One potential, non-pharmaceutical intervention for urinary incontinence is Physical Therapy. Specialized Physical Therapy can work with you to design a customized program that will help address weakness and spasm, regular bowel and bladder emptying as well as exercises to prevent further injury. Some common techniques that Specialized Physical Therapy uses to help improve bladder control are:
Exercises – Many people simply need to strengthen and re-educate their pelvic floor muscles to dramatically improve their symptoms. Gaining greater control over the muscles deep in your lower abdominals can also help improve pelvic floor muscle function. Rigid contractions of both the abdominal and pelvic floor muscles can actually make leaking or pain worse.
Biofeedback – Although many people have heard of Kegel exercises, more than half are not able to contract the right muscles based on verbal or written instructions [3]. Biofeedback can be used in combination with an exercise program to help make sure you are targeting the proper muscle groups. Biofeedback provides you information by a computer screen or a sound that tells you when you are contracting the correct muscles. This enables you to learn how to control the muscles during functional activities in sitting, standing and lying down. It also lets you know if you are fully allowing the muscles to relax. This is a crucial function especially with clients with pelvic pain.
Muscle Stimulation – Sometimes pelvic floor muscles are so weak that doing exercises (even with biofeedback) isn't enough. The muscles need to be physically reminded how to work properly. To do this your Physical Therapist will teach you how pelvic floor muscle electrical stimulation can assist your muscles to remember how to contract. As the muscles start to remember how to work properly, your Physical Therapist will add strengthening exercises into your treatment program.
Behavioral modifications are lifestyle and dietary changes that can significantly reduce your symptoms and improve your overall health. Combining behavioral modifications with pelvic floor strengthening techniques improves the effectiveness of your program. Your Physical Therapist at Specialized Physical Therapy may include one or all of the following to help improve your control over your bladder:
Bladder Training – People with incontinence often get into the habit of going to the bathroom too often. There are a number of techniques you can use to gradually increase the amount of time between bathroom trips, including learning how to control the urge to urinate and learning how to empty your bladder more completely. A licensed Physical Therapist can also give you advice on how to modify your daily habits to help you regain control of your bladder. Monitoring what and how much you drink, losing weight and doing regular exercise may also help reduce or eliminate your symptoms.
Relaxation Techniques – Stress, anxiety and tension only make bladder problems worse. Physical Therapists at Specialized Physical Therapy can instruct you in breathing, postural and relaxation techniques that can help put you back in control.
Treatment of pelvic floor problems at Specialized Physical Therapy may include any of the following:
- Extensive education and resources regarding your unique problems and concerns related to PF disorders
- Postural Asymmetry Exercises
- Breathing Training
- Connective Tissue Manipulation
- Visceral Mobilization
- Myofascial Release Techniques
- Trigger Point Release including internally
- Bowel and Bladder Retraining
- State of the art computerized Biofeedback for pelvic floor muscle retraining
- Balloon biofeedback for pelvic floor opening
- Dilator Therapy for stretching and pelvic floor muscle retraining
- Heat and Electrical Stimulation Modalities
