How does physical therapy help with urinary incontinence. What are the most effective exercises for managing urinary incontinence. Can physical therapy cure stress incontinence. How long does it take to see results from pelvic floor therapy. Which types of urinary incontinence respond best to physical therapy.

Understanding Urinary Incontinence: Types, Causes, and Symptoms

Urinary incontinence is a common condition affecting millions of people worldwide, characterized by the involuntary loss of urine. To effectively address this issue, it’s crucial to understand its various forms and underlying causes.

Types of Urinary Incontinence

• Stress incontinence: Urine leakage during physical activities or movements
• Urge incontinence: Sudden, intense urge to urinate followed by involuntary loss of urine
• Mixed incontinence: Combination of stress and urge incontinence
• Overflow incontinence: Frequent or constant dribbling of urine due to bladder not emptying completely
• Functional incontinence: Physical or mental impairments preventing timely toileting

Why do different types of urinary incontinence occur? The underlying causes vary depending on the type:

• Stress incontinence often results from weakened pelvic floor muscles or damaged urethral sphincter
• Urge incontinence may be caused by overactive bladder muscles or neurological conditions
• Overflow incontinence can stem from bladder outlet obstruction or nerve damage affecting bladder muscles
• Functional incontinence is typically related to mobility issues, cognitive impairments, or environmental barriers

The Role of Physical Therapy in Treating Urinary Incontinence

Physical therapy plays a crucial role in managing and treating urinary incontinence, offering non-invasive, effective solutions for many patients. How does physical therapy address urinary incontinence? By focusing on strengthening pelvic floor muscles, improving bladder control, and modifying behaviors that contribute to incontinence.

Key Components of Urinary Incontinence Physical Therapy

1. Pelvic floor muscle training (Kegel exercises)
2. Bladder training techniques
3. Biofeedback therapy
4. Electrical stimulation
5. Manual therapy techniques
6. Education on lifestyle modifications

Can physical therapy effectively treat all types of urinary incontinence? While it’s particularly effective for stress and urge incontinence, physical therapy can also benefit patients with mixed and functional incontinence. The success rate varies depending on the type and severity of incontinence, as well as patient compliance with the treatment program.

Pelvic Floor Exercises: The Foundation of Incontinence Treatment

Pelvic floor exercises, also known as Kegel exercises, form the cornerstone of urinary incontinence physical therapy. These exercises target the muscles that support the bladder, urethra, and other pelvic organs, helping to improve bladder control and reduce leakage.

How to Perform Kegel Exercises Correctly

1. Identify the correct muscles by stopping urine mid-stream (for identification only, not as an exercise)
2. Contract pelvic floor muscles for 5-10 seconds
3. Relax muscles completely for 5-10 seconds
4. Repeat 10-15 times, 3 times daily

Why are proper technique and consistency crucial in pelvic floor exercises? Incorrect execution can lead to suboptimal results or even exacerbate symptoms. Consistency is key to building strength and improving muscle control over time.

Advanced Physical Therapy Techniques for Urinary Incontinence

Beyond basic pelvic floor exercises, physical therapists employ a range of advanced techniques to address urinary incontinence. These methods provide additional support and feedback to enhance treatment outcomes.

Biofeedback Therapy

How does biofeedback therapy work in treating urinary incontinence? This technique uses sensors to monitor muscle activity, providing visual or auditory feedback to patients. This real-time information helps patients identify and correctly contract their pelvic floor muscles, improving the effectiveness of exercises.

Electrical Stimulation

Electrical stimulation involves the use of low-level electrical currents to stimulate pelvic floor muscles. This technique can be particularly beneficial for patients who struggle to identify or contract these muscles voluntarily. The electrical impulses help strengthen muscles and improve bladder control.

Manual Therapy Techniques

Physical therapists may employ hands-on techniques to address muscle tension, improve flexibility, and enhance overall pelvic floor function. These may include myofascial release, trigger point therapy, and stretching exercises.

Lifestyle Modifications and Behavioral Strategies for Managing Incontinence

Alongside physical therapy exercises and techniques, lifestyle modifications play a crucial role in managing urinary incontinence. Physical therapists often provide education and guidance on these behavioral strategies to complement the treatment program.

Key Lifestyle Modifications

• Bladder training: Gradually increasing the time between bathroom visits
• Fluid management: Adjusting fluid intake timing and volume
• Dietary changes: Avoiding bladder irritants like caffeine and alcohol
• Weight management: Maintaining a healthy weight to reduce pressure on pelvic organs
• Smoking cessation: Reducing coughing and bladder irritation

Why are these lifestyle changes important in managing urinary incontinence? By addressing contributing factors and modifying behaviors, patients can significantly reduce symptoms and improve overall bladder control.

