Urinary Incontinence: Can Pelvic Floor Exercises Help?

Do you ever feel a slight discharge of urine, or struggle to ‘hold it’ before reaching the toilet? Then you may be one of the thousands who suffer from a common condition called urinary incontinence. It is thought some 37% or 4,440,000 women in Australia experience urinary incontinence.

Many who experience ‘incontinence’ feel too ashamed or embarrassed to discuss it. Indeed only 31% of sufferers report actually having sought professional help for the condition. Yet with appropriate guidance and support from a qualified women’s physiotherapist such as The Brisbane Spine Clinic, incontinence can be well managed through a combination of treatments including pelvic floor exercises.

Forms Of Urinary Incontinence

Urinary incontinence is frequently associated with pregnancy and childbirth, menopause or a range of chronic conditions such as asthma, diabetes or arthritis. Its severity can range from an occasional leak when you cough, laugh, lift or exercise to an inability to control your bladder, which may cause you to wet yourself.

Today, four primary forms of incontinence are recognized, each with several potential causes:

1. Stress Incontinence
   Stress incontinence in women is often caused by pregnancy and childbirth, which can stretch and weaken the pelvic floor muscles triggering stress incontinence during activities that push down on the bladder. During menopause, oestrogen is produced in lower quantities. Oestrogen assists in maintaining the thickness of the urethra lining which keeps the urethra sealed after passing.Other contributing factors include diabetes, chronic cough associated with smoking, asthma, or bronchitis, constipation and obesity.
2. Urge Incontinence
   Urge incontinence is not well understood however it appears more common as we age. Symptoms can worsen due to stress and with the intake of caffeine in tea, coffee and soft drinks and by alcohol.
   Urge incontinence may also surface as a result of constipation, or a history of poor bladder habits.
3. Incontinence Associated With Chronic Retention
   When the bladder doesn’t empty properly, frequent leakage of small amounts of urine can occur. Causes include:
   • A urethra blockage created by a full bladder
   • Prolapsed pelvic organs
   • Damage to the nerves controlling the bladder, urethral sphincter or pelvic floor muscles
   • Diabetes, stroke, Parkinson’s disease or multiple sclerosis as these problems can interfere with the sensation of a full bladder
   • Certain medications including over the counter medications and some herbal products.
4. Functional Incontinence
   This form of incontinence concerns physical, intellectual or environmental issues that can contribute to incontinence in someone with normal bladder function.
   • Being unable to walk to the toilet
   • Toilet is hard to get to or use
   • Lack of handrails or good lighting making going to the toilet difficult
   • Not being able to get to the toilet unaccompanied.

Indications You May Have Urinary Incontinence

After urinating do you sometimes feel you haven’t emptied your bladder completely?

• Do you get sudden urges to use the toilet?
• Do you sometimes worry about losing control of your bladder?
• Do you need to get up twice or more at night to use the toilet?
• Do you sometimes experience leakage before you get to the toilet?
• Do you sometimes leak when lifting, sneezing, laughing or coughing?
• Do you sometimes leak when exercising or playing sport?

If you answered ‘Yes’ to any of these questions you may have a bladder control problem.

Seek Professional Help

Obtaining professional help from a qualified physiotherapist is strongly recommended. Studies indicate up to 50% of women who try Kegel Exercises from a brochure get the technique wrong. This can potentially further weaken the pelvic floor muscles.

Pelvic Floor And Kegel Exercises

The pelvic floor muscles comprise of an essential support sling inside the pelvis. It is important to increase your pelvic floor muscles (PFM) strength and endurance to promote bladder control.

Exercises to strengthen the gluteal muscle are also highly recommended as they help your pelvic floor muscles operate correctly while helping to support the pelvis and sacrum.

Studies by Patricia Neumann show 84% of women with stress urinary incontinence see positive results with PFM training after five physiotherapy sessions.

5 Ways To Prevent Urinary Incontinence From Becoming Worse

There are five simple ways that may help prevent urinary incontinence from becoming worse

1. Do regular pelvic floor exercises
2. Include more fibre in your diet as constipation is a recognised cause of urinary incontinence
3. Maintain a healthy weight
4. Reduce your intake of caffeine, acidic foods and alcohol
5. If you smoke, stop!

Final Observation

Urinary incontinence can have multiple causes but it can be treated. Have a confidential conversation with Caroline who is Brisbane Spine Clinic’s women’s physiotherapist about the benefits of physiotherapy for urinary incontinence. Don’t feel embarrassed or uncomfortable to discuss it. If urinary incontinence lingers or is impacting on your quality of life, it is important to seek medical advice.

*Please note, content within this article is for educational purposes only and treatment and advice mentioned may not be suited for everyone. Please consult a team member at the Brisbane Spine Clinic or your General Practitioner for specific advice.