Written by Roshni Ravi, Pelvic Health Physiotherapist
Stress incontinence is a type of urinary incontinence that occurs with physical activity or exertion. This can be from coughing, sneezing, laughing or exercise e.g. jumping. All of these actions can put pressure on the bladder thereby causing leaks. The pelvic floor is important in preventing this leaks and supporting the bladder.
Pelvic floor exercises such as a kegel are commonly recommended for leaks. However, a lot of time the pelvic floor is actually tight rather than weak. Reverse Kegels involve relaxing the pelvic floor muscles, allowing them to lengthen and release tension. This helps to prevent over-tightening and over-activity of the pelvic floor muscles, which can contribute to stress incontinence.
Hypertonic pelvic floor
Hypertonic pelvic floor refers to a condition where the pelvic floor muscles are in a state of excessive and persistent contraction. This can lead to a number of symptoms, including pelvic pain, urinary and fecal incontinence, and sexual dysfunction.
Hypertonic pelvic floor can be caused by a number of factors, including pregnancy, childbirth, surgery, chronic constipation, and chronic pelvic pain. It can also be a result of excessive or improper use of pelvic floor muscle exercises, such as Kegels.
Treatment for Hypertonic pelvic floor
Treatment for hypertonic pelvic floor typically involves a combination of physical therapy and relaxation techniques. Physical therapy may include manual therapy to release muscle tension, as well as exercises to stretch and relax the pelvic floor muscles. Relaxation techniques, such as deep breathing, progressive muscle relaxation, and biofeedback, can also be helpful in reducing muscle tension.
If you’re experiencing leaks, reach out to a pelvic floor therapist for an assessment or discovery call!
FAQ’s about Stress Incontinence
Q: What is stress incontinence?
A: Stress incontinence is a type of urinary incontinence that occurs when pressure is placed on the bladder, such as during coughing, sneezing, laughing, or exercising, and causes involuntary urine leakage.
Q: What causes stress incontinence?
A: Stress incontinence is typically caused by weakened pelvic floor muscles and/or a weakened urethral sphincter, which can occur due to aging, pregnancy and childbirth, menopause, obesity, chronic coughing, or certain medical conditions.
Q: Who is at risk for developing stress incontinence?
A: Women are more likely to develop stress incontinence than men, especially those who have gone through pregnancy and childbirth, menopause, or pelvic surgery. Other risk factors include obesity, chronic coughing, and certain medical conditions that affect the bladder or nervous system.
Q: How is stress incontinence diagnosed?
A: Stress incontinence can be diagnosed through a physical exam, a urine test, and other tests such as a bladder diary or urodynamic testing.
Q: What are the treatment options for stress incontinence?
A: Treatment options for stress incontinence may include:
- pelvic floor exercises,
- behavioral therapies,
- medications,
- medical devices such as pessaries, and in some cases,
- surgery.
Q: Can stress incontinence be prevented?
A: While stress incontinence may not be completely preventable, there are steps you can take to reduce your risk. Maintaining a healthy weight, doing regular pelvic floor exercises, and avoiding smoking and excessive caffeine consumption are some of these.
Q: Is stress incontinence a normal part of aging?
A: While stress incontinence is more common in older adults, it is not a normal part of aging and should not be ignored or accepted as an inevitable consequence of getting older. Treatment options are available, and seeking help from a healthcare provider is important.
Written by Roshni Ravi, Pelvic Health Physiotherapist
Constipation is a common gastrointestinal (GI) disorder that causes difficulty with passing stool or reduces the frequency of having a bowel movement. It can be caused by different factors such as dehydration, diet e.g. not enough fibre, or a sedentary lifestyle. However, there are other possible underlying muscular reasons for constipation.
The pelvic floor can be a common culprit for constipation. The pelvic floor is a group of muscles that support the pelvic organs such as the uterus, bladder and rectum. These muscles are important in daily function, which includes bladder and bowel control. They can be either tight or weak which can lead to a variety of issues, one of them being constipation.