The Physical Therapy Treatment Process for Urinary Incontinence

Understanding the physical therapy treatment process can help patients prepare for and engage effectively in their incontinence management journey. The process typically involves several key stages:

Initial Assessment

During the first appointment, the physical therapist conducts a comprehensive evaluation, including:

• Medical history review
• Physical examination
• Pelvic floor muscle strength assessment
• Bladder diary analysis

Treatment Plan Development

Based on the assessment findings, the therapist creates a personalized treatment plan tailored to the patient’s specific needs and goals.

Treatment Sessions

Regular sessions involve a combination of exercises, techniques, and education. The frequency and duration of treatment vary depending on individual needs and progress.

Home Exercise Program

Patients are typically provided with exercises and strategies to practice at home between sessions, reinforcing the in-clinic treatment.

Progress Evaluation

The therapist regularly assesses the patient’s progress, adjusting the treatment plan as needed to ensure optimal outcomes.

How long does it typically take to see results from urinary incontinence physical therapy? While some patients may notice improvements within a few weeks, it often takes 6-12 weeks of consistent treatment and exercise to achieve significant results. However, the timeline can vary depending on individual factors and the severity of the condition.

Combining Physical Therapy with Other Treatment Modalities

While physical therapy is highly effective for many patients with urinary incontinence, some cases may benefit from a multidisciplinary approach. Physical therapists often work in conjunction with other healthcare providers to provide comprehensive care.

Complementary Treatments

• Medications: Anticholinergics or beta-3 agonists for overactive bladder
• Pessaries: Devices inserted into the vagina to support pelvic organs
• Botox injections: For severe overactive bladder cases
• Surgical interventions: In cases where conservative treatments are insufficient

How do physical therapists collaborate with other healthcare professionals in treating urinary incontinence? They often work closely with urologists, gynecologists, and primary care physicians to ensure coordinated care and optimal outcomes for patients.

Overcoming Barriers to Urinary Incontinence Physical Therapy

Despite the effectiveness of physical therapy in treating urinary incontinence, many patients face barriers to seeking or adhering to treatment. Addressing these challenges is crucial for improving access to care and treatment outcomes.

Common Barriers to Treatment

• Embarrassment or stigma associated with incontinence
• Lack of awareness about physical therapy as a treatment option
• Limited access to specialized pelvic health physical therapists
• Financial constraints or insurance coverage issues
• Time commitment required for treatment

How can healthcare providers and patients work together to overcome these barriers? Education, open communication, and advocacy for improved access to specialized care are key strategies. Additionally, telehealth options for certain aspects of treatment may help improve accessibility for some patients.

Urinary incontinence physical therapy offers a non-invasive, effective approach to managing a condition that affects millions of people worldwide. By understanding the various types of incontinence, the role of physical therapy in treatment, and the importance of complementary lifestyle modifications, patients can take proactive steps towards improving their bladder control and quality of life. With dedicated effort and the guidance of skilled physical therapists, many individuals can achieve significant improvements in their symptoms and regain confidence in their daily activities.

Page Not Found | Choose PT

You can try searching:

Search

We like to fix broken things. Help us!

Find a Physical Therapist

• 
  
  
  Twitter
  
• 
  
  
  Facebook
  
• 
  
  
  Youtube
  

#ChoosePT

All contents © 2023 American Physical Therapy Association.
All Rights Reserved. Images and illustrations may be subject to copyright ownership by parties other than APTA and have been used by permission or licensed for exclusive use by APTA only.

Use of this and other APTA websites constitutes acceptance of our
Terms & Conditions | Privacy Policy | Disclaimer

Find a Physical Therapist

• 
  
  
  Twitter
  
• 
  
  
  Facebook
  
• 
  
  
  Youtube
  

#ChoosePT

All contents © 2023 American Physical Therapy Association.
All Rights Reserved. Images and illustrations may be subject to copyright ownership by parties other than APTA and have been used by permission or licensed for exclusive use by APTA only.

Use of this and other APTA websites constitutes acceptance of our
Terms & Conditions | Privacy Policy | Disclaimer

Page Not Found | Choose PT

You can try searching:

Search

We like to fix broken things. Help us!

