So you leak a little bit of urine when you sneeze, laugh, or cough. You feel like you pee your pants when you jump on the trampoline with your kids or do squat jumps at bootcamp workouts. Or maybe you get the sudden urge to go and can’t get to the bathroom fast enough. Sound familiar?
People usually fall into one of two camps: those who are too embarrassed to talk about their symptoms, and those who think these symptoms are an inevitable consequence of giving birth or aging. The truth is incontinence affects one in three Canadian women and one in nine Canadian men. It is a common problem, especially in post-partum women. However, common is not the same thing as normal. Incontinence is not normal or inevitable – it can be corrected with pelvic floor physiotherapy!
So what is incontinence?
Incontinence is the involuntary loss of urine. Stress incontinence involves the loss of a small volume of urine due to an increase in intra-abdominal (core) pressure (think laughing, coughing, sneezing, lifting, exercise, etc.). In comparison, urge incontinence usually involves the loss of a larger volume of urine with a strong, uncontrollable urge to void (not making it to the bathroom). Mixed incontinence is a combination of stress and urge incontinence.
What causes incontinence?
Incontinence is often caused by a combination of factors. The pelvic floor muscles, which form a bowl or hammock shape to keep the organs from falling out the bottom of the pelvis, also act as sphincters that control urination and defecation. Sometimes these muscles are too tight, sometimes (more often) they are loose and weak, and sometimes they just have poor coordination. If those sphincters cannot close the instant before you cough or sneeze, urine leakage is almost inevitable.
Here’s the good news: pelvic floor muscle training has the highest level of research evidence (Level 1, Grade A) to support it as a first line treatment for urinary incontinence. This means it has more research to back it than almost any other treatment physiotherapists use for any condition. The only catch is that pelvic floor muscle training is not a one-size-fits-all treatment. In order to effectively treat incontinence, it is important to first determine the specific pelvic floor muscle problem (tight vs. loose vs. poor coordination). An internal vaginal and/or rectal exam is an important part of the assessment, because these muscles lie internally and cannot be felt externally.
Pelvic floor physiotherapy can treat much more than just incontinence. It can also help pelvic organ prolapse, constipation, and a variety of pelvic pain syndromes. In addition, many people (especially females) with low back pain experience pelvic floor muscle dysfunction, so it can be an important part of recovery from persistent low back pain. The pelvic floor forms the base of the core musculature, so proper function cannot be emphasized enough! Remember – you don’t have to live with these symptoms! Book an assessment today to start the process of pelvic floor rehabilitation.
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