Weak pelvic floor muscles can lead to decreased rectal tone and difficulty with evacuating stool, thereby resulting in constipation. Pelvic floor muscle dysfunction can also influence the urgency to have a bowel movement. If there is reduced tone in the muscles, they may not sense the urge to defecate making it more difficult to have regular bowel movements. The opposite could also happen where there is increased tone and it causes an increased urge to have a bowel movement.
Treatment for constipation can include a number of lifestyle modifications such as increased fibre and water intake, and regular exercise. However, consulting with a pelvic physiotherapist can improve outcomes, by creating an exercise program specific to your pelvic floor dysfunction. The need for lengthening versus strengthening of the pelvic floor is determined through internal examination. Another option is seeing a naturopath for ways to adjust your diet accordingly. Quite often, both treatments go hand in hand.
Experiencing constipation or constipation like symptoms? Book a consultation with one of our pelvic physiotherapists today!
FAQs
Q: What is constipation?
A: Constipation is a condition characterized by difficulty in passing stools or infrequent bowel movements.
Q: Can pelvic health physiotherapy help with constipation?
A: Yes, pelvic health physiotherapy can help with constipation by addressing the underlying musculoskeletal and neurological issues that may be contributing to the condition.
Q: What are some of the common causes of constipation?
A: Common causes of constipation include poor diet, lack of exercise, dehydration, certain medications, and underlying medical conditions such as irritable bowel syndrome (IBS).
Q: How does pelvic health physiotherapy address constipation?
A: Pelvic health physiotherapy uses a variety of techniques, including manual therapy, exercises, and biofeedback, to improve pelvic muscle function and coordination. By improving pelvic muscle function, constipation can be reduced or eliminated.
Q: What is biofeedback and how is it used in pelvic health physiotherapy?
A: Biofeedback is a technique used to help patients become more aware of their body’s responses to different stimuli. In pelvic health physiotherapy, biofeedback is often used to help patients learn to relax and contract their pelvic muscles effectively.
Q: How long does it take to see results from pelvic health physiotherapy for constipation?
A: The length of time it takes to see results from pelvic health physiotherapy for constipation depends on the severity of the condition and the individual patient. In some cases, patients may see improvement after just a few sessions, while in other cases it may take several weeks or months to see significant improvement.
Q: Are there any risks associated with pelvic health physiotherapy for constipation?
A: Pelvic health physiotherapy is generally considered safe and effective, but as with any medical treatment, there is always a small risk of side effects or complications. Patients should discuss any concerns or questions with their healthcare provider.
Did you know children can benefit from pelvic physiotherapy too?
Most children are dry at night by school age. Approximately, 30% of children wet the bed at 4 ½ years of age. Fecal incontinence is also common in children. If a child has regular soiling or poo accidents after the age of 4 they should be assessed.
There is no cause to worry. Pelvic Health issues in children can be resolved with the help of a trained pelvic health physiotherapist.
Common conditions experienced by children include:
Constipation: infrequent bowel movements, frequent movements with pain or difficulty
Incontinence: inability to maintain bowel or bladder function. Could be inability to make it to the bathroom in time or leakage with giggles and coughing
Bed Wetting (Enuresis): leaking urine through the night while sleeping.
Voding issues (eg. Dysfunctional voiding & postponement): inappropriately engaging pelvic floor muscles during voiding or delaying going to the bathroom, sometimes as a result of fear or pain.
Did you know 85% of children have bed wetting or fecal incontinence because of constipation?
If your child is 5 or older and experiencing any of the above symptoms pediatric Pelvic Floor Physiotherapy can help them get back to being kids, and relieve familial stress!
Our trained therapists create a personalized treatment plan with parents and children to better target your concerns and furthermore improve your child’s overall quality of life. Treatment is always in a way that is fun and engaging for your young one.
What does a pelvic floor assessment entail?
Your physical therapist will start by taking a detailed child developmental and family history. We may also ask you to complete a bladder diary to better track your child’s voiding patterns and perform a functional assessment of their breathing. Thereafter, the physiotherapist will do a visual assessment for which the child need not undress. Sometimes, the physiotherapist will use externally placed sensors to assess the functioning of the pelvic floor muscles.
