Pelvic floor physical therapy for stress incontinence
Pelvic floor physical therapy is a great way to address stress incontinence, a specific type of urinary leakage.
As someone in a female body, you may be aware of all of the commercials and articles that exist for diapers, pads, and botox injections to help you "deal with" urinary leakage. Because let's face it and call it like it is: it really sucks to leak urine.
Whether you're walking around the house, in an exercise class, out for a run, or sneezing at the grocery store, leaking can feel super embarrassing and at the end of the day, it ends up limiting what you do and also leads to the utilization of strategies to mitigate leaking like crossing your legs first before you sneeze, avoiding jumping all-together, or saying "no" to activities with your kids because you know you can't tolerate lifting them or running around with them without leaking.
You don't have to resort to wearing a pad/diaper and going through procedures like botox injections to treat your leaking. Pelvic floor physical therapy can help you, and I'd love to be your pelvic health physical therapist if you're located in Durham.
But if you're not ready to book just yet and want to get some more information first, keep reading. Inside this blog you'll learn about stress incontinence and what you can do about it as well as the role of pelvic floor physical therapy in getting rid of urinary incontinence for good!
What is stress incontinence?
Stress urinary incontinence is a type of urinary incontinence that occurs when there is an increase abdominal pressure, such as coughing, sneezing, laughing, or exercising.
When the pressure increases in the abdominal cavity, urine leaks out because that pressure is too much for the pelvic floor muscles to handle.
The good news: because this is what we call a "pressure issue", it means that what we need to do is learn and retrain the body on how to manage that pressure so when there is a pressure increase, the muscles in the pelvic region know how to deal with the pressure.
The pelvic floor muscles and incontinence
The pelvis is shaped like a bowl and the pelvic floor muscles sit at the bottom of that bowl.
Because organs sit on top of the pelvic floor muscles, that means that the pelvic floor muscles have an important role in supporting those organs.
So if there’s a problem with the pelvic floor muscles, you can see where we might start to have problems that affect the nearby organs as well, like the bladder.
There can be many different reasons why the pelvic floor muscles might stop performing well, but the top 3 issues I tend to see in my clinic are that
the muscles are too weak
the muscles are too tense
or the muscles are not well coordinated.
And keep in mind that these categories are not exclusive to each other so patients can definitely fall into two or even all three of them.
My job as a pelvic floor physical therapist is to figure out exactly what is going on with the pelvic floor muscles so that we can do the correct exercises to make them function well, whether that is strengthening, relaxing, or coordinating movement.
When you might be noticing leakage of urine
It's important to know that there are activities in which I commonly see patience with urinary leakage. This list is not exhaustive, but it does include a lot of the typical presentations I see.
You may be noticing urinary leakage with:
Lifting (it doesn't need to be a heavy weight, but could be)
Jumping
Sneezing
Coughing
After jumping rope for a certain amount of time or the entire time
Laughing
Reaching overhead
Picking up your kids
After a stressful day at work, you may leak more with overall movement
Exercising: running, yoga, pilates, volleyball, etc.
Walking around
Going up a set of stairs
Core exercises
Pelvic floor physical therapy and stress incontinence
When it comes to pelvic floor physical therapy for those who are having stress incontinence, we have to first figure out exactly what is happening when the leaking is occuring.
Some people will have problems running, but not lifting, some will not have problems when they sneeze, but it's game over when they run.
So, we first need to dive into exactly how you are experiencing leaking: when, where, how much, and with what activities and how long into those activities. This can help us make sure that it's a pelvic floor muscle issue and is situationally dependent, rather than a sphincter muscle or neurological issue that happens unrelated to any sort of pressurization activity.
Then, a pelvic floor assessment can help determine what the muscles feel like: are they tight and aggravated? Are they able to do a pelvic floor contraction? Is your pelvic floor muscle activity coordinated, strong, and appropriate for the task at hand? Is your pelvic floor muscle function what we would call "typical" or are there things that we can work on to make it better? Is the pelvic floor muscle strength enough to withstand increases in pressure and is it all pressure or just when the pressure is A LOT like that when jumping?
Based on these test results and your history, we will work together to determine how we will manage your urinary incontinence both in the short term and the long term so that you can get the best results possible. In this case, no more leaking!
What does pelvic floor pt look like and what is the timeline?
Pelvic floor physical therapy at Durham Pelvic might look a little different than you'd expect, so let's talk about it.
First things first: you will always be in a private room with the same physical therapist (me!), for a full 60-minute session.
Inside our sessions, I typically blend manual therapy with targeted exercises that are specific to your unique presentation.
Depending on what you need, we may work on strategies to:
Strengthen the pelvic floor
Teach the muscles how to relax first, so that they can then contract when necessary (if they are always tight and strained, they won't be able to help you when the pressure exceeds them, they're already stressed to the max)
Work on pelvic floor coordination during movement
A large focus of treatment is doing what actually makes you have urinary incontinence so that we can not only build your confidence within that situation, but also so we can improve pelvic floor muscle coordination and core pressurization strategies so that you can avoid leaking.
Pelvic floor muscle exercises are not just "Kegals". We do so much more than just that. And by the way, Kegals are oftentimes not the answer and can potentially make your urinary incontinence worse. Read more on Kegals and urinary incontinence here.
Where to find a pelvic floor physical therapist
You can find a pelvic floor physical therapist local to you by searching for one in Google! If you're located in or near the Durham, NC area, I'd love to work with you at Durham Pelvic.
I love being able to help those with urinary incontinence not only figure out what is causing their symptoms but to also conquer situations that previously made them so uncomfortable and/or do things they stopped doing because they would leak.
I've got you and I'd love to help.
To get started, you can book a discovery call or submit a contact form here.
