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  • Rebecca Maidansky PT,DPT

Urinary Incontinence: What To Do About It

Read along to learn what urinary incontinence is, why it happens and most importantly, what you can do about it!


30-40% of postpartum women experience urinary incontinence (1)(2).


Urinary incontinence (UI) is any involuntary loss of urine.



UI can be broken down into a few different types. Stress incontinence occurs when you leak urine with an activity that increases your intra-abdominal pressure, like coughing, sneezing, lifting or jumping. Urge incontinence occurs when you get a strong, sudden, uncontrollable urge to urinate causing you to leak. Mixed incontinence is a combination of the two.



Our society has normalized urinary incontinence, even turned it into memes.


However, UI is no laughing matter. In fact, those struggling with UI are more likely to experience anxiety, depression, social withdrawal and more likely to rate their quality of life lower (3). Additionally, these symptoms tend to get worse over time.


The upside? SO much can be done to improve your bladder control and pelvic floor PT is here to guide you through it.


I've said it once and I'll say it again, common does not mean normal. Just because urinary incontinence is common does not mean that it is a normal part of pregnancy or the postpartum period. It does not mean that it is a normal part of being a mother. We are not meant to lose control of our bladders as we age. We are simply not educated on what we can do in order to address these symptoms.


So what causes UI? A number of factors. Typically, your pelvic floor helps control your bladder, bowels and sexual function. However, pregnancy and birth put your pelvic floor through a lot. Whether you've had a C-section or vaginal birth, your muscles just spent months supporting extra weight that they did not have to support before. Furthermore, the abdominal muscles that typically help support your pelvic floor just spent months growing, stretching and becoming inhibited so they are not offering your pelvic floor the same support they once were.


During pregnancy, your posture changes, your movement changes and then you give birth. Birth is a beautiful, magical, planned, trauma to the pelvic floor causing significant amounts of stretching to the tissue. In many cases, tearing occurs as well.


I give this example frequently and I'll give it again.


If you sprain your ankle, you wouldn't anticipate it to work normally again without time and exercise, right? You'd probably go to PT and do weeks to potentially months of work on your ankle before you went back to playing sports again. Your pelvic floor just went through much more than an ankle sprain, yet we don't often think to give it help during recovery.


That, in large part, is what causes UI during and following pregnancy. Sustained stretching, inhibition and trauma to the muscles that previously supported our bladder


Fortunately, like I said earlier, there is so much that can be done to help you regain control of your bladder. I'm here to give you 5 steps for managing your incontinence.


1. Set up an appointment with a pelvic floor PT. Talk to them about what you're experiencing and what they can do to help you. They'll walk you through questions about how your bladder is behaving and teach you techniques to improve your bladder control. They'll be able to assess your pelvic floor muscles with an internal examination and help you understand if your muscles are weak, tense or both. Then, they'll help create a daily exercise plan for you to get your bladder under control. If you're in Austin, give us a call or shoot us a message. If you're not in Austin, click here to find someone in your area.


2. Avoid bladder irritants. Certain dietary irritants can cause you to leak even more. Some of those irritants include caffeine, alcohol, spicy foods, carbonated and acidic drinks and artificial sweeteners. While these things won't hurt your bladder, they can make controlling it even harder. Drinking more water and less of these irritants can help improve your control.


3. Keep drinking water. You don't want to stop drinking water, if anything, increase water intake even though that's counter intuitive. Stay hydrated. Dehydration can irritate your bladder even more and will not help your control.


4. Put yourself on a bladder schedule. Pay attention to how often you're urinating. Is it every 8 hours? Is it every hour? Normal bladder emptying in adults is every 2-4 hours and you want to make sure you're falling within that range. Forcing yourself to pee every time you think of it can train your bladder to have more difficulty holding urine in the future. Ignoring the urge to urinate for hours can also contribute to bladder control issues. Make sure you're emptying at a normal rate.


5. Don't resort to kegels all day, every day. Without seeing a pelvic floor PT, there's no telling whether your urinary leakage is a result of pelvic muscle weakness or tightness. There's also no way to tell whether you're doing a kegel, or pelvic floor contraction, correctly. Many people do these contractions incorrectly, accidentally bearing down rather than squeezing and lifting. If you're not sure that you're doing a pelvic floor contraction correctly, you might not be. This mistake can contribute to your incontinence.


If you're in Austin and wondering if pelvic floor PT is right for you, give us a call or shoot us a message.


For more information, follow us on Instagram at ladybirdpt or on the Lady Bird Physical Therapy Facebook page!



