Do you have or have you had difficulties controlling your bladder?

Urinary incontinence (UI) is a common symptom that can affect women of all ages, with a wide range of severity and nature. UI is any involuntary or accidental loss of urine. Whilst it is common, it doesn’t need to be your normal.

There are several subtypes of UI. The three most common in females are stress, urgency and mixed urinary incontinence. Stress urinary incontinence (SUI) is the complaint of involuntary loss of urine on effort or physical exertion (eg sporting activities) or on sneezing or coughing. Urgency urinary incontinence (UUI) is the ‘complaint of involuntary loss of urine associated with urgency’. Mixed urinary incontinence is a combination of SUI and UUI.

Reports estimate that UI is prevalent with stress UI accounting for more than two-thirds of cases. Many women ‘put up’ with their symptoms because they think it is normal or ‘not bad enough’ to seek help. Remember incontinence is not normal and there is help available.

Incontinence can have long-term physical and emotional impact; affecting quality of life, self-esteem, motivation and independence. Several studies have shown that women with UI change their movement pattern and withdraw from physical activity. If woman are stopping exercise because of their incontinence that can create a variety of other health problems.

Risk factors for UI are age, high body mass index, number of children (parity) and mode of delivery (with vaginal birth being the most significant). Interesting to note also, is that UI is also high amongst young, female athletes who have not had children.

The good news is that there is help available. A women’s pelvic health physiotherapist can help you to improve your bladder control. A pelvic health physiotherapist can offer thorough assessment and management strategies including lifestyle modifications, pelvic floor exercises and bladder training. There is strong evidence (Level 1) that pelvic floor exercises should be the first-line treatment for urinary incontinence in females. At your pelvic health appointment your physiotherapist Eleni can check that you are doing your pelvic floor activation correctly and start you on an appropriate exercise program. Education is a big part of treatment and you can learn little tips that can make a big difference.

So why are the pelvic floor muscles so important? The pelvic floor muscles are the base of a group of muscles called
the core. The floor of the pelvis is made up of layers of muscle and other tissue. These layers run like a hammock from the pubic bone at the front to the coccyx (tailbone) at the back, and from one ischeal tuberosity (sitting bone) to the other (side to side). The pelvic floor muscles are normally firm and thick.

The pelvic floor muscles have numerous functions (as described by The Continence Foundation of Australia). The pelvic floor muscles give you the ability to control the release of urine (wee), faeces (poo) and flatus (wind) and to delay emptying until it is convenient.

When you contract the pelvic floor muscles, they lift the internal organs of the pelvis and tighten the openings of the vagina, anus and urethra. Relaxing the pelvic floor allows passage of urine and faeces.

Pelvic floor muscles are also important for sexual function in both men and women. The pelvic floor muscles in women also provide support for the baby during pregnancy and need to be relaxed during the birthing process.

Here are some things you can do to help yourself.

  • Drink well
  • Eat well
  • Try to maintain an ideal body weight
  • Get active or keep active
  • Do your pelvic floor muscle exercises regularly (a thorough assessment will be able to tell if you are doing them correctly. In some people these muscles can be working too much and they need to learn how to relax their pelvic floor muscles, whilst in others the muscles aren’t working enough)
  • Practice good toilet habits, avoiding constipation and straining, and not going to the toilet out of habit.

 

Plenty can be done to improve or in some cases cure incontinence. Start making some of the changes suggested above and consider seeing your local pelvic health physio to get back on track. The Continence Foundation of Australia’s website also has a lot of useful information and is a great resource.

Eleni Cody

Women’s Health Physiotherapist

Eleni Cody