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Urinary Incontinence

Urinary incontinence (UI) is the inability to control urine. An estimated 13 million adults (men and women) of all ages suffer from UI. Dysfunctional voiding patterns and leakage also occur in children of all ages. There are four basic types of incontinence.

Stress incontinence is when urine leaks out when stress (pressure) is put on the bladder, for example when someone sneezes or coughs.

Another type of leakage is called urge incontinence which is sometimes known as “overactive bladder.” This leakage occurs when there is a strong urge to urinate occurs and someone is not able to make it in time to urinate.

The other type of incontinence is called overflow incontinence which occurs when the bladder does not empty normally and becomes very full. Then dribble occurs out of the bladder.

Finally mixed incontinence is also another form which means basically that someone suffers from more than one type of incontinence which are described above.

If you or someone you know is suffering from urinary incontinence, please know that there are options for treatment. You do not have to live everyday wearing depends pad and you can learn to gain the control you need to live an enjoyable life. Some options that people have are medication, surgery and pelvic floor physical therapy. After discussing these options with your doctor, you should make the best treatment for yourself.

In terms of pelvic floor therapy, it does help to teach people new ways to control their bladder and train those muscles that are involved in controlling and stopping the leakage. These are the pelvic floor muscles.    

Pelvic floor therapists can help patients with the following interventions:

1) Education on proper food and fluid intake
2) Retraining of voiding habits
3) Strengthening and muscle re-education of the pelvic floor muscles
4) Strengthening Core muscles 
5) Biofeedback used to help retrain the muscles
6) Electrical Stimulation
7) Proper postural control and body mechanics
8) Education on proper home program

Benefits of Physical Therapy
* Increased bladder control
*Increased bowel control
*Decreased pain or pressure
*Restore or improve function with : less pad usage, eliminate pad usage, improve sleep, decrease or eliminate accidents, improve ability to function in the community, decrease adult isolation

Please contact us at HisTherapy if you have any questions regarding pelvic floor PT and how it can help with bladder control. 864-534-1780 or

What Does a PT Do for Urinary Incontinence

As many of you may know that a physical therapists can help people to exercises with weights to help with strengthening or they can teach someone how to use crutches after surgery to help them walk. But how can physical therapists help with bladder or bowel problems like incontinence?

The pelvic floor muscle is a skeletal muscle just like other muscles in our body and they respond to

the same training techniques. Some physical therapists have developed special skills in

training the pelvic floor muscles. These therapists are called pelvic floor therapists.

If someone wants to strengthen their biceps arm muscle they have to learn the correct

exercises. Then they perform the exercises with the correct difficulty (not too hard, not too

easy) for the correct duration of time (it takes 4 to 6 months to increase the size of a

muscle). Pelvic floor muscle training is the same. First you have to learn the correct

exercise. This is challenging as it is an inside muscle and sometimes hard to find. In

fact, 40% of people are doing the exercise wrong. The best way to tell if you are doing

the exercise correctly is by palpating inside the vagina or rectum. A trained physical

therapist can measure the muscle by palpating just inside the vagina or rectum and asking

you to squeeze. This usually not painful but gives a lot of information about the muscle

How big is the muscle?

 Can you feel the muscle?

 Is the muscle painful and tense? – it is very important to relax and this may be the primary reason exercises do not work.

 Can the muscle elevate and support the organs – especially important when the organs are sagging?

 Can the muscle squeeze tight – to stop urine leakage?

 Can you hold the contract – long enough to get to the bathroom?

 Does the belly muscle work with (or against) the pelvic muscle?

 Does the breathing work with the pelvic floor muscle?

All these things are helpful in developing the correct exercise program. In many cases

the exercises are difficult to learn and additional information is needed. EMG

biofeedback can help. This device allows you to see the muscle contraction just like the

EKG allows you to see the heart contraction. To monitor the pelvic floor muscle a sensor

is placed inside the rectum / vagina or stuck to the outside of the rectum. If the

contraction is strong the line goes up (and stays up). If the contraction is weak the line

does not go up very high and fall quickly. Seeing this can help you to activate the correct
muscles and keep them activated increasing the effect of the exercises.

A proper exercise program includes the answers these questions:

 How long to hold the contraction?

 How long to rest between? – rest is as important as hold

 How many to do at a time and how many times to do them in a day? – studies tell us that you must do more than 45 per day to get results

 What position should the exercises be done in?

 How do you breathe during the exercises?

If you want more information about this or any of our services please call us at 864-534-1780.

Preventing and Treating Stress Incontinence

Stress incontinence is a condition, usually in women, in which you involuntarily urinate when pressure in the abdomen increases suddenly, as in coughing or jumping. This tends to happen because the pelvic floor muscles have been weakened or damaged, causing the bladder to leak. The two biggest causes of stress incontinence are menopause and damage to the pudendal nerve. After menopause, women lose the added protection from estrogen that acts on the perineum by fluffing up the tissue. Additionally, in younger patients with leakage, it could be a bladder infection or excessive exercise causing the leakage. To help prevent stress incontinence, healthcare professionals recommend these three basic things, avoid constipation, be careful lifting heavy objects, and exercise with care. All of these small changes can make a big difference for your pelvic muscles and bladder leakage if you take the time to recognize them. Unfortunately, for many women while this is going on they think, “Oh, this is normal,” or are too embarrassed to say anything to their doctor, but this is no problem to push to the side. If the problem is more severe or has been going on longer, there are other treatments such as exercises, biofeedback, and electrical stimulation. All of these treatments help women learn to control their pelvic muscles and prevent stress incontinence. 

Instructions For Controlling Urinary Urge

When you experience an urge to urinate: 

First            Stop and stand very still.  Sit down if you can or stand quietly.  Do not move; try to stay                           very still to maintain control. 

Second        Quickly squeeze and let go of your pelvic floor muscles 5 to 6 times to keep from leaking.                       Use moderate to maximal effort for the exercise.  This sends a message to the bladder to                        relax and hold urine.  Try to distract yourself by thinking of something other than going                         to the bathroom. 
Third          Relax.  Take a deep belly or diaphragmatic breath and let it out slowly.  Try to make the                           urge to urinate go away by continuing with distraction techniques and positive thoughts. 

Finally       If the urge returns,  repeat the above steps to regain control. When you feel the urge                               subside somewhat,  walk normally to the bathroom.  Do not rush.   Continue to do your                           quick flicks to relax the bladder.  You can urinate once the urge has subsided.