Everything You Always Wanted to Know About Urinary Incontinence But Were Afraid to Ask

Heather Whiting DPT, CSCS

What is Urinary Incontinence? Urinary incontinence is when there is an undesired leakage of urine. It can be anywhere from a couple of drops of urine to close to a regular flow. There are different types of urinary incontinence. You can have stress incontinence, urge incontinence and overflow incontinence to name a few. Stress incontinence occurs when there is an increase in abdominal pressure such as lifting a heavy object, sneezing, coughing or during exercise. Urge incontinence occurs when a person hears running water, is drinking water or during sleep. It is caused by a spastic bladder and the patient has very little control over their bladder and often urinates 7 or more times a day. Overflow incontinence is when the person cannot fully empty their bladder and it causes over activation of the bladder nerves resulting in an increase in urinary frequency.

What causes Urinary Incontinence in women? There are many different causes for urinary incontinence in women. It can occur during and after pregnancy, in women with strong core muscles, women with low back pain and often occurs as women age. If you find yourself with urinary incontinence after a trauma, you should seek immediate medical attention to rule out any underlying neurological dysfunctions, such as cauda equina syndrome. Often it is a result of weakening pelvic floor muscles and structural dysfunctions such as joint alignment problems or scar tissue adhered to the bladder.

How can a Physical Therapist help me with my Urinary Incontinence? Physical therapy can help urinary incontinence in several different ways. Often, there is a structural dysfunction that has changed the pelvic floor muscles ability to contract effectively. This can be misalignments of the coccyx, sacrum, pubic ramus, ileums and/or scar tissue within the abdominal contents. We can assess and treat these dysfunctions and follow it up with appropriate strengthening exercises. The exercises are targeted to activate your deep core muscles that are usually ignored with traditional abdominal exercises. We here at EHS are always assessing your posture as well and will most likely make corrections to ensure you have the most efficient posture that will continue and aid in your healing process.

 What would my course of treatment involve? Every course of treatment begins with an evaluation. This is the time we discuss your past medical history, current symptoms and your goals for treatment. Your therapist will then look at your posture, assess your pelvic structures mentioned earlier and assess your strength. From this information, a plan of treatment will be formulated. Manual therapy is a relationship between the therapist and the patient. The therapist will clear up any structural dysfunctions, start the strengthening process and educate you on proper posture. It is the patients responsibility to make the necessary postural adjustments in their everyday life and to perform the home exercise program as prescribed by their therapist.

What can I do at home to help improve my condition? Your therapist will give you things to focus on in your day to day activities. You need to be aware of proper posturing and avoiding motions, identified by your therapist, which can be counterproductive to the course of treatment. Your therapist will also provide an appropriately prescribed home exercise program for you to perform at home.

Dr. Heather Whiting joined the EHS team of physical therapists through the post graduate program started by the Institute of Physical Art (IPA). Heather graduated from Northeastern University with her Doctorate in Physical Therapy and a minor in Spanish. In addition to her academic pursuits at Northeastern, she was also a member of the women’s varsity swim team earning All-CAA Conference honors and was voted team captain. During her NCAA Division I swimming career she was a valued member of multiple record breaking relay teams.


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