Find a Physical Therapist

• 
  
  
  Twitter
  
• 
  
  
  Facebook
  
• 
  
  
  Youtube
  

#ChoosePT

All contents © 2023 American Physical Therapy Association.
All Rights Reserved. Images and illustrations may be subject to copyright ownership by parties other than APTA and have been used by permission or licensed for exclusive use by APTA only.

Use of this and other APTA websites constitutes acceptance of our
Terms & Conditions | Privacy Policy | Disclaimer

Find a Physical Therapist

• 
  
  
  Twitter
  
• 
  
  
  Facebook
  
• 
  
  
  Youtube
  

#ChoosePT

All contents © 2023 American Physical Therapy Association.
All Rights Reserved. Images and illustrations may be subject to copyright ownership by parties other than APTA and have been used by permission or licensed for exclusive use by APTA only.

Use of this and other APTA websites constitutes acceptance of our
Terms & Conditions | Privacy Policy | Disclaimer

Urinary incontinence exercises for women, Kegel exercises

Previous

Next

Increasingly, women are experiencing urinary incontinence. There can be many reasons – the pathology of the location of internal organs, complications after childbirth, stress or frequent lifting of weight. The muscles of the small pelvis, like on belts, hold the bladder, if they weaken, then it changes its location in the abdominal cavity, which leads to big problems. Therapeutic exercises for urinary incontinence is a fairly effective way to deal with them. Kegel gymnastics strengthens the muscles of the small pelvis, allows them not only to get stronger, but also to stand in the right place. This is a medically recognized technique that is prescribed by the attending physician in cases that do not require surgical intervention.

Urinary incontinence exercise includes 3 main actions: contraction, retention, contraction of the pelvic muscles. Normal compressions can be done anywhere: while watching TV, while cleaning or cooking food. They involve a movement that mimics the cessation of urination. You can do them unnoticed by others.

Kegel gymnastics involves a gradual increase in load. You should start with 10 contractions and gradually increase their number to 30, adding 5 per week. Before doing Kegel exercises need to go to the toilet to keep the bladder empty. Otherwise, there will be pain in the lower abdomen, the muscles will not cope with the load and it will be worse. As for the time of the event, it does not matter, you can do gymnastics at any convenient time. The first few times it is better to do exercises lying down. As for the posture, you need to start with the most comfortable for you. Here it is very important that a woman is comfortable. The body relaxes, the muscles of the thighs, the abdominal cavity do not tense up.

Basic Kegel exercises

Urinary incontinence exercises – a set of exercises aimed at strengthening the muscles of the small pelvis. With its help, it is possible to completely get rid of the pathology and maintain muscle tone, but you need to do the exercises constantly, otherwise the incontinence may return again. The basic movement includes contraction, retention, and muscle contraction, reminiscent of the cessation of urination. It is considered correct to squeeze the muscles, hold them for 3 seconds and relax, count the same number of seconds and repeat the exercise. You can gradually increase the number of seconds up to 15.

Once you have reached this mark, you can move on to the next exercise. It’s called the “elevator”. Compression occurs under a certain pressure, it feels like when you go up in an elevator, and then it starts to relax smoothly, as if he is going down.

Another type of complication involves the rapid contraction and relaxation of the pelvic muscles, but it should not be erratic. You need to keep a certain rhythm that is comfortable for you.

Pushing out is another type of exercise very familiar to new mothers. Childbirth, by the way, is often the cause of urinary incontinence in women. The exercise suggests pushing, as in childbirth. The process is very similar to a bowel movement, so you need to go to the toilet before performing it.

Proper and effective performance of Kegel exercises can be prevented by such factors as: difficult childbirth, early postpartum period, large vagina syndrome, flaccidity of muscles, ligaments. That is why more and more often gynecologists recommend the procedure of laser rejuvenation of the walls of the vagina to all women who have similar problems.

If you want to learn more about the technique – Vaginal rejuvenation with Fotona laser, to clarify the cost of the procedure, where to do it in Kyiv, follow the link.

Exercises for women with urinary incontinence

In order to make the exercise more effective, Kegel developed postures in which to do the above actions will be more effective: exercise.

Such intimate gymnastics can be done at home in your free time. The effect of it will be noticeable in a few weeks.

Common mistakes when performing Kegel

If you do gymnastics with mistakes, it will not bring the desired result or may even lead to a deterioration in the condition. Basic errors include:

1. not exercising on an empty bladder, otherwise pain may occur;
2. conducting the first workouts standing or sitting, and not lying down – in a horizontal position;
3. holding the breath – it should be even and calm;
4. strain during exercise the muscles of the buttocks, pelvis or abdominal cavity.

