What is urinary Incontinence?
Urinary incontinence, the involuntary loss of urine, is one of the more common conditions that can be managed with the help of pelvic floor physiotherapy, and it’s not just Kegel’s! Leakages can occur during physical exertion, jumping jacks, lifting, coughing, sneezing and even laughing. It can affect women of all ages! Therefore, whether you are a young gymnast, pregnant, an aging woman experiencing hormonal changes such as menopause, it is not uncommon to experience episodes of incontinence, increased urinary frequency, and even urinary urgencies. If you have experienced these symptoms, you are not alone:
According to the International Consultation on Incontinence, occasional leakage affects 25%-45% of all adult women.
Urinary leakage, a taboo?
There are at least 3.3 million Canadians who have urinary incontinence and only 1 in 4 people have discussed it with their doctor. Why people don’t talk to a healthcare professional about it? This may be due to embarrassment, the thought that leaks are normal, as well as a lack of resources and knowledge. This suggests that the amount of people experiencing incontinence could be even greater for these reasons.
Urinary incontinence is not a normal part of aging!
Menopause changes that occur in women as they get older may contribute to incontinence, but that doesn’t mean you just have to live with it. Almost all cases of urinary incontinence can be improved with treatment. Even if your problems have existed for a long time or your pregnancies date back several years, pelvic floor rehabilitation will often be effective in improving your daily life.
Urinary incontinence also affects athletic women
High-impact sports increase the pressure exerted on the pelvic floor. If the muscles of the “CORE” (abdominal, lumbar, pelvic floor and, the diaphragm) are unable to manage the increased intra-abdominal pressure, it can result in urinary incontinence.
| Rate of urinary incontinence according to sports | |
| Pilates | 26% (Bo, 2011) |
| Fitness | 27% (Bo, 2011) |
| Basketball | 42% (Jacome, 2011) |
| Cross Country | 46% (Poswiata, 2014) |
| Elite Dancing | 52% (Thyssen, 2002) |
| Jogging (Endurance) | 62% (Araujo, 2008) |
| Volleyball | 66% (Schettino, 2014) |
| Trampoline | 73-80% (Da Roza, 2015; Eliasson, 2002) |
So, what about pregnant women?
Urinary incontinence is very common during pregnancy and post-partum, but that doesn’t mean there is nothing you can do about it. Pelvic floor muscle training is the first line of treatment for pregnant and post-partum women presenting with urinary incontinence. Start early with a pelvic health assessment during the pregnancy, which has been shown to prevent and reduce urinary incontinence in post-partum. The International Consultation on Incontinence recommends pelvic floor exercises in the prenatal period:
Continent women doing appropriate pelvic health exercises as early as week 20 of pregnancy were less likely to experience urinary incontinence:
- 56% less at the end of pregnancy
- 50% less after childbirth
- 30% less than three to six months after childbirth
Pelvic Health Physiotherapy: More than just Kegel’s!
While effective in strengthening the pelvic floor, 1 in 2 women would not do their Kegel (pelvic floor muscle) exercises properly.
Every woman is different, some need strengthening, some need relaxation, while others need specific coordination exercises, without straining or using compensatory muscles! Posture, movement patterns, and management of intra-abdominal pressure are controlled by the “CORE” (the muscles of the pelvic floor, abdominals, back and the diaphragm).
So, even if you strengthen your pelvic floor, without a proper assessment and treatment of your condition, the pressure will be directed to the weaker part of the “CORE” and can result in incontinence, diastasis or pain.
How to prevent these leaks as naughty as surprising?
Pelvic floor rehabilitation can prevent and treat urinary incontinence. It aims to normalize the strength, tone, flexibility, and coordination of the pelvic floor muscles.
Without being limited to the perineum, a comprehensive approach considers the adjacent joint and muscle structures, such as the sacroiliac joint, the hips, the “CORE”… The posture, the breathing pattern, the management of intra-abdominal pressure, adhesions or scarring of the abdomen, and functional movements are elements assessed during a pelvic floor physiotherapy consultation.
If you have any questions, please call or email Kimberly!
Kimberly Lessard, MPT, Physiotherapist
kimberly.lessard@kokaneephysiotherapy.com
Tel: (250) 352-7030