Note: An internal assessment is not performed.
What does the pelvic floor treatment entail?
- Education dietary foods/irritants, habit training, digestion, pelvic floor anatomy
- Biofeedback machines using Bluetooth to keep children engaged playing games with the aid of their pelvic floor muscles.
- Electrical Stimulation
- Toilet training
- Massage
Which locations of Triangle Physiotherapy offer Pediatric Pelvic Health in Toronto?
Pediatric Pelvic Floor Physiotherapy is offered at Triangle Physiotherapy North York, Triangle Physiotherapy Mississauga and Triangle Physiotherapy Lawrence Park.
Click here to book an appointment for your child.
Pelvic Floor Physiotherapy for Women
Did you know:
- 1 in 5 women who have had a baby suffer from poor bladder and bowel control
- 1 in 2 experience pelvic organ prolapse
- 1 in 5 suffer from pelvic or sexual pain
- Most physical activity will engage your Pelvic Floor Muscles
Also read, Physiotherapy Clinic in Etobicoke
Pelvic Floor Muscles
In order to better understand what happens in muscular dysfunction, it is important to first understand the normal function of these muscles, as well as other muscles that they work with. The Pelvic Floor Muscles are part of a group of muscles that are collectively referred to as your “core” muscles. This muscle group is composed of 4 distinct but linked group of muscles:
- Pelvic Floor Muscles
- Diaphragm
- Abdominal Muscles
- Lower Back Muscles
Also read, Physiotherapy Oakville
The Pelvic Floor muscle group is located at the base of the core. It is an important muscle group that works with the rest of the core to maintain pressure inside the torso when lifting heavy objects, coughing/sneezing or doing any other physical activity involving your lower back muscles. Some of the most important functions of the Pelvic Floor Muscles are:
- Maintaining control of the bowel and bladder in order to control leakage
- Holding up and supporting the bowel, bladder and in case of women, uterus
- Playing an important role in sexual function
Pelvic Floor Muscles are located within the pelvic cavity and attach from the front to the pubic bone to the back to your tail bone or coccyx.
Also read, Physiotherapy treatment Mississuaga
Pelvic Floor Dysfunctions in Women
For women, the Pelvic Floor holds additional importance as it is the group of muscles that handles enormous pressure during pregnancy. The ever-increasing weight of a child puts a strain on the pelvic muscles and the bladder, leading to frequent urination. As such, pelvic floor discomfort is quite common in women that are pregnant.
Advantages of Pelvic Physiotherapy for Women
Pelvic Floor Physiotherapy helps in the treatment and prevention of:
- Pelvic and bladder pain
- Painful intercourse
- Urinary leakage, frequency or urgency
- Post-pregnancy related problems
- Abdominal pain
What Do We Treat and How Do We Treat It?
At Triangle Physiotherapy, our Pelvic Health Physiotherapists can help treat:
- Vaginal Pain Syndrome (as a result of pelvic dysfunction)
- Pelvic Floor Dysfunction
- Pelvic Organ Prolapse
- Urinary Conditions
- And many more conditions!
Our assessments include:
- A thorough, 1-hour detailed history of your health issues, and specifically your pelvic issues
- A brief internal and external examination
Our treatments involve:
- Individualized treatment sessions that are 30 – 45 minutes in duration
- Generally, 4 – 8 treatments at a frequency of 1x/week* (varies from patient to patient) is recommended to best address your symptoms
If you’re a woman suffering from any of these conditions or are expecting a baby and would like to have healthy pelvic muscles, book an appointment today at any one of our 8 clinics in Etobicoke, Oakville, Mississauga (Square One), Mississauga (Erin Mills), North York, Toronto (King Street) Toronto (Queens Quay) and Toronto (Yonge Street).
Pelvic Floor Disorders are a common occurrence but the treatments available for pelvic floor dysfunction are not widely known. Pelvic Floor Physiotherapy has been proven to help with Pelvic Floor Dysfunction and this is where we come in! Triangle Physiotherapy has state-of-the-art facilities with private rooms for pelvic health treatments. Your comfort is our priority while addressing this sensitive issue.
