Physical Therapy Offers Help for Urinary Incontinence

Appropriate physical therapy can help patients address urinary incontinence

A middle-aged woman smiles in an indoor environment with open window and greenery visible in the background

Urinary incontinence, or involuntary loss of bladder control, isn’t something that just happens to older patients.

In fact, the condition affects men and women both old and young. According to the National Association for Continence (NAFC), more than 25 million Americans experience urinary incontinence, which can leave them feeling ashamed, socially isolated, and depressed.

Urinary incontinence is not a disease; rather it is a symptom. In many cases, urinary incontinence is due to weak muscles in the pelvic floor, which help support the bladder to hold urine in until you can get to a bathroom.

Incontinence and the pelvic floor

The pelvic floor is a combination of muscles, ligaments and connective tissues that support the pelvic organs, including the bladder, vagina, uterus, prostate and rectum. These muscles may be weakened by a number of factors, including pregnancy, childbirth, surgery, heavy lifting, effects of aging, obesity, and chronic medical and neurologic conditions.

If the pelvic floor muscles are weak, the bladder may not be adequately supported, and urinary incontinence can result.

Symptoms of pelvic floor disorders

In addition to urinary incontinence, other symptoms of pelvic floor disorders include:

  • Difficulty sitting
  • Pain with sexual intercourse
  • Lower back & abdominal pain
  • Rectal and vaginal pain

A recent study published in the Journal of the American Medical Association found that pelvic floor disorders affect up to one-quarter of American women. Fortunately, new research has shown that physical therapy treatment can help resolve symptoms of urinary incontinence in women.

A 2008 study published in the Annals of Internal Medicine reported that pelvic floor muscle training, in conjunction with bladder training, helped treat the symptoms of urinary incontinence in women. The study, which included 96 randomized controlled trials from 1990 through 2007, concluded that pelvic floor muscle training and bladder training resolved urinary incontinence in women more effectively than other treatments, including drug therapy, medical devices, estrogen therapy and others.

As a result, the American Physical Therapy Association’s (APTA) Section on Women’s Health is urging women who experience pelvic floor disorders to consider examination and treatment from a physical therapist.

Prevention, examination and treatment

According to APTA, proper preventive measures, along with examination and treatment by a physical therapist who has completed specialized training to address pelvic floor muscle dysfunctions, can help patients manage, if not alleviate, this often debilitating condition.

The most effective weapon in the fight against pelvic floor disorders are Kegel contractions, or exercises that involve contracting, holding, and releasing the pelvic floor muscles. Once patients have correctly identified these muscles, a physical therapist will train them how to enhance pelvic floor muscle function and how to incorporate the exercises into functional activities.

Pelvic floor exercises can be done easily throughout the day and in different positions to enhance strength development. For those with very weak muscles, the exercises are best performed while lying down.

Physical therapists can also offer tips on lifestyle changes that will help make the bladder less irritable, such as avoiding common bladder irritants, retraining the bladder and lifting, moving, and exercising correctly.

Scripps Health pelvic floor physical therapy team

At Scripps Memorial Hospital La Jolla, our pelvic floor physical therapy team has completed extensive training to treat all pelvic floor conditions. Our therapists utilize a variety of techniques as well as education to ensure each patient’s needs are addressed. All pelvic floor treatments are conducted one-on-one in a private setting.

If you experience urinary incontinence or believe you have a pelvic floor disorder, make an appointment with your physician. He or she can refer you to a physical therapist for treatment.

This Scripps Health and Wellness information was provided by Natalie Herback, DPT, CLT, physical therapist with Scripps Memorial Hospital La Jolla and a member of the APTA Section on Women’s Health.