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PHYSICAL THERAPY FOR WOMEN'S AND MEN'S HEALTH Urinary Incontinence |
| Evaluation, treatment and advice for those impacted by incontinence | What are the most common forms of incontinence? Incontinence has many causes, and the types of incontinence are named for the dysfunctions in the urinary tract and pelvic floor muscle system that control bowel and bladder elimination in the continent child or adult. "Stress" and "urge" incontinence are the most common diagnoses, and can occur together. This is called "mixed incontinence."
| What causes incontinence and how is it diagnosed? The pelvic floor muscle group can be weak or damaged from childbirth or other traumas, which reduces its effectiveness in maintaining continence. Pelvic floor muscle dysfunction can also occur from direct injury or from gradual weakening or influences from chronic problems in the low back, sacroiliac or hip areas. Careful history taking in this area, a lumbo-pelvic screening and a specific pelvic floor muscle evaluation are necessary to successfully treat pelvic muscle dysfunction.
| What is stress incontinence? The term describes the inability of the pelvic floor muscle group - which fills the bottom of the pelvic cavity - to hold against the "stress" of increased intra-abdominal pressure. These pressure increases may take place during activities such as walking, running, jumping, sneezing and coughing. When the pelvic floor muscles below will not hold tight against the increased pressure from above, the pressure drops inside the urethra (the tube that carries urine out of the body). This causes uncontrolled leakage of the bladder's contents.
| What is urge incontinence? It occurs when the bladder muscle contracts with enough force to overcome the urethral pressures suddenly. Put simply, it's a strong urge to void followed by urine leakage. In some cases, the bladder doesn't even need to be full to capacity before the leakage takes place. This condition is often one that has developed gradually, and is worsened by low daily water intake, as well as by eating or drinking substances that irritate the interior bladder wall lining.
| How are these conditions treated at Olympic Physical Therapy? Your physical therapist will begin by doing a muscle evaluation and taking a careful history that includes the following: any already-identified medical conditions; bladder and bowel function; elimination habits; and intake of types and amounts of daily fluids. This allows your therapist to analyze the neuromuscular reasons for why the system is not functioning properly.
At this point, you will be instructed if changes in bowel and bladder habits or fluid intake need to be made, and your progress will be tracked. Improvement may take some time, as some changes are more successful if accomplished gradually. You may be asked to keep a "voiding diary" to aid in the analysis of your treatment. You will also be shown appropriate exercises to do at home. When you return for follow-up, a special device will be used that allows you and your therapist to see the actual muscle activity. This enables the therapist to measure your progress and ensure you're doing the exercises correctly.
| What is the goal? Increased bladder control and pelvic floor muscle strength. |
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