Pelvic Floor Muscles & Pelvic Floor Dysfunction
The pelvic floor is made up of layers of muscles and other tissues. These muscles are stretched end to end from the tailbone to the pubic bone. Sometimes these muscles tend to lose their normal control and cause pelvic floor dysfunction.
Also read, Physiotherapy Clinic in Etobicoke
What causes Pelvic Floor Dysfunction?
Pelvic Floor Dysfunction can be caused by any of the following two conditions:
- Hypotonicity – When the pelvic floor muscles become weak and are unable to continue proper functioning, they cause stress incontinence, urge incontinence and pelvic organ prolapse (when a pelvic organ drops from its normal position).
- Hypertonicity – When the pelvic floor muscles become tight, leading to urinary and fecal urgency, urge incontinence, chronic pelvic pain, etc., the condition is known as pelvic floor dysfunction.
Also read, Physiotherapy Treatment in Oakville
What Do We Treat?
We treat a variety of Pelvic Floor Dysfunctions such as:
Conditions in Males
- Post-Prostatectomy Incontinence
- Pelvic Pain
- Pelvic Floor Dysfunction
Conditions in Females
- Pelvic Organ Prolapse
- Vaginal Pain Syndrome
- Urinary Conditions
- Pelvic Floor Dysfunction
Musculoskeletal Conditions
- Lower Back Pain
- Groin/Pubic Pain
- Sacroiliac Pain
- Piriformis Syndrome
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Rectal & Bowel Conditions
- Constipation
If you suffer from any of the above-mentioned conditions, you should consider booking an appointment at any one of our 6 clinics in Etobicoke, Oakville, Mississauga, North York, Toronto (King Street) and Toronto (Yonge Street).
How can Pelvic Physiotherapy help me?
Pelvic Floor Physiotherapy can help you with:
- Pelvic exercises to gain bladder and bowel control.
- Exercises to regain normal muscle strength and tone.
- Manual Therapy techniques to help you locate & work your weak pelvic floor muscles.
- Tips on good postures.
- Identification of other problem areas that might need physiotherapy treatment.
- Appropriate lifestyle guidance and recommended changes.
Pelvic Physiotherapy is an effective treatment for solving Pelvic Floor Dysfunction and we Triangle Physiotherapy, our Pelvic Physiotherapists will help you get back to doing the things you love.
It is always an inconvenience when our bodies don’t perform the way we want them to. It is especially worrisome when we don’t understand why we aren’t feeling at our best. Many times, the feeling of being “off” can be attributed to a vestibular problem. Vestibular disorders can affect a person in numerous ways, and often without any pattern. The vestibular system includes the parts of the inner ear and brain that help control balance and eye movements. It consists of five sensory organs that provide our brain with information about head position and movement.
People with vestibular disorders often experience problems with vertigo, dizziness and visual disturbance. Although dizziness & vertigo can occur in people of any age, it is more common amongst older adults. The feeling of dizziness can be tough to manage and might cause someone to restrict their physical activities and social engagements in order to prevent an injury from a fall. Other typical, secondary problems that can arise from vestibular disorders are nausea/vomiting that reduced the ability to focus or concentrate, and fatigue.
Evidence has shown that vestibular rehabilitation can be effective in improving symptoms related to many vestibular disorders. Symptoms due to vestibular disorders can reduce the quality of life and slow down all aspects of our daily routine.
Also read, Physiotherapy Clinic in Oakville
Some common symptoms are:
- Dizziness and imbalance
- Decreased in muscular strength and flexibility
- Increased joint stiffness
- Reduced on stamina
- Vision disturbance
- Hearing changes
- Psychological changes
Diagnosis and treatment are not always the only solution for vestibular disorders. It is important to understand some common, significant limitations in order to better manage them.
Also read, Physiotherapy Mississauga
Some common limitations are:
- Balance is commonly taken for granted until it is impaired
- People with vestibular disorders can suffer cognitive impacts, such as poor concentration, memory, and word recall
- People also restrict their movement and activity level to avoid pain
It is important to note that most of these symptoms can also be caused by other conditions and should be discussed with a healthcare professional or a skilled physiotherapist. At Triangle Physiotherapy, with the help of our skilled team of physiotherapists, your vestibular issues can become a thing of the past!
