For ten years I have been a physiotherapist and treated men and women of various ages and walks of life. Often when asking patients the question about how the waterworks are functioning, I get a somewhat down-played response, like ‘it’s just one of those age things’, or ‘it’s just something we all deal with’. Often there is a justification that they are managing it with pads, that they were already doing pelvic floor exercises and it might just go away one day. But most of these people had never sought help from a health professional. This is when it hit me, does the population think its okay to have incontinence?
Well, I’m here to tell you that IT IS NOT NORMAL TO LEAK URINE OR FAECES. Not when you cough, not when you’re on your way to the toilet, not when you walk, and not when you play a sport. There are many reasons why you may develop incontinence, and they don’t all present the same.
Types of Incontinence
Stress Incontinence occurs when you get leakage on activity where abdominal pressure increases, such as coughing, laughing, changing positions, or lifting.
Urge Incontinence occurs when you have the sensation you need to go to the toilet, but you leak urine before you are unable to make it in time.
There are other types of incontinence, however, these are the most common.
The Pelvic Floor
Yes, we have all heard of them, and know we should be doing them. The pelvic floor plays a vital role in helping to control the flow of urine and faeces, along with supporting our pelvic organs, helping provide support to our musculoskeletal body system, and having a role in sexual function. During the childbearing years, these muscles can become weakened due to a load of carrying your baby during pregnancy, the stretch during childbirth and the effect that changing hormones. As the body ages, it will start to slowly lose muscle mass, which can also have a weakening effect on the pelvic floor.
Did you know 98% of women don’t do pelvic floor exercises! And 50% of people doing their pelvic floor exercises incorrectly!
What we must remember about the pelvic floor at any stage of life, is that it is a muscle, and muscles can be trained to be stronger and work better!
Other things affecting continence
We mustn’t forget that while our pelvic floor plays a large and important role incontinence, there are other factors to consider. Sometimes the bladder can have difficulty with being able to fill and empty regularly, which may mean you have to go to the toilet frequently (or even not enough), and the timing might be a bit unpredictable. Pelvic organ prolapse can also affect symptoms of incontinence. By understanding the habits of the bladder and bowel, and knowing the function of the pelvic floor, strategies can be put in place to retrain, strengthen, and attempt to regulate bladder actions better.
So what can I do?
This is where a Continence & Women’s Health Physiotherapist will be able to help! It’s essential to understand the reasons why you are incontinent fully, and your Physiotherapist will be able to do a thorough assessment to discover this. A plan can then be put into place, which may consist of pelvic floor and other exercises, bladder or bowel training and strategies, breathing and relaxation techniques, just to name a few, but this will all depend on the reason why you have incontinence in the first place!
The Pelvic Floor First #leakface campaign looks at educating the public about incontinence, and that there are options to help with this issue. You can find more information about this at leakface.com.au.