Clarifying your Incontinence Concerns
Many people are confused as to the reasons behind their continence concerns. People believe that incontinence; the involuntary loss of urine, is a normal occurrence after childbirth or aging. Continence concerns are common but NOT normal and issues are varied. Stress Incontinence (SI) refers to leakage that is noticed during a cough or sneeze, when laughing, or during strenuous activities like soccer, jumping jacks, or other aerobic activities. Sometimes women get the sudden and urgent need to get to a bathroom. Urge Incontinence (UI) is the loss of urine that is accompanied by this sudden, urgent feeling. Often, women with urge incontinence begin to dread activities like grocery shopping or going for a long car ride. It’s hard to enjoy yourself when you’re always thinking of where the nearest bathroom is, and sometimes that front door just won’t open fast enough.
Mixed Incontinence (MI) refers to the most common form of incontinence, which is a combination of both SI and UI.
Urinary leakage may have started off with minimal and tolerable amounts of leakage that occurred with that cough or sneeze, but then leakage can accelerate to amounts that are substantial enough to wear protective padding, continence garments or simply just avoiding activities that were once enjoyed.
Common Causes of Incontinence
Continence complaints for women can result from:
- Childbirth: It is common but NOT normal for women to experience continence complaints after giving birth, particularly if you have experienced difficult labours, tearing or experienced additional trauma to the pelvic floor through the use of forceps or suction.
- Aging: It is common, but again NOT normal to notice increased incontinence with aging. This is partly due to changes in our hormones which affect the muscle and pelvic floor tissue’s integrity.
- Weak and/or tight Pelvic Floor Muscles: The pelvic floor muscles function like all other muscles in our body. A muscle that is weak may not generate the required force to support the internal organs.
- In addition to weakness, a tight pelvic floor can create Trigger Points (TP) which consequently also result in weakness.
- Pain or Trigger points (TP): Can occur within the pelvic floor tissue, muscles, or even the surrounding abdominal muscles. These trigger points can create weakness and pain in the pelvic floor.
There is overwhelming scientific research that supports the role of physiotherapy for treating incontinence.
Treatment to Improve Your Health
We address the causes of continence concerns using treatments such as:
A comprehensive assessment including a thorough review of your Bladder History
- Hands on techniques to address both external and internal muscle weakness, pain, or trigger points
- Releasing scar tissue, connective tissue, and nerve tissue
- Inclusive assessment of areas that can contribute to continence concerns such as the low back, hips and bones of the pelvis, in addition to an assessment of the strength of the core abdominal muscles
- Education of the specific progression of pelvic floor exercises, the importance of hydration, and correct toileting practices
- Therapeutic modalities, when indicated, including acupuncture, muscle stimulation, and biofeedback
Most continence complaints are significantly improved with measurable changes in leakage within 8-12 weeks. Your commitment is typically 2-3 times a week for 40 minute sessions, during the first 4-6 weeks, while learning your home exercise program that is individually tailored to meet your concerns. If your continence complaints are not resolved in a timely manner based on your diagnosis, we will work with your healthcare provider to request further tests and necessary treatment.
Occupational Therapy may be a fantastic addition to your treatment team. Your OT will help you to develop individualized strategies for
- managing your symptoms
- managing the emotions intertwined with them
- navigating your relationship with your symptoms, your body, and with movement
- re-engaging in the life activities, roles, and relationships that are important to you.
Individualized care plans may include nervous system regulation, somatic & sensory tools, Cognitive Behavioural Therapies, Graded Exposure, mindfulness techniques, and exploring day to day functioning, day to day demands, and life balance.
To help keep you on the Path to Improved Health you will receive a home based program as a tool for you to maintain your continence achievements. With your permission, your primary healthcare provider will also receive an overview of changes, improvements of continence and overall function.
Discharge Peak Review
We want you to remain at the peak of your Path To Improved Health and we will follow up with you on your progress upon your discharge from our clinic. Continence care can be a lifelong process, and we are here to support you as you move towards maintaining an independent program. Sometimes regressions or reoccurrences occur after exacerbating events, such as a bout of the stomach flu, a chronic cough, or repetitive, heavy lifting. Should you ever experience any reoccurrence or regression in your symptoms, we invite you to return to the clinic at your convenience.