Incontinence can be a fairly sensitive or embarrassing subject to those who suffer from it. Incontinence is the involuntary loss of urine or faeces from the bladder and bowel. But know this, incontinence is an ACCIDENT, it is something that is uncontrollable and can happen to any expecting mother. Urinary incontinence affects around 10-13 million men and women, and it is twice as common in women as men. Anthony Atala, MD, said, “I would say virtually all pregnant women experience some type of incontinence”. Incontinence should not rule your pregnancy or your life.
Pregnancy can interfere with the normal way your urethra relaxes and contracts. You are able to urinate when the muscles around your urethra relax, allowing urine to pass through your bladder and out of your body. After urination, your muscles around your urethra contract, holding off urine flow until your body is ready to urinate again. Hormone changes during pregnancy and the additional pressure on the bladder from your uterus can cause stress incontinence. Mothers who are experiencing stress incontinence may urinate whilst sneezing, walking, coughing, laughing, running, and during exercise. Women who have a family history of incontinence, gain more weight than recommended during pregnancy, and are over the age of 35 are at higher risk of experiencing incontinence.
There are numerous ways to avoid pregnancy incontinence, along with visiting a pelvic health physiotherapist to avoid leakage.
1) Schedule your bathroom breaks. Try to make it to the toilet at least every two hours, as when pregnant, women urinate more frequently.
2) If you think your bathroom visits are proper, try practicing kegel exercises. Kegels help strengthen the pelvic floor. Practicing a kegel is the same as stopping the flow of urine within your urethra. Contract your muscles to the count of ten and then release. Repeat exercises ten to twenty times in a row two to three times a day. The average time to see results is four to eight weeks of regular practice.
3) Watching your weight while carrying has a significant effect on developing incontinence. Women who gain more weight during pregnancy are more likely to experience incontinence. Combining these factors with your pelvic physiotherapist will lower your risk of developing incontinence during your pregnancy, allowing your experience to be worry free.
If you are still unsure or worried about the risk of incontinence during your pregnancy, contact a pelvic floor physiotherapist at Triangle Physiotherapy. Triangle Physiotherapy has five convenient locations: Etobicoke, Oakville, Mississauga, North York, Toronto, and King West. At Triangle, we follow a no-waiting policy and our team is compromised of professionals who love what they do. Triangle staff will ensure that you will have a safe and comfortable pregnancy while in their care, and will help get your pregnancy back on track and in your hands.
Back pain? You are not alone. Over 80 % of Canadians will experience back pain atleast once in their life. However, about 90% of back pain is not caused by any serious injury or disease. That being said, it doesn’t make it any less painful or debilitating. For a lot of people traditional physiotherapy and massage therapy works well, but if it doesn’t don’t be discouraged… there is still hope! As a physiotherapist myself that has suffered from back pain, yoga has changed my life! It has helped me increase my flexibility, core strength, improve my posture and overall enhance my life.
Why Yoga?
1. Stretching
The spine is meant to move in lots of different ways. If we don’t move or stretch it gets stiff and rusty. This can start to cause some aches and pains which can get worse over time if it is not addressed. It can also make you more susceptible to becoming that 10% of people that suffer from a more significant injury. “But it hurts to move” you say… Yes, often times it does cause some discomfort to move especially if you haven’t tried to move in certain directions for a long time but science now tells us that it is far better for your back to move in a controlled and safe way rather than not moving. This is where yoga can help…. Yoga is a very gentle and proven way to help loosen up your back and make sure it moves smoothly within all its normal ranges of motion.
2. Strengthening
All of us have heard that if you have back pain you should strengthen your core, right? Yoga creates a great way of functionally strengthening your core. What that means is instead of isolating certain muscles, the yoga poses (asanas) that you are taken through will help you learn how to use all the muscles of your core together (including your diaphragm and pelvic floor!). If you continue strengthening your core on the ground then your body doesn’t get stronger in the positions it needs for every day activities. For example vacuuming your house requires you to be slightly bent over and pushing/pulling. Yoga poses that can simulate that will force you to strengthen your core muscles in the positions it is needed so that once you get stronger, vacuuming won’t be painful.
