Urinary incontinence is an important health issue to many people. It is the inability of your body to retain urine and may affect a person at any age. Men and women may experience incontinence as a secondary factor to many other medical conditions, such as stroke, multiple sclerosis, hormonal changes, aging, neurological injury, and pelvic floor overload (constant cough, constipation, more than 6 hours on your feet and obesity). Many women experience urinary incontinence during pregnancy or after child birth as well as at menopause. Trained physiotherapists can provide treatment for stress, urge, and mixed urinary incontinence. Stress incontinence is the loss of urine with activities such as coughing, sneezing, laughing, walking, running, and jumping. Urge incontinence occurs when you have the urge to urinate, but cannot reach the toilet in time. Urgency can also be an issue that affects function and is the strong urge to urinate, often very frequently but without the loss of control of urine. A physiotherapist will take a comprehensive history and assess the muscles of the pelvic floor and they will design a program that helps patients find and contract the correct muscles and to learn a training program to strengthen the pelvic muscles that control the retention and release of urine. If the pelvic floor is assessed and found to be tight or with high tone then different techniques including manual therapy, stretching and relaxation may be the focus. Treatment also includes nutrition counseling, education concerning lifestyle factors and coping techniques to minimize the effect on your daily activities. Specialized equipment including computer biofeedback and muscle stimulators are used with females if required. Bowel Incontinence can also be a significant issue affecting one’s daily life and is the leakage of stool from the rectum. Our physiotherapists are also equipped to assess and treat this condition in a similar fashion.
Prolapse of the bladder (cystoceole), uterus or rectum (rectoceole) can also occur for various reasons including aging/menopause, peri or post-natal concerns including labour and delivery, obesity or previous surgery. These can lead to a feeling of strong pressure or discomfort in the pelvic area and further contribute to the incontinence issues or urgency/frequency issues listed above. Your physiotherapist can assess the function of your pelvic floor and design an individualized treatment plan to meet your needs.
Pelvic floor issues can also contribute to local pelvic pain, low back pain, abdominal and hip pain, vagina, rectum, bladder or perineum pain or pain with intercourse (dyspareunia). With your consent a detailed examination will take place, including an internal exam to assess the function of your pelvic floor. The physiotherapist will then create a customized treatment plan with you to address any concerns. A combination of treatments is common including education, manual therapy, exercises and stretching, bowel or bladder retraining, Kegels or reverse Kegels among others.