A friend posted on Facebook a few weeks ago about “#momstruggles.” She was referring to her attempt to jump on the trampoline with her kids. Many women responded in agreement that they weren’t as young as they used to be and their bladder control isn’t what it used to be.
Most women who have given birth consider urinary leakage normal. Urinary incontinence is common, with as many as 13 million Americans being incontinent. Roughly 25 percent of young women, 50 percent of middle-age women and 75 percent of older women experience incontinence. It affects their ability to play with kids and grandkids, run, play tennis and even laugh.
There are multiple types of urinary incontinence. Stress urinary incontinence means there is involuntary leakage with physical exertion. It can have multiple contributing factors.
Regardless of the cause, the symptoms make women feel embarrassed and powerless as though they are beginning to lose control of their bodies. The real truth is that although urinary incontinence is common, it is not normal. There are many options to help treat this condition and get women active again.
Kegel exercises are relatively well-known, and some women even do them consistently. Other women have tried them but haven’t noticed any changes in the frequency or severity of their urinary leakage. It’s easy to give up hope when the only thing you know doesn’t seem to work.
Even with instruction most women are performing these exercises incorrectly. One tip is to make sure that the abdominal muscles and gluteal muscles are not being tightened at the same time. When these muscles tighten, they often overpower the pelvic floor muscles since they are smaller and usually weaker.
Some individuals are reluctant to bring this issue up in discussion with their physicians, but doctors recognize that the first line treatment for stress urinary incontinence is a pelvic floor exercise program. They may prescribe a home program or refer patients to physical therapy. This can be a surprise to many people.
Physical therapists who do pelvic floor physical therapy often get additional specialized training. When a patient is seen for pelvic floor physical therapy, they can expect the therapist to do a full evaluation of overall strength, flexibility, pain and movement. The therapist will collect information about symptomatic bladder, bowel or other pelvic floor problems.
To get a complete understanding of contributing factors an internal examination is performed to assess the condition, coordination and strength of the pelvic floor muscles and surrounding tissues. It is sometimes possible to treat symptoms without doing an internal examination if that is the patient’s preference. Maintaining a patient’s comfort throughout each session is a priority.
An individualized treatment program is then developed, usually including instruction on pelvic floor muscle training, breathing or relaxation techniques, dietary modifications, bladder retraining and a home program.
Most patients begin to see progress quickly after implementing some of the changes into their lifestyles. Progress continues to be made well after a patient is discharged from physical therapy. Moms can jump on the trampoline with their kids. Women can run, play tennis, sneeze and laugh without worrying. Patients are always grateful to have control of their bodies and their active lives back.
Tricia Burbank, DPT
FIT Physical Therapy