy for incontinence is one of them.

In this guide, we will talk about the signs and symptoms of incontinence, and which treatment options may be right for you.

 

 

Contents

What Is Urinary Incontinence?

Urinary incontinence refers to the loss of bladder control.

The severity of incontinence can range from occasionally leaking urine when sneezing or coughing to having sudden, strong urges to urinate that can result in not making it to the bathroom in time. 

The pelvic floor muscles are largely responsible for urinary control. These muscles run from to back and attach to the bottom of the pelvic bones. They create a hammock structure that helps to support and lift the internal muscles.

These muscles also:

  • Stabilize the pelvic bones
  • Provide lower back support
  • Control the sphincter muscles; and
  • Assist with sexual function

Urinary incontinence is more common in women than men and the different types include:

  • Stress incontinence
  • Urge incontinence
  • Overflow incontinence
  • Functional incontinence
  • Frequency incontinence
  • Mixed incontinence

What Causes Incontinence?

Urinary incontinence is not a disease, but rather a symptom that can be caused by medical issues or daily habits. Incontinence can be a temporary problem or a long-term issue. 

Some causes of temporary incontinence include: 

  • Consuming certain drinks that act as diuretics like carbonated drinks, caffeinated drinks, and alcohol.  
  • Consuming certain foods that act as diuretics like chili peppers, chocolate, artificial sweeteners, and foods that are high in spice, sugar, or acid.
  • Certain medications like blood pressure medication, heart medications, sedatives, and relaxants.
  • Medical issues such as constipation or a urinary tract infection. 
  • Large doses of vitamin C.

Some causes of long-term incontinence include: 

  • Diabetes
  • Stroke
  • Multiple Sclerosis
  • Enlarged prostate or prostate cancer
  • Childbirth or menopause

Incontinence Symptoms

Incontinence symptoms can vary depending on the type of incontinence you are experiencing. 

It is important to always speak with your doctor about symptoms so other medical issues can also be ruled out.

Let’s take a look at some of the different urinary incontinence types and accompanying symptoms that may be affecting you.

Urinary Stress Incontinence

This is a common type of incontinence that occurs when the pelvic muscles become weak and no longer correctly support the bladder and urethra.

Women are more likely to develop stress incontinence than men. 

Studies show that one-third of adult women have stress incontinence on a weekly basis.

Certain actions and activities can put pressure on the bladder and cause leakage such as: 

  • Coughing 
  • Sneezing
  • Laughing
  • Lifting
  • Bending 
  • Straining

Physical therapy for stress incontinence can help strengthen the pelvic muscles to prevent leaks. 

Overactive Bladder or Urgency Urinary Incontinence

Overactive bladder incontinence (OAB) is associated with a strong urgency to urinate and is often accompanied by frequent urination. 

If you are unable to make it to the bathroom, the type of leakage is classified as urgency urinary incontinence (UUI).

Overflow Incontinence

This type of incontinence occurs when the bladder doesn’t empty correctly, causing it to overflow and cause leaks. 

Signs of overflow incontinence include: 

  • Frequent, small urinations
  • Ongoing dribbling

This type of incontinence typically occurs in males with prostate problems. 

Functional Incontinence

Bladder leakage that is not linked to pelvic floor dysfunction is known as functional incontinence.

It’s most common in people who have trouble reaching the toilet on time, such as those with limited mobility. 

Functional incontinence can occur even without a strong urge to urinate. The causes may include:

  • Obstacles that block access to the bathroom (furniture, loose rugs, etc.)
  • Limited mobility caused by joint or muscle weakness
  • Dementia, confusion, or delirium 
  • Assisting devices that slow movements, such as walkers and wheelchairs
  • Depression or anger

Frequency Incontinence

Infections are the most common cause of frequency incontinence. People experiencing frequency incontinence may feel the need to empty their bladder often and may get up more than once in the night to urinate. 

Sensitivity to certain drinks or food can also cause frequency incontinence.

Mixed Incontinence

It is possible to have more than one type of urinary incontinence.

Mixed incontinence refers to having two or more different types of incontinence.

Consulting a doctor to find out if you have one or more types of incontinence can help determine the cause of your urinary leaks so you can receive proper treatment. 

Urinary Incontinence Diagnosis

Identifying the causes of urinary incontinence requires a thorough exam conducted by a licensed physical therapist. 

You will be asked questions about your symptoms and daily experiences and the physical therapist will assess:

  • Whether you experience pain in your pelvic floor muscles
  • The muscles in your hips and lower back
  • Your strength, flexibility, and coordination

If required, you may be referred to a doctor to conduct:

  • Ultrasound testing or an MRI
  • Urodynamic testing

Once diagnosed, treatment, including incontinence physical therapy, can begin immediately.

Incontinence Treatment

 

Incontinence treatment can vary depending on the type and severity of incontinence you are experiencing, as well as the underlying cause. 

