Physical Therapy For Urinary Incontinence In Woman

By Deborah Holmes, PT

In response to a new study published in the Journal of the American Medical Association showing that pelvic floor disorders, such as urinary incontinence, affect up to one-quarter of American women, women who suffer from this widespread disorder are being urged to consider examination and treatment from a physical therapist.
Recent research has demonstrated physical therapys effectiveness at treating the symptoms of urinary incontinence. A study published in the Annals of Internal Medicine reports that pelvic floor muscle training, in conjunction with bladder training, resolved the symptoms of urinary incontinence in women. Proper preventive measures and examination and treatment by a physical therapist can help patients manage, if not alleviate, this often debilitating condition.
The study concluded that pelvic floor muscles training and bladder training resolved urinary incontinence in women, as compared to drug therapy, electrostimulation, medical devices, injectable bulking agents, and local estrogen therapy.
Taking Action
Physical therapists use a variety of methods to help patients correct pelvic floor dysfunction. The initial patient evaluation requires determining the type of incontinence (stress, urge, or both), the extent of incontinence, assessing the strength, motor control and endurance of pelvic floor muscles, and screening for any other musculoskeletal issues, then developing an individualized exercise treatment program, and making sure patients understand their role in the treatment program.
Kegel exercises, or pelvic floor muscle exercises that involve contracting, holding, and releasing pelvic floor muscles, are the most effective weapon in the fight against stress incontinence. Once patients have correctly identified these muscles, a physical therapist will train how to enhance pelvic floor muscle function, coordinate with abdominal muscle exercises and bring these exercises and awareness into functional activities. These exercises need to be brought into daily activities, and can be done when sitting at your desk or on the toilet, while driving, or at the gym.
Patients who experience stress incontinence are reminded to “squeeze as you sneeze,” or to coordinate pelvic floor and abdominal muscles before doing the activity that causes leakage, (eg, sneezing, coughing, laughing, lifting, etc). Physical therapists can also offer tips on lifestyle changes that will help make the bladder less irritable avoiding common bladder irritants, retraining the bladder, keeping a bladder diary and lifting, moving, and exercising correctly, particularly by avoiding improper sit-up techniques.