*Incontinence and PT

INCONTINENCE

Incontinence   is an involuntary loss of bladder (urine) or bowel (feces).  Urinary incontinence affects over 25 million people. This problem is seen in people of all ages including men and children, but is seen more often in women and people over 65, and during and after childbirth. It takes a huge toll on sufferers in regards to medical cost and worry.  Here is a slideshow on symptoms, causes, and treatments for incontinence.

Types of incontinence:

• Stress incontinence: involuntary loss of urine that occurs with physical exertion and increased abdominal pressure. Leakage of small amount of fluid. Often occurs with coughing, sneezing, straining, jumping, or running. This occurs due to under active pelvic floor muscles. Stress incontinence  may be caused by pregnancy and childbirth, injury or trauma, surgery involving the vagina or rectum, episiotomy (during childbirth), and/or lack of exercise and lack of use.
• Urge incontinence: leakage of medium to large amounts of urine when a person feels a sudden strong urge to urinate.  For example, this type of incontinence often occurs when putting the key in the door or hearing running water. Possible causes include poor sensation or not being aware that the bladder is full, neurological problems,  enlarged prostate in men, and bladder pain. 
• Mixed incontinence: includes symptoms of both stress and urge incontinence.
• Functional incontinence: urine leakage that occurs when a person is unable to get to the toilet in time. The causes may include joint pain, dementia, poor eyesight, or just difficulty in getting up and walking.  This type is more common in the elderly.  
• Fecal or Bowel incontinence:  involuntary loss of feces. 

Conservative Physical Therapy Management of incontinence due to pelvic floor dysfunction may include: 

• Manual Therapy:  “hands on” treatment to improve pain and restore function and movement. 
• Mobilization and Manipulation:  movement of a joint to improve pain and restore functional movement.
• Therapeutic exercise:  specific exercise to improve pain and restore functional movement.  
• Functional Movement Training:  exercises to improve posture and movement
• Kegel exercises or pelvic floor retraining:  exercise to correct pelvic floor muscle.  dysfunction.   It is important to get proper training in doing this exercise correctly to avoid problems. 
• Biofeedback:  a way of using a computer or other device to “see” and improve body functions such as muscle activity or indicators of stress.  Also used to “see” the function of the pelvic floor muscle to improve therapeutic exercise.   
• Electrical Stimulation or TENS:  used to help improve pain, inflammation, muscle spasm, muscle function, and circulation.

Not all physical therapists work with the pelvic floor.  There are women's health physical therapists who specialize in pelvic floor rehabilitation.  They work with conditions that may include incontinence, pelvic pain, pregnancy, and osteoporosis.  You can get more information on this specialty area of physical therapy or locate a PT who works with these conditions at the website for the Section on Women's Health of the American Physical Therapy Association here.

*Links are given to provide a general overview of a topic and not intended to suggest complete or authoritative information on a particular subject.  The information provided is always subject to change.*