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The Link Between Pelvic Floor Physical Therapy and Urinary Incontinence 

Written by Dr. Kylie Reardon, PT, DPT

Urinary incontinence is the unintentional loss of urine and affects many people regardless of age or gender. Pelvic floor physical therapy is a treatment that can help address dysfunction in the pelvic floor muscles, which can be an effective treatment for urinary incontinence. Underlying causes are weak or tight pelvic floor muscles, poor coordination, overactivity, and pelvic organ prolapse. It can involve strengthening, relaxation techniques, coordination exercises, lifestyle modifications, bladder training, and manual therapy.

What is Urinary Incontinence?

Urinary incontinence is characterized by the unintentional loss of urine. As many as 1 in 3 Americans have some type of urinary incontinence that causes them to leak urine uncontrollably. Urinary incontinence, in general, more commonly affects women but can affect anyone regardless of age or gender. Common symptoms associated include: 

  • Leaking urine when coughing, sneezing, laughing, or exercising, 
  • Feeling sudden uncontrollable urges to urinate
  • Frequent urination 
  • Waking up many times at night to urinate
  • Urinating during sleep
The Link Between Pelvic Floor Physical Therapy and Urinary Incontinence

Types of Urinary Incontinence:

  1. Stress Incontinence: Characterized by loss of urine due to pressure changes in the abdomen. This type of incontinence occurs when physical movement, such as coughing, sneezing, laughing, or exercising, puts pressure on the bladder, causing urine to leak. Overly tight or weak pelvic floor musculature may be a factor in this type of incontinence.
  2. Urge incontinence: A sudden and intense urge to urinate, leading to leakage in the event one cannot make it to the bathroom. Commonly referred to as an Overactive bladder. 
  3. Overflow Incontinence: Occurs when the bladder is too full causing leakage or dribble. This may occur due to the reduced ability to empty the bladder. 
  4. Functional Incontinence: Caused by the inability to make it to the bathroom in time due to a mental or physical impairment. This type can be seen in elderly adults who have reduced mobility. 
  5. Neurogenic Incontinence: Also known as neurogenic bladder.  Nerves carry messages between the bladder and the spinal cord and the brain. The messages tell the muscles of the bladder to either tighten or release. In the neurogenic bladder, these nerves don’t work the way they should.
  6. Mixed Incontinence: This type of incontinence includes two or more of the above types. Stress and urge incontinence can frequently be seen together. 

What is the Pelvic Floor? 

Your pelvic floor is compromised of muscles and connective tissues that support your internal organs such as your bowels, bladder, and reproductive organs. Everyone has a pelvic floor, not just females! These muscles act as a hammock or slings that hold your organs in place. The muscles of the pelvic floor also function to assist with bodily functions like peeing, pooping and sex. The pelvic floor can also be referred to as the pelvic diaphragm and is an integral part of your functional core. 

What is Pelvic Floor Physical Therapy? 

Pelvic floor physical therapy is a treatment to help address dysfunction in the pelvic floor muscles. Pelvic floor dysfunction can occur due to tightness, weakness, lack of coordination, injury, or innervation to pelvic floor musculature and connective tissue. Pelvic floor physical therapy can be an effective treatment for urinary incontinence because it targets the underlying cause of the condition.

How Pelvic Floor Physical Therapy can help with urinary incontinence:

  • Strengthening pelvic floor muscles: Weak pelvic floor musculature may need to be strengthened to assist in function 
  • Reducing tone or tightness: Inflexibility, tender points, and tightness of the muscles may lead to symptoms. Manual therapy and relaxation techniques can be useful. 
  • Improving muscle coordination: Incorporating breathing mechanics, core engagement, and coordination of pelvic floor control.
  • Decreasing overactivity: Lifestyle modifications, bladder training, and pelvic floor exercises to reduce symptoms 
  • Addressing pelvic organ prolapse: If pelvic organ prolapse is causing urinary incontinence, pelvic floor physical therapy can help to improve the strength of the pelvic floor muscles to provide support for the pelvic organs.

Inspira Physical Therapy & Pilates can help you regain control of your life by addressing pelvic floor dysfunction and providing personalized treatment for urinary incontinence. Book Online. 

The International Urogynecological Association (IUGA) is dedicated to the global advancement of urogynecological knowledge and patient care through education and the promotion of basic and clinical research on disorders of the female pelvic floor.

The North American Menopause Society (NAMS), founded in 1989, is a nonprofit multidisciplinary organization with the mission of promoting the health and quality of life of women during midlife and beyond through an understanding of menopause and healthy aging.

References:

  1. National Institute of Diabetes and Digestive and Kidney Diseases. (2010). Urinary incontinence in women. Retrieved August 15, 2012, from https://www.niddk.nih.gov/health-information/urologic-diseases/bladder-control-problems
  2. FamilyDoctor.org. (2010). Urinary incontinence. Retrieved May 21, 2012, from https://familydoctor.org/condition/urinary-incontinence/
  3. Mayo Clinic. (2022). Urinary Incontinence. Retrieved from https://www.mayoclinic.org/diseases-conditions/urinary-incontinence/symptoms-causes/syc-20352808
  4. National Institute of Diabetes and Digestive and Kidney Diseases. (2021). Urinary Incontinence in Women. Retrieved from https://www.niddk.nih.gov/health-information/urologic-diseases/urinary-incontinence-women
  5. Urology Care Foundation. (2021). Types of Urinary Incontinence. Retrieved from https://www.urologyhealth.org/urologic-conditions/urinary-incontinence/types-of-urinary
  6. Beaumont Health. Pelvic floor dysfunction. Retrieved from https://www.beaumont.org/conditions/pelvic-floor-dysfunction#:~:text=Pelvic%20floor%20dysfunction%20occurs%20when,pelvic%20region%2C%20genitals%20or%20rectum.
  7. LLUH Health & Wellness Blog. (n.d.). Could Pelvic Floor Physical Therapy Help You? Retrieved from https://lluh.org/patients-visitors/health-wellness/blog/could-pelvic-floor-physical-therapy-help-you

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