Urinary Incontinence, You Don’t Just Have to Live With It!
Are you suffering from urinary incontinence? A surprising number of people are. Do you know the “ potty dance” or the “gotta-go, gotta-go jig?” Do you cringe when you cough, sneeze, laugh or avoid stairs for fear of an unavoidable leak? If you’ve ever felt the embarrassment of urinary “leakage” or know someone who has, you’re not alone.
Urinary incontinence is most commonly believed to be age related. But, the fact is, millions of women and men, of all ages, races, and geographic locations suffer from bowel and bladder issues.
Have you spent hours searching for a cure, pondering the “Super Kegal Exerciser” or trying bulky pads, hydrogel adhesives, or the most recent pelvic floor exercises or app? If you have, then it’s likely that none of these “solutions” have provided the long lasting relief you’re searching for. In fact, some women have suffered with this affliction for so long they’ve resorted to surgery, and even that drastic measure has failed them!
Regardless of the causal factors, the good news is that effective treatments are available. Physical therapists perform treatments that do not require you to wear embarrassing and bulky diapers or pads or adhesives, and do not require dangerous and expensive surgeries.
As we age, the muscles and tissue surrounding the urethra often become weak. These tissues may also become weak during pregnancy and postpartum, or during and after menopause, when estrogen production declines. The sphincter that closes the urethra can get lax or the bladder muscle itself may lose its elasticity. Both structures may gradually lose their ability to hold against abdominal pressure placed on them by activity.
Stress Urinary Incontinence (the most common type) can occur when an activity, such as coughing or sneezing, laughing, or even galloping a horse causes urine, from a few drops to a few ounces, to leak from the urethra. For most women the urethra still does it’s job, most of the time, but even a few drops can disrupt your day, and keep you from feeling your best.
Continuous or long-term exposure to urinary leakage can also place you at risk for urinary tract infections, yeast infections, or annoying skin rashes.
There are different types of urinary incontinence, including stress, overflow, urgency, over active bladder, and functional leakage. Your physician, through urological testing, can determine your type.
Most of you have heard of the term “Kegal.” Your Kegal muscles (pelvic floor muscles) are really just a hammock or sling of muscles at the bottom of your pelvis. This sling holds your organs in place, provides support for your core muscles. It is important in sexual function, and opens and closes those important sphincters that control bowel and bladder function.
Kegal exercises are not a remedy for all incontinence related problems and can be harmful to certain physical conditions. Performing Kegals when one has pelvic pain may actually make your symptoms worse. Conversely, if performed correctly and for the right reasons, these exercises may significantly help to reduce leakage. But, see your doctor or Pelvic Health Specialist before undertaking any Kegal exercises.
As a Doctor of Physical Therapy and a Certified Pelvic Health Physical Therapist, I evaluate a variety of issues, including constipation, pelvic pain, hip pain, low back pain, tailbone pain, and many other, seemingly unrelated anomalies. During a pelvic health exam I focus on the body from the rib cage to the knees. A Pelvic Health Specialist may perform internal musculoskeletal exams and external exams to determine the cause of your weakness, pain, or dysfunction.
A Pelvic Health Specialist will take an in-depth history, observe posture, test strength, look at your spinal and pelvic structure, and evaluate sensation. Just like other skeletal muscles, the pelvic floor can get bound up, spasm, or be too relaxed. The pelvic floor muscles need to be able to contract and relax, just like lifting a weight with your arm to strengthen then lengthen your bicep.
My friend Julia agreed to share her “tinkle tale:” Julia is a 62 year old active female. She loves going to Yoga and Zumba and is sexually active. While practicing Yoga, Julia was performing her “downward dog” position when she was startled by a “whoops moment.” She’d leaked urine for the first time since she was pregnant, forty years ago. Julia decided she would prepare for her next yoga session by wearing a protective pad.
Much to Julia’s surprise, not only did she leak during her “downward dog,” but also during other poses. The light protective pad was inadequate. As Julia continued with her yoga she became more frustrated. As the problem worsened, she eventually quit Yoga and gym exercise altogether.
Her primary care physician referred Julia to a Pelvic Health Physical Therapist who discovered that Julia had a small bladder prolapse that was interfering with her ability to contain the flow of urine when abdominal pressure was high, and that her pelvic floor muscles had become weak.
After six weeks of focused physical therapy, appropriate exercises, learning about bladder irritants in the diet like citrus, spicy foods, artificial sweeteners, tomato based products, and learning some healthy bowel and bladder habits, Julia was able to return to her full fitness program. Julia’s intimacy with her husband has also blossomed and she is once again active!
As we transition from cold and flu season to allergy season, abdominal pressures from coughing and sneezing can become worse. But, treating pelvic floor dysfunction can be “Easy Pees’y.” You don’t have to live with “Aw Chew…Whoops” any longer.
Be happy to know that non-surgical help is available and can be fun! If you are having any type of incontinence, pelvic pain, or just plain not feeling well “down there” talk to your doctor or seek out a Pelvic Health Specialist to guide you back to feeling strong and confident.
Don’t give up your exercise or activities and don’t shut yourself in due to fear of embarrassment. Take charge of your life and educate yourself about the helpful benefits and options available.
by Dr. Karla J. Gowan, PT, DPT, PCC, PRPC
Dr. Karla J. Gowan earned her Doctorate (DPT) in Physical Therapy from the University of St. Augustine in Florida in 2003. Adding this extra curriculum afforded her a certification in Primary Care PT. Preceding her Doctorate, she received a Master’s Degree in Physical Therapy from Idaho State University in 1997 and a Bachelor’s Degree in Health Sciences from Boise State University in 1995. Her most recent accomplishment in 2013 is a certification in Pelvic Health from the Pelvic Rehabilitation Institute. Dr. Gowan has been a member of Newport Hospital and Health Services Rehabilitation Team since 2006.