There are many other benefits of yoga that can help with pain from breathing techniques (if it works for women in labour then it can work for your back pain too!) Also, mind-body awareness and connection is developed to help you realize if there are postures or positions that you are doing out of habit that you don’t realize can be harming your body. Yoga can correct imbalances of your musculoskeletal system that you didn’t even know existed.
What to expect…
As a physiotherapist and yoga therapist I will go through a thorough assessment with you to make sure yoga is right for you. Our class sizes are extremely small so we can make sure you are safe, feel comfortable and we can work on your specific goals and achieve them! Alternatively, we have one-on-one sessions that are great if you haven’t tried yoga before or if you are not sure if yoga is right for you. I have had many people say to me “Oh I can’t do yoga… I’m not flexible at all!” You are actually the perfect candidate for yoga, you just need some direction and guidance on how to make it work for you.
If you are still unsure if this is right for you, please book your FREE consultation with me and we can discuss your specific condition and concerns.
Namaste.
Rachel Muttiah
Reg. Physiotherapist & Yoga Therapist
Stats taken from the Bone and Joint Health Network of Canada and the Ministry of Health.
A Rectus Diastasis is a separation in the 6-pack muscle, the rectus abdominis.
How does it occur?
It most often occurs during pregnancy. Sometimes it will spontaneously correct following birth, but it does not always.
It can also occur with overstretch of abdominal musculature.
Why is it a problem?
There is no pain with this condition.
However, the abdominal wall and the core will become weak. Your abdominals work with your pelvic floor, so a separation of your rectus abdominis muscles can make your pelvic floor less efficient and may result in prolapse and incontinence.Your abdominals also work with your lower back musculature, therefore it can lead to lower back pain.
How do I know if I have a Rectus Diastasis?
If you lift your head while lying on your back and the center of your belly protrudes out, you may have a rectus diastasis.
It is measured by the number of fingers you can fit between the muscle when lying on your back and lifting your head. Normal is 1/2 a finger above and below the belly button, and one finger at the belly button.
How do I treat it?
If the abdominal separation is greater than 4 fingers, an abdominal binder is recommended. If you use an abdominal binder, it should be from your hip bones to your rib cage, you need to keep the binder on 24/7. You can only take the binder off when you do your correction exercise below, or when you take a shower. You should keep it on at bedtime.
Exercise recommended:
Lie on your back with your knees bent. Place a sheet around your waist, crossed as if tying a knot and pull snug. Raise your head only, chin towards your chest. Hold for a count of 5, exhaling during the count. Lower your head as you loosen your grip on the sheet. Repeat 10-20 times per session, 2 sessions per day. It should be corrected within several weeks. If it does not correct within this time, please see a physiotherapist who specializes in pelvic health.
To get your pelvic health assessed, schedule a consultation with a pelvic floor physiotherapist at Triangle Physiotherapy and Rehabilitation!
Written by: Kamand Zendeganidoost, Registered Physiotherapist
Tags : physiotherapy treatment Toronto, physiotherapy clinic Toronto, physiotherapy clinic Oakville, physiotherapy exercise Oakville, physiotherapy exercise Toronto, physio Toronto, physio clinic Mississauga, advanced physiotherapy Oakville
What is the Pelvic Floor?
The pelvic floor is a set of muscles that spread across the bottom of the pelvic cavity like a hammock. The pelvic floor has three openings that run through it, the urethra, the vagina, and the rectum. The functions of the pelvic floor include:
- To support the pelvic organs, specifically the uterus, the bladder, and the rectum
- To help provide sphincter control for the bladder and bowel
- To withstand increases in pressure that occur in the abdomen such as coughing, sneezing, laughing, straining, and lifting
- To enhance the sexual response
The pelvic floor becomes dysfunctional in many women when there is an imbalance in the joints, muscles and connective tissue integrity.
