Urinary Incontinence Treatment Options

Urinary incontinence, the involuntary leakage of urine, affects millions of people around the world, particularly women. It can significantly impact quality of life and lead to social isolation, depression, and even urinary tract infections. Fortunately, there are several treatment options available for urinary incontinence that can help manage the condition and improve your quality of life.

Here are some of the most effective urinary incontinence treatments:

1.     Pelvic floor physical therapy: This is often the first-line treatment for urinary incontinence. It involves bladder training, pelvic floor muscle exercises, and lifestyle changes such as reducing caffeine and alcohol intake. Working with a pelvic floor physical therapist, you can improve bladder control and reduce the frequency of urinary incontinence episodes.

2.     Medications: There are several medications available to treat urinary incontinence. These include anticholinergics, which help reduce bladder contractions, and alpha-adrenergic agonists, which increase the tone of the urethral sphincter. It is essential to consult a doctor before taking any medication, as some can have side effects and interact with other medications. Medications can sometimes be helpful while you are going through pelvic floor physical therapy to help manage your symptoms until you gain some strength.

3.     Medical devices: For people with more significant urinary incontinence, medical devices such as a pessary can help provide support to the urethra and reduce urine leakage. There are some temporary over the counter supports that you can try, but you will need to see a physician or a pelvic floor physical therapist to be fit for a pessary, and it may take a couple of different sizes and styles to find one that works best for you.

4.     Surgery: For people with severe or persistent urinary incontinence, surgery may be an option. Surgery often includes some type of support to the prolapsed organ and depending on your age, may also include a hysterectomy. There is significant downtime in recovery so you should discuss this option thoroughly with your pelvic floor physical therapist and physician to determine if this is your best course of treatment. It is recommended that you try a course of pelvic floor physical therapy before considering surgery.

It is essential to speak with a healthcare professional (often will be a gynecologist, urologist, urogynecologist, or pelvic floor physical therapist) before pursuing any urinary incontinence treatment option. They can help determine the underlying cause of the condition and recommend the most appropriate treatment for your unique situation.

If you think you are having some pelvic floor dysfunction, contact us or your local pelvic floor physical therapist for treatment. You can also contact us for help finding someone local to you.

THIS WEBSITE DOES NOT PROVIDE MEDICAL ADVICE. The information provided in this blog, including but not limited to text, graphics, images and other material are for informational purposes only. No material on this site is meant to be a substitute for professional medical care, treatment or advice. Always speak to your health care provider with any questions you may have regarding a medical condition or treatment. Never delay or disregard professional medical advice because of something you have read on this website.

So you had a baby…….now what?

One thing we are never quite sure of after having a baby is what is “Normal” down there. Sometimes the question is what is a normal part of the process in postpartum healing or what is a common dysfunction that can occur. Let’s talk about what may be commonly happening but needs to be addressed. Leaking of urine or feces can happen especially if there is significant tearing that occurs in the perineum. Pressure or heaviness in the perineal region can be related to the pelvic organs not sitting in the right way. Pain in the pelvic region can be related to tearing, pelvic girdle dysfunction or hypertonic pelvic floor muscles. It is important to look above the pelvis as well at the abdominal wall to see if there is any separation or doming happening since these muscles work with the pelvic floor. While these are not considered “normal”, they are common and sometimes the most important thing is to give our bodies time to heal and recover.

What can you do to aid the recovery?

1. Get rest as much as you can, even if that doesn’t mean sleeping.

2. Ask for help in order to make sure you are taken care of as well as baby.

3. Make healthy food choices and hydrate properly

4. Move your body in ways that feel right including walking, stretching and strengthening exercises.

5. If you still are having concerns at your 6-week check-up ask for a referral to a pelvic health Physical Therapist.

What can I do to start moving my body?

1. Walking. The CDC recommends that health pregnant and postpartum women do at least 150 minutes of moderate-intensity aerobic physical activity per week. Using this guideline can be helpful for setting up walking goals initially.

Breaking it down into smaller sections if key early on!!!

2. Pelvic floor exercises or Kegels as many people know them are great to start early on as long as wounds have healed. The goal is to hold the contraction for 10 seconds and do 10 reps but that may be too much to start. Try a shorter hold like 3 seconds and see if you can get all 10 reps without the pelvic floor feeling fatigued. 3. Diaphragmatic breathing for up to 5 minutes a day can be helpful since the pelvic floor, abdominals and diaphragm all work in relationship together. Focus on a 360-degree expansion of the rib cage and then knit it all back together on exhale.

4. Abdominal activations to cue the inner layer of the abdominals or the “corset” layer can help to get strength and stability back. Practice this in different positions such as sitting, lying down or standing.

With all these tips, hopefully all postpartum moms can feel ready for the next stage in recovery… Return to running and higher impact activities!

If you think you are having some pelvic floor dysfunction, contact us or your local pelvic floor physical therapist for treatment. You can also contact me for help finding someone local to you.

