Clarifying your Incontinence Concerns
Many men feel isolated and alone as to the reasons behind their pelvic health concerns. Men, like women, can experience incontinence or urinary leakage. Unlike women, who often are under the misconception that incontinence is normal, men are acutely aware that it is NOT normal or expected. Incontinence can be dramatically recognized following prostate surgery and/or radiation. Men are alarmed by the immediate decrease in their quality of life that comes with being reliant on urinary pads throughout the day. The leakage that typically results when you exert pressure on your bladder during laughing, coughing, lifting or exercising is termed Stress Incontinence (SI). Men seeking out physiotherapy are relieved to hear it is not normal to wake frequently throughout the night to urinate, to feel absolute panic when they have to urinate from fear that they won’t be able to make it to the bathroom or to feel like they can never completely empty their bladder. The leakage of urine that happens with a sudden, uncontrollable need to go to the bathroom is termed Urge Incontinence (UI) and is also known as an ‘overactive bladder’. Like women, many men’s pelvic health concerns go beyond urinary leakage. Men may suffer painful pelvic health complaints such as post-ejaculatory pain, post-urination dribble or excruciating and often unpredictable sharp pain that can often radiate through their rectum and testicles. This unpredictable pain is often likened to the ‘sciatica’ of the pelvis –and is called Pudendal Neuralgia.
Common Causes of Incontinence
Continence complaints for men can result from:
- Surgical Trauma: As with many surgeries, the trauma of the surgery can change the strength and integrity of the pelvic floor.
- Progressive Weakness of the Pelvic Floor: The pelvic floor can become weakened over time from activities such as heavy lifting, chronic straining (as with constipation and Irritable Bowel Syndrome) as well as higher impact activities such as running and jumping.
- 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): These can occur within the pelvic floor tissue, muscles or even the surrounding abdominal muscles. These trigger points can create weakness in the pelvic floor.
- General Health: The risk for incontinence increases with those men who have higher abdominal obesity, those who smoke, and those who have suffered from chronic low back pain.
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.