- Weak pelvic floor muscles: contributing to stress incontinence, urge incontinence and pelvic organ prolapse.
- Tight pelvic floor muscles: contributing to Urinary and Fecal Urgency, Urge Incontinence, Chronic Pelvic Pain, Dyspareunia, Vaginismus, Vulvodynia, Pudendal Neuralgia, Interstitial Cystitis and Chronic Prostatits.
One of the most common seen conditions amongst pelvic physiotherapist is stress incontinence in women.
What is Stress Urinary Incontinence?
Stress urinary incontinence is the involuntary release of urine during laughter, coughing, lifting of objects or any movement that increases pressure on your bladder. When the bladder is full, the muscles in the wall of your bladder contract forcing urine through the urethra and out of your body. Sphincter muscles and pelvic floor muscles keep the urethra closed to avoid leakage of urine. These muscles relax at the same time the bladder contracts in order to allow urine to exit your body.
Causes of stress incontinence:
Hormonal changes:
During the week before your menstrual cycle, estrogen levels fall, causing symptoms of stress urinary incontinence to worsen. Additionally, as a woman goes through menopause, estrogen levels also fall causing the pelvic floor muscles to weaken.
Pregnancy:
If you are pregnant, you may experience stress urinary incontinence due to hormonal changes and the enlarging size of the uterus. During pregnancy, estrogen levels are lower, leading to less muscular strength in the sphincter and pelvic floor muscles. Additionally, as the fetus grows extra weight is placed on your bladder.
Childbirth:
Vaginal delivery can damage your pelvic floor muscles making urine leakage more likely. The supporting tissues of your bladder can also be damaged during vaginal delivery causing a cystocele, or prolapse of your bladder, symptoms of which include urinary incontinence. You may not know you have suffered damage to your pelvic floor until after you have gone through menopause, when the pelvic floor muscles are further weakened due to a fall in estrogen levels.
Hysterectomy and other surgery:
The bladder and uterus are very close together and have common supporting ligaments and muscles. Surgery to, or removal of your uterus as in a hysterectomy, risks damage to the supporting structures of your bladder. If these supporting structures are damaged, a cystocele is likely to occur. Symptoms of a cystocele include urinary incontinence.
Illnesses:
When you are ill and suffering from severe coughing, the pelvic floor muscles may fatigue and allow temporary stress incontinence due to an increase in abdominal pressure experienced while coughing.
Obesity:
Obesity can increase the abdominal pressure on the bladder leading to urinary incontinence.
Neurological damage:
Any neurological disorder such as multiple sclerosis, Parkinson’s disease or stroke can cause urinary incontinence by interfering with the nerve signals that control your bladder. Additionally, if the nerves that supply your bladder or pelvic floor muscles are damaged, urinary incontinence may also result
How is Stress Urinary Incontinence treated?
Treatments of stress urinary incontinence are individual based. The following should be considered:
Pelvic floor muscle strengthening:
Strengthening the supporting muscles of your bladder is very effective inhelping stress urinary incontinence.
Bladder training
Bladder training involves learning to delay the urge to urinate. You areinstructed to breathe deeply, relax, and distract yourself with another activitywhen you feel the urge. The initial goal is to delay urination by increments and eventually once every2 to 4 hours.
Pessary
Pessaries can help when a cystocele or prolapsed bladder is the cause forurinary incontinence. A pessary is a device of various shapes and sizes that isplaced in the vagina to support the bladder and keep it in place.
Surgery
For severe cystoceles, or bladder prolapses, surgery is needed in order tocorrect the position of the bladder and help with urinary incontinence.
Important Tips
- Avoid constipation. Repeated straining can have a very damaging effect on the pelvic floor muscles.
- It’s important for women to be active. Regular exercise and recreational sporting activities play a key role in keeping women fit and healthy well into old age
- Drink plenty of water
- Learn to tighten your pelvic floor muscles before you cough, sneeze or lift heavy items.
To get your pelvic health assessed, schedule a consultation with a pelvic floor physiotherapist at Triangle Physiotherapy and Rehabilitation!
Written by: Kamand Zendeganidoost, Registered Physiotherapist