THIS WEBSITE DOES NOT PROVIDE MEDICAL ADVICE. The information provided in this blog, including but not limited to text, graphics, images and other material are for informational purposes only. No material on this site is meant to be a substitute for professional medical care, treatment or advice. Always speak to your health care provider with any questions you may have regarding a medical condition or treatment. Never delay or disregard professional medical advice because of something you have read on this website.

Postpartum Return to Run

You have been cleared to exercise…but what does that mean and how do you get back to that?

You have hopefully been staying active by walking and childcare but now the fun begins. Remember that it is important to stay on top of selfcare with quality sleep, hydration and health food choices. At your 6-week postpartum appointment, you were cleared to resume what you were doing before becoming pregnant but that was over 10 months ago so it is important to ease back in.

Starting with lower impact cardiovascular exercises including:

• Swimming

• Cycling (stationary)-if in class setting make sure to ride your own

  ride and not get pushed to hard too soon

• Elliptical trainer

Make sure that you have introduced strength training into your sessions as well. Muscle strength is important with returning to running and higher impact exercise. Key areas to focus on for strength training include:

• Lower extremity: Squats, lunges, heel raises, bridging, dead lift,

  step downs

• Core: plank, side plank

• Upper body: rows, lat pull downs

As you progress through these areas and feel stronger, adding in plyometrics can be helpful. Trialing some of the following:

• Jog in place

• Double leg hop in place, double leg hop to front and sides

• Single leg hop in place, single leg hop to front and sides

• Jumping jack: legs only then and lower arms and lastly full range arms

Running progression can begin once you have been cleared but keep aware of any signs of leakage of urine or feces, pelvic heaviness or pressure or pain. Goal would be to start with a run/walk interval. Make sure not to progress faster than 10% per week. If you have some of the symptoms listed above, this may benefit from a referral to a pelvic physical therapist.

If you think you are having some pelvic floor dysfunction, contact us or your local pelvic floor physical therapist for treatment. You can also contact me for help finding someone local to you.

THIS WEBSITE DOES NOT PROVIDE MEDICAL ADVICE. The information provided in this blog, including but not limited to text, graphics, images and other material are for informational purposes only. No material on this site is meant to be a substitute for professional medical care, treatment or advice. Always speak to your health care provider with any questions you may have regarding a medical condition or treatment. Never delay or disregard professional medical advice because of something you have read on this website.

What is Pelvic Floor Physical Therapy

Maybe you have heard this term, maybe you have not. But if you are here, then you must have some pelvic floor concerns and a pelvic floor physical therapist is the best place for you to start! 

Let’s start at the beginning. A physical therapist is usually a Master’s or Doctorate level practitioner who has gone through 2-4 years of education beyond a Bachelor’s degree. By definition from The Oxford Languages, a physical therapist is “a person qualified to treat disease, injury or deformity by physical methods such as massage, heat treatment and exercise rather than by drugs or surgery”. We are the movement and musculoskeletal experts to help improve the quality of life in people of all ages.

A Pelvic Floor Physical Therapist (or also called a pelvic health physical therapist) is a physical therapist who has taken additional training beyond that Master’s or Doctorate level degree to learn about the pelvic floor, bladder dysfunction, bowel dysfunction, pelvic pain, pregnancy and post partum issues and more. Pelvic floor physical therapy is a highly specialized segment of physical therapy and although it is looking at specific pelvic floor dysfunctions, the physical therapist will still look at the person as a whole because everything above and below the pelvis can affect and be affected by the pelvis. 

I have been a physical therapist since 2003 and have been working with pelvic floor patients for nearly that entire time. Since 2003, I have taken on average 2-3 advanced training courses per year to learn more and more techniques to help women with pelvic floor dysfunction. 

Some things that I see frequently:

• Urinary incontinence

• Urinary frequency

• Night time frequency

• Urinary urgency

• Pelvic pain

• Constipation

• Bowel urgency

• Pain during intercourse

• Prenatal pelvic, back and hip pain

• Postpartum pain 

• Diastasis Recti Abdominus

As a pelvic floor physical therapist in the clinic, I look at everything from the head to the toes because it can ALL affect or be affected by the pelvic floor. I do also assess your pelvic floor muscles both externally and internally (yep……internally!) to see if you can contract AND relax your muscles. So many women think pelvic floor physical therapy is just Kegels but did you know that if you cannot relax your pelvic floor muscles, you should absolutely not be doing Kegels?! 

I also work with many women virtually but this looks a little different than in the clinic. There is no exam so I rely on information from you about how you feel. There are a few conditions that really need the hands on treatment so I sometimes will refer women who come to me virtually to a local pelvic floor physical therapist for that hands on treatment but there is much that can still be done without that examination. 

One last little tid bit of information on pelvic floor physical therapy………in many European countries, every woman that delivers a baby gets 6 pelvic floor physical therapy visits to help heal her body after pregnancy and delivery!!! Doesn’t that sound amazing?!

If you think you are having some pelvic floor dysfunction, contact us or your local pelvic floor physical therapist for treatment. You can also contact me for help finding someone local to you.