Physiotherapy Women's Health
1. What is Incontinence and How is it Caused?
Incontinence means involuntary leakage of urine, faeces, gas or a combination. It’s caused by problems with the muscles and nerves that help the bladder hold or release urine. When the muscles and nerves that help the bladder hold or release urine. Women are most likely to develop urinary incontinence during pregnancy and after childbirth, or after the hormonal changes of menopause.
It can cause problems with these muscles and nerves. Indeed, the pelvic floor muscles are overstretched and they are then unable to contract properly, leading to leakage. The most common cause of incontinence in women is natural delivery of babies.
2. Type of incontinence:
· Stress urinary incontinence: leakage during coughing, sneezing, laughing, jumping, lifting, doing sports
· Urge urinary incontinence/ Overactive bladder: Sudden and intense urge to urinate, followed by leakage
during triggers but also linked to sound of running water or opening a door
· Mixed incontinence: Both stress incontinence and urge incontinence, when your bladder is overactive.
· Overflow incontinence : When the bladder doesn't empty completely, causing urine to leak out. It's often
seen in people with bladder or nerve damage.
3. Incontinence/Overactive Bladder Assessments:
At your first session, your physiotherapist will monitor your level of incontinence using a fluid intake diary and/or a bladder output diary (urination calendar) :
a fluid intake diary and/or a bladder output diary
a manual test of the pelvic floor muscles to check their strength and asymmetry
a biofeedback with Neurotrac Myoplus Pro (internal probe) device to determine the exact strength of the pelvic floor muscles
Electrical stimulation to strengthen the pelvic floor muscles
Abdominal separation assessment to determine the severity of abdominal separation.
4. Incontinence treatments and advice
List of bladder irritants, including foods and liquids to avoid
Electrical stimulation*: to strengthen pelvic floor muscles
Working manually on pelvic floor strength and tonicity
Kegel exercises (Pelvic floor muscle trainer)
Hypopressive gymnastic (low pressure exercises)
Return into functional exercises combine with core strengthening exercises
*The parameter of electrical stimulation and biofeedback (Kegel exercises) depend on the type of incontinence