Often, during the first session, a woman cannot recognize the muscles of the small pelvis. Experts advise inserting a finger into the vagina, and carry out the first workouts with it. Hands must be clean, otherwise there is a risk of infection. Once you understand which muscles to train, the finger is removed.

A woman’s health is not only a guarantee of her personal happiness, but also of the whole family, so you need to carefully monitor it, follow all the doctor’s recommendations, monitor the amount of fluid consumed (first courses and fruits are also considered). It is very important to determine the cause of incontinence and eliminate it, if possible. During the period of treatment, a woman is contraindicated in lifting weights, being nervous.

095-033-54-45 (Obolon), 063-594-95-95 (Poznyaki),
073-424-44-22 (Goloseevo).

2. Home
3. Aesthetic gynecology
4. Kegel exercises for urinary incontinence

Women’s Pelvic Floor Strengthening Exercises

This fact sheet has been compiled to educate patients about pelvic floor strengthening exercises.

More than 50% of women who have given birth have problems with urination, and at an older age, prolapse of the uterus (prolapse), which can be caused by weakness of the pelvic floor muscles.

Strong pelvic floor muscles help improve bladder and sexual function, as well as maintaining internal organs in a normal anatomical position. Pelvic floor muscle problems can be caused by pregnancy, childbirth, chronic constipation, being overweight, smoking, menopause, and neurological problems.

Symptoms of weak pelvic floor muscles may include incontinence when coughing and sneezing, frequent urination and the need to urinate at night, pain in the vagina, pain during sex.

To prevent and alleviate urinary incontinence and organ prolapse, it is very important to learn how to contract the pelvic floor muscles correctly.

The pelvic floor muscles are located in the pelvic floor area between the pubic bone and the coccyx. Their function is to maintain the correct position of the organs (uterus, bladder, intestines) inside the pelvis, as well as to keep the urethra and anus closed to prevent involuntary leakage of contents, and to relax them during emptying.

Like all other muscles in the body, the pelvic floor muscles also need special training.

Manual

Get into a comfortable sitting or lying position. Try to tighten your pelvic floor muscles as if you are trying to interrupt the flow of urine or intestinal gases by pulling the muscles up.

You may feel tension when the muscles contract. Do not hold your breath, take a deep breath through your nose and slowly exhale through your mouth. At the same time, the abdominal muscles can also tense up, this is normal.

Try to keep the muscles of the buttocks and legs relaxed. After each contraction of the pelvic floor muscles, try to completely relax these muscles.

Three basic ways to control the correct contraction of the pelvic floor muscles:

1. Observe the perineum through a mirror and tighten the pelvic floor muscles. Watch to see if the vagina moves inward in the opposite direction from the mirror. If you see the movement of the vagina towards the mirror, stop immediately and seek help from a physical therapist who specializes in training the muscles of the pelvic floor.
2. Place your thumb or index finger into your vagina. As your pelvic floor muscles contract, you should feel your vagina tighten around your finger.
3. Contract your pelvic floor muscles during sex, asking your partner if they feel pressure.

How to Do Pelvic Floor Exercises

1. Contract your pelvic floor muscles and try to hold that contraction for a count of seconds, and then relax those muscles for the same number of seconds. For how many seconds can you maintain muscle tension? How many reps can you do?
2. Alternately contract your pelvic floor muscles for 1 second and then relax them for 1 second as well. How many of these short repetitions can you do before you feel tired in the muscles? Always relax your pelvic floor muscles before each new contraction.

Your goal is to do 10 long contractions, holding the muscle tension for 10 seconds; each contraction should be alternated with a 10 second relaxation. Then do 10 short contractions; each contraction should alternate with a short relaxation.

You can start with a shorter duration and fewer repetitions. Do exercises at least 3 times a day. At first, the exercises are easier to perform in a sitting or lying position. You should feel the results in 3-5 months. Subsequently, to maintain the result of the exercise, you can do it once a day. As your muscles strengthen, try to do the exercises in other positions as well (for example, lying on your side, while resting on your knees, standing, while moving).

Try to tense your pelvic floor muscles before coughing, sneezing, lifting weights, laughing.

Avoid carbonated or caffeinated drinks to prevent constipation. Drink at least 1.5 liters of water per day. When you have a bowel movement, place your feet on a small footrest to squat as if (this makes it easier to have a bowel movement). When you have a bowel movement during constipation, pressure on the pelvic floor muscles increases.

Eat healthy and be physically active (move at least 150 minutes per week).