Stress Urinary Incontinence

Urinary incontinence is any involuntary leakage of urine.  Stress urinary incontinence is the leakage of urine associated with activities that put extra stress on the muscles of the pelvic floor, such as sneezing, coughing, laughing, running, or jumping.  Incontinence occurs in men and women, though it is more common in women.  Incontinence may result after trauma to the pelvis, such as childbirth, prostatectomy, or chronic coughing and may also result for normal, age-related tissue changes.  Women may experience leaking after giving birth, but any incontinence that lasts beyond a few weeks postpartum is a sign of possible pelvic floor dysfunction, and should be evaluated. Women of all ages may experience incontinence and unfortunately they commonly do not discuss it with their physician, and they think it is ‘normal’.  Physical therapists can treat patients with incontinence by evaluating muscle dysfunction and creating a personalized treatment plan to correct these impairments.

The most commonly discussed treatment for incontinence is pelvic floor strengthening, or Kegel exercises. Pelvic floor muscles may become weak or deconditioned after events such as pregnancy or over time with age. If this is the case, Kegel exercises, prescribed by a physical therapist, can strengthen these muscles, train them how to contract appropriately, and eliminate incontinence.

Not every person with incontinence needs to do Kegel exercises.  Sometimes a person’s pelvic floor muscles can become contracted or tight.  This can occur when a person, often unconsciously, clenches these muscles to substitute for another muscle group, to guard against discomfort, or in response to other physical or emotional stressors.  In this case, the muscles are strong and always active therefore they need to be reminded how to relax and lengthen.  A physical therapist can help reduce the tension in these muscles through manual techniques and other exercises to stop incontinence.