Your doctor may prescribe a combination of treatments. 

Conservative and non-invasive treatments are usually implemented first, such as physical therapy for urinary incontinence, and more advanced treatments may be prescribed if there is no relief from your symptoms. 

Let’s take a look at some treatment options that may be available to you. 

 

Behavioral Techniques

Certain techniques and lifestyle changes can help reduce your symptoms.

Some techniques your doctor may recommend include: 

  • Bladder training. This exercise involves delaying urination after feeling the urge to go to help retrain the bladder.
  • Scheduled toilet trips. This practice involves going to the bathroom every two hours instead of waiting for the urge to go. 
  • Double voiding. Waiting a few minutes after urinating and trying to urinate again can help you learn to empty your bladder more when going to the bathroom.
  • Fluid and diet management. Avoiding food and drinks that act as diuretics, reducing fluid intake, and increasing exercise can help reduce symptoms.

Medications

Some medications that may be used to treat incontinence include: 

  • Anticholinergics. Medications like oxybutynin can help calm an overactive bladder and reduce incidences of incontinence.
  • Mirabegron. This medication relaxes bladder muscles and can help increase the amount of urine your bladder can hold. Mirabegron may also help you empty your bladder more completely.
  • Alpha-blockers. This type of medication is used for men experiencing overflow incontinence. Alpha-blockers like tamsulosin work to relax the bladder neck muscles and make it easier to empty the bladder. 
  • Topical estrogen. Lose-dose topical estrogen is prescribed for women experiencing incontinence. The medication helps improve incontinence symptoms by toning tissues around the urethra and vaginal area. 

Physical Therapy

Your doctor may prescribe a type of physical therapy for urinary incontinence known as pelvic floor physical therapy. 

This type of physical therapy focuses on strengthening the pelvic floor muscles to help decrease the risk of incontinence episodes. 

Incontinence physical therapy exercises may be accompanied by electrical stimulation, which can help strengthen pelvic floor muscles and effectively reduce incontinence incidences. 

Other Therapies

Other types of treatments include: 

  • Bulking material injections. This involves injecting synthetic material around the urethra to help keep it closed and reduce urine leakage. 
  • Botox injections. Botox injected into the bladder can help if you have an overactive bladder.
  • Nerve stimulators. A device is implanted under the skin to electrically stimulate nerves involved in bladder control.

Medical Devices

Some medical devices designed for females can help reduce incontinence symptoms, including: 

  • Urethral insert. This is a small, tampon-like disposable device that is inserted into the urethra to prevent leaks during physical activity. 
  • Pessary. A pessary is a stiff ring that is inserted into the vagina for all-day wear to help hold up the bladder and prevent urine leakage. 

Surgery

If you aren’t getting results from other treatments, surgery may be recommended. 

Some surgeries used to treat incontinence include: 

  • Sling procedures
  • Bladder neck suspension surgery
  • Prolapse surgery
  • Artificial urinary sphincter implantation

Incontinence Physical Therapy – Will PT Help?

Does incontinence physical therapy work? The answer is yes. 

Physical therapy for incontinence may help reduce your symptoms and incidences of incontinence by strengthening the pelvic floor muscles. 

Pelvic floor weakness, tightness, or uncontrolled spasming can contribute to the inability to control your bladder.

Strengthening your pelvic floor muscles helps: 

  • Decrease the urgency to urinate.
  • Keep the urethra closed.

In addition to incontinence physical therapy exercises, your physical therapist may use electrodes to measure your pelvic floor activity and stimulate the muscles to help improve function. 

Biofeedback may also be used to read and measure pelvic floor activity and help to ensure you’re using your pelvic floor muscles correctly.

Best Incontinence Exercises

The primary exercises for strengthening the pelvic floor muscles begin with incontinence physical therapy. 

It is important to consult a Doctor of Physical Therapy before attempting any exercises by yourself. 

Let’s take a look at some incontinence physical therapy exercises that may be part of your treatment plan.

Kegels

Kegels are an exercise that helps strengthen the muscles which control urination.

To perform this exercise, you tighten the muscles you would use to stop urinating and hold for a period of time before releasing.

This important incontinence physical therapy exercise can be perfected with the help of a physical therapist and practiced at home multiple times throughout the day.

Muscle Strengthening Exercises

Your therapist may create a strengthening exercise program for you to stretch and strengthen other muscles that support bladder function alongside pelvic floor therapy. 

 How In Motion O.C. Can Help With Incontinence

You don’t have to stop doing the activities you love because of incontinence. 

At In Motion O.C., we are dedicated to helping people like you improve your life through physical therapy. 

All incontinence physical therapy sessions are held in our state-of-the-art facility and conducted by licensed Doctors of Physical Therapy.

As the #1 rated Physical Therapy clinic on Yelp! and Google, we have hundreds of testimonials to assure you that we provide nothing but the best care in physical therapy. 

In Motion O.C.