How do you get your life back from incontinence? Before we begin our discussion, ask yourselves these questions:
- Am I always at the back of the aerobics class?
- Do I prefer watching sport instead of joining in?
- Am I always housebound or have decreasing social outings
- Do I know every toilet in town?
- I can’t sit through a film without interruption, can I?
If your answer to all these questions is a “Yes,” then you might be suffering from urinary incontinence. Any unwanted or involuntary leakage of urine is not normal, you can get help. In fact, You don’t have to leak when you laugh, cough, or do exercise. No worries, you are not alone; take a look at these statistical facts:
- One in 3 women who ever had a baby wet themselves.
- Bladder incontinence affects up to 13% of Australian men and up to 37% of Australian women.
- Bowel incontinence affects up to 20% of Australian men and up to 12.9% of Australian women.
- A third of all women suffer bladder control problems and around half of all women in nursing homes are there primarily because their incontinence is unmanageable at home.
But the Good News Is…
In 1998, the World Health Organisation said that “incontinence is a largely preventable and treatable condition,” and that it’s “certainly not an inevitable consequence of aging”.
A recent Australian study found that 84% of women with stress urinary incontinence (leaking with activities such as coughing, sneezing and jumping) were cured with the help of pelvic floor muscle training by a physiotherapist with a special interest in pelvic floor rehabilitation. The average number of visits required was only 5.
So What in the World is a Pelvic Floor Muscle?
The pelvic floor muscle are the muscles that make up the floor of the pelvis. They form a sling that supports the pelvic organs in both men and women. They help you to control your bladder and bowel, they are important for sexual function and they work with your abdominal muscle ‘corset’ to help you stabilize and support your lower back.
If not monitored and taken care of well, they can become weak, loose, and stop supporting your pelvic organs correctly. They can also get too tight causing pain and dysfunction.
Causes of Loose Pelvic Floor Muscle
Pregnancy and childbirth – especially after multiple births, instrumental delivery, perineal tears or large babies.
Constipation and straining on the toilet – this can lead to weakening of the pelvic floor muscles which can create a prolapse of the pelvic organs into the vagina. Healthy bowels are an important part of good pelvic floor function.
Chronic coughing and/or repetitive heavy lifting – can cause repeated downward forceful pressure onto the pelvic floor muscles.
Aging – muscles tend to weaken with age. Therefore, pelvic floor training will help at any age.
Obesity and people who are involved in high impact exercise – such condition increases the strain on the pelvic floor muscles. Incorrect sit ups, curl ups, or abdominal bracing exercises without involving the pelvic floor can aggravate loose pelvic floor muscle.
Menopause – due to hormonal changes.
Pelvic surgery – such as prostatectomy or hysterectomy can result in urinary incontinence which can be assisted with pelvic floor strengthening.
We can control them. We can control contraction and relaxation of these muscles. They can be consciously trained like your biceps muscles or your abdominal. These muscles ensure you keep control of your bladder and your bowel, and stop descent of your uterus, bowel or bladder into (and outside of) your vagina (this is called a prolapse). It is important to have good bladder and bowel habits and strengthen your pelvic floor every day of your life.
Remember, leakage is not normal – you can get help.
Symptoms that You Have a Leaking Problem
1. You’re leaking urine when you cough, sneeze, laugh or do any exercise. This is not normal, even when heavily pregnant. This is called stress urinary incontinence.
2. You have to rush to get to the toilet in time. This is called urgency.
3. You sometimes leak when you are rushing to the toilet or before you are ready to void. This is called urge incontinence or over-active bladder syndrome.
4. You have trouble controlling your bowel movements and wind.
5. You feel like you haven’t emptied your bowel completely and you feel like you need to strain.
6. You feel a dragging or heavy sensation into your vagina, or you have noticed a bulge inside or protruding outside your vagina.
7. You have decreased sexual sensation.
Here is the thing, though. If you do feel these symptoms, there would be some people who would tell you falsehoods about your leaking problem.
Common Myths about Urinary Incontinence
The following are what some believe about leaking problems, but are found to be non-factual.
- It is always weak pelvic floor muscles that cause problems.
- Pelvic floor muscle exercises are easy.
- I can learn how to do pelvic floor muscle exercises from a pamphlet.
- Doing the exercises don’t work; I’ve tried them and they make no difference.
- You do your pelvic floor exercises by stopping your flow of urine on the toilet.
- I’m too old for the exercises to help.
- The damage has already been done now that I’ve had children; there’s no point in doing the exercises now.
- I’ve already had a surgery for a prolapse, so there’s no point doing the exercises now.
- You don’t need to do the exercises until after you’ve had a baby.
- Men don’t have a pelvic floor or need to do the exercises.
You need not believe in these mythologies. What you can do is perform some pelvic floor muscle training with the guidance of a physiotherapist for you to remain in control of your life.
A physiotherapist can individually assess your pelvic floor muscle function, give you an individual program, and teach you what lifestyle factors you need to address, including healthy bladder and bowel habit training. It can be interesting to have an assessment done, if you are in any way unsure of whether you are doing your exercises correctly. Many people have difficulty identifying which muscles to exercise. As women in particular, we tend to pass urinary complications off as normal even when it is NOT. Speak out and get some assistance today. The earlier you seek help, the better.
It is recommended, that 6 weeks after you give birth, you should have a pelvic floor muscle assessment with a woman’s health physiotherapist. If you are unsure if you are contracting the muscles correctly, or would like to know how strong your muscles are and how you could improve, book a session with your woman’s health physiotherapist today.
From there Joshua moved down to Geelong for 3 years at Geelong Hospital working in intensive care, surgical, respiratory and orthopaedic physiotherapy.