Incontinence: I Laughed so Hard the Tears Ran Down my Legs !

Incontinence:  I Laughed so Hard the Tears Ran Down my Legs !

Kirsten Stalberg

As a physiotherapist with special interest and training in women’s health, I wanted to write a short article about a condition which many women are affected by: incontinence. There is much embarrassment and shame surrounding this very common problem, and I feel it is time to help this topic out of its proverbial closet. So, let’s get down to the nitty gritty and answer a few questions some of you may have.

What is incontinence?
Urinary incontinence is defined as any involuntary loss of any amount of urine that is sufficient to be a problem. My professional opinion is that any unwanted loss of urine is a problem, and although it is a common condition, it is NOT a normal process of aging.

How common is it?
Do you lose urine when you run? Laugh? Sneeze or cough? Do you almost make it home then wet yourself as you put your key in the door? Do you plot your day’s activities by proximity to bathrooms? It has been estimated that one in four women suffer from urinary incontinence, and that over 40% of menopausal women have incontinence. Incontinence is often related to a weakening or disuse of the muscles of the pelvic floor, which leads to uncontrolled leakage of urine. Childbirth, falls, and incorrect core training techniques can all contribute to incontinence.

Who Can Help?
Let your GP know. There are many causes of incontinence, and your GP can help you by screening some of them out, and directing you to specialists as needed.

Now, here is where physiotherapy comes in. Find a physiotherapist trained in Pelvic Floor Rehabilitation that has both the training and experience to assess your pelvic floor. To effectively assess the pelvic floor, an internal examination is required to check whether these deep muscles are weak, tight or overworking. If you are squeamish about this, we can also visualize the pelvic floor muscles using a Real Time Ultrasound machine. This is a non-invasive assessment, that takes about 30 minutes and you can see the layers of your own muscles and measure their function. This is the same type of machine that is used in imaging babies in utero. A physiotherapist will also check your pelvic alignment, spine and hips as incontinence if often associated with back pain and weakness.

What problems can be addressed?
Stress Incontinence
Urge Incontinence
Urinary Frequency
Interstitial Cystitis
Chronic Pelvic Pain
Overactive Bladder
Pelvic Floor Relaxation

How does it work? It’s not just kegels!
Pelvic rehabilitation may include external and internal treatment. These include relaxation training, pelvic floor strengthening and core conditioning utilizing a Pilates based program, as well as adjunct therapies such as acupuncture, myofascial techiniques and biomechanical corrections, so that the whole body is addressed and balance is achieved. Even 3 -4 treatment sessions can make a huge difference.

How effective is it?
Studies have shown a 60-80% improvement in symptoms with specific retraining for pelvic floor rehabilitation.

Still to come !
In my next article, I will answer some frequent questions about another common condition called dyspareunia, a medical term used to describe painful sexual intercourse. Dyspareunia is a common condition that can affect one-fifth of women at some point in their lives, and especially as they get older.

I hope this has clarified some questions, and helped you face this taboo topic. Speak with your friends, colleagues, and medical profession; you will start noticing it is more common than you think. I wish everyone the best on their path to wellness in 2012, a path that includes jumping for joy and running to your goals, without any leaks!

Kirsten Stalberg B.Physio
Trimetrics Physiotherapy Associate

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