Incontinence and Physical Therapy

Incontinence is the inability to control urination. It affects people of all ages and genders, but women are twice as likely as men to develop incontinence.

There are four different types of incontinence with different symptoms and behaviors for each. These include:

• Stress incontinence: Incontinence that occurs during coughing, sneezing, laughing, lifting heavy objects or making other movements that put pressure, or stress, on the bladder, is called stress incontinence. This results from weak pelvic muscles or a weakening of the wall between the bladder and vagina. The weakness is due to pregnancy and childbirth or from lower levels of the hormone estrogen during menstrual periods or after menopause.
• Urge incontinence: Urge incontinence is incontinence after feeling a sudden urge to urinate with the inability to control the bladder, such as while sleeping, drinking water or listening to water running.
• Overflow incontinence: Overflow incontinence occurs when the bladder is constantly full and reaches a point where it overflows and leaks urine. This condition can occur when the urethra is blocked due to causes such as kidney or urinary stones, tumors, or an enlarged prostate. It may also be the result of weak bladder muscles, due to nerve damage from diabetes or other diseases.
• Functional incontinence: Functional incontinence occurs when physical disabilities, external obstacles, or problems in thinking or communicating prevent a person from getting to a bathroom before they urinate.

If you are experiencing incontinence, you may benefit from physical therapy to help gain control of your situation. Your physical therapist can assess your condition and prescribe treatments and exercises to help strengthen or stretch muscles or gain neuromuscular control of muscles that control urination. 

Some common treatments that physical therapists use for incontinence management include:

• Therapeutic modalities like electrical stimulation
• Biofeedback
• Postural instruction and exercise
• Kegel exercises
• Relaxation exercises
• Exercises to improve abdominal and core muscle control

Your physical therapist can prescribe the treatment that is best for your specific condition based on findings from your clinical presentation and history.

If you have incontinence, there are a few things you should do right away.

• Don't panic. Incontinence is a common thing, and many men and women suffer from it. It often goes untreated due to the social stigma attached with the inability to control urination. But incontinence is treatable with the right therapies.
• See your doctor for a complete examination. Although rare, incontinence may be caused by a serious problem, like bladder cancer. A visit to your doctor is necessary to find out what is causing your incontinence and to get on track for the correct treatment.
• Visit a physical therapist who is a specialist in incontinence management. You can find one at the American Physical Therapy Association special interest section on Women's Health. Your physical therapist can evaluate and completely assess your condition. He or she can then prescribe the correct treatment so you can get started on treatment right away.

If you are dealing with problems with controlling urination or are having difficulty with incontinence, you owe it to yourself to get treatment. A visit to your physical therapist may be one way for you to get on track to quickly and safely get control of your incontinence.

Edited by Brett Sears, PT.