Urinary incontinence is the accidental leaking of urine. It can affect many people and may range from minor (leaking a couple of drops) to significant (complete emptying of the bladder). Some people may not be incontinent, but may still have urinary dysfunction, such as unusually intense urges to urinate, increased frequency of urination, or both.
There are a few different types of urinary incontinence, each with a different cause. The two main types we will focus on are stress urinary incontinence and urge urinary incontinence.
Stress urinary incontinence is when activities that put stress on the bladder and the pelvic floor muscles cause incontinence. The pelvic floor muscles (see image below) help to keep urine in the body until we reach the bathroom. Activities that stress the bladder and pelvic floor muscles include coughing, sneezing, laughing, and physical activities like running and jumping. Stress incontinence is typically associated with weakness and/or decreased coordination of the pelvic floor muscles. Stress urinary incontinence can also happen in high impact sports.
Urge urinary incontinence is when there is an uncontrollable urge to urinate that ultimately results in the leaking of urine before making it to the bathroom. Urge incontinence is typically associated with tightness of the pelvic floor muscles. However, other factors can contribute to urge incontinence such as “bladder irritating” foods and drinks, fluid intake, environmental triggers, and some medical conditions.
As mentioned, some people may experience unusually strong urges to urinate or increased frequency of urination, without experiencing incontinence. The causes of urinary urgency and frequency are similar to the causes of urge urinary incontinence.
Your pelvic health physical therapist can help you to determine which type of urinary incontinence you have, as well as the specific cause (or causes) of your incontinence. If your pelvic health physical therapist finds that your pelvic floor muscles are weak, they will teach you how to strengthen them. If your pelvic floor muscles are tight, they will work with you to learn to relax them. Additionally, your pelvic health physical therapist will help you figure out whether you are drinking too much, or not enough, fluid. They will guide you in properly hydrating throughout the day. They will also discuss techniques for overcoming strong bladder urges and performing activities that stress the bladder/pelvic floor muscles without becoming incontinent.
If you have urinary incontinence, urgency, or frequency, and would like to schedule a physical therapy evaluation, contact us at email@example.com or 617-618-9290. We would love to help you get back on track!
Jess Danahy, PT, DPT