Did you know up to 4 out of 10 women suffer from pelvic floor related issues such as urinary incontinence (Continence Foundation of Australia, 2019). Urinary incontinence is an involuntary loss of urine from the bladder and can be more prevalent after child birth and menopause. It can also be associated with chronic coughing, sneezing and lifting weights. Urinary incontinence effects both men and women, with women make up 70% of people who experience incontinence (Continence Foundation of Australia 2019). Incontinence can be treated and managed, and in many cases can be cured. There are different types of urinary incontinence, with the two main types being stress incontinence and urge incontinence. These two types can occur separately or together, with both being treatable by physiotherapy.
Stress incontinence is the most common type of incontinence and occurs when there is an inability of the urethra to maintain closing pressure especially when there is an increase in intra-abdominal pressure. The increase in intra-abdominal pressure increases pressure on the bladder and incontinence occurs if the structures in the pelvic floor are unable to cope. Activities such as coughing, sneezing, lifting and bending increases intra-abdominal pressure. Stress incontinence can be caused by a number of things such as:
- Weakened pelvic floor muscles
- Straining and chronic cough, sneezing or constipation
- Weight lifting
A study by Bo and colleagues in 2011, found similar prevalence of urinary incontinence in group fitness instructors compared to that of the general female population. Similarly, yoga and Pilates instructors reported an equal prevalence to that of other fitness instructors. Therefore, general exercise does not seem to protect against urinary incontinence but rather we must exercise the pelvic floor muscles specifically.
Urge incontinence is the sudden and urgent desire to urinate and unable to hold it until a toilet is reached. This is due to the bladder muscle (detrusor) being over-active and can be caused by:
- Poor bladder habits
- Older Age
- Nerve damage
- Uterine fibroids
- Interstitial cystitis
- Caffeine, alcohol and carbonated drinks
- Low fluid intake
Physiotherapy assists with urge incontinence through different strategies such as bladder retraining and urge suppression techniques. Limiting alcohol, caffeine and carbonated drinks can also assist to limit urge incontinence.