By: Elizabeth Yates, PTA, CFPS
What is incontinence?
Incontinence is the unintentional passing of urine or bowel. It is very common, and affects over 33 million Americans with over 75% of them being women. There are several types of incontinence, but the most common is stress incontinence, which affects about 15 million women in the U.S. This occurs when urine leaks out when the bladder is under pressure (stress); for example, when coughing or laughing. Leakage occurs when the pressure inside the bladder becomes greater than the strength of the outer muscles that keep the urethra closed.
What causes incontinence?
The most common cause is pelvic floor muscle weakness. This can be caused by damage to the muscles during childbirth, particularly if the child was born vaginally; increased pressure on the bladder due to pregnancy or obesity; damage to the bladder or nearby area during surgery, such as a hysterectomy; or associated straining from chronic constipation. Neurological conditions that affect the brain and spinal cord, connective tissue disorders and/or certain medications can also cause incontinence symptoms.
What are the pelvic floor muscles?
The pelvic floor muscles span from the pubic bone to the tailbone and act like a hammock to support the pelvic organs: uterus, bladder and rectum. When these muscles are weak, it can cause incontinence. Just like other muscles in the body, these muscles can be strengthened, which can help reduce frequency and severity of accidental leaking. Strengthening the pelvic floor muscles is a conservative way to help treat incontinence.
How to strengthen the pelvic floor?
- Find the right muscles: Identify the pelvic floor muscles by stopping urination midstream. If there is significant pelvic muscle weakness, this will be difficult, but this will help cue tightening of the proper muscles. Stopping urination midstream is a helpful way to identify the proper muscles, but is not recommended to perform repeatedly, so only do this in order to feel the proper muscles initially.
- Perfect the technique: Imagine sitting on a marble and tighten the pelvic muscles as if lifting the marble. Perform both contractions below to work on both slow and fast twitch muscle fibers of the pelvic floor.
- Maintain Focus: Tighten only the pelvic floor muscles. Be careful not to flex the muscles of the abdomen, thighs, or buttocks. Remember to breathe regularly while contracting the muscles.
- Slow contraction: Slowly tighten the muscles to a count of five, hold for 10 seconds, then slowly release for a count of five. Depending on the severity of weakness, holding fewer seconds may be appropriate to begin, then gradually increase as strength improves. Repeat for 10-15 repetitions.
- Quick contraction: Strongly contract and relax the muscles for one second each. Repeat rapidly for 10-25 repetitions.
- Repeat both exercises three times a day. Aim for 50-100 repetitions throughout the course of the day. If you are quickly fatigued, perform less repetitions at one time and do them more often throughout the day.
- Make them a Habit: Make these exercises part of a daily routine. These exercises can be performed in any position and discreetly at any time of the day.
- Be Diligent and Patient: With regular performance of these exercises, expect to see results within a few weeks to a few months, depending on severity. It is important to be consistent for optimal results.
Positive lifestyle changes can also be helpful in treating this condition. Weight loss decreases extra pressure on the bladder; and diet changes, such as increasing fiber intake, can help with preventing chronic constipation. Additionally, avoiding bladder irritants and drinking plenty of water are helpful for bladder health. Irritants can include dairy, caffeine, carbonated beverages, acidic drinks/foods (i.e. citrus) and more.
This information is for educational purposes and does not replace provider’s consultation. Be sure to speak with your provider regarding any concerns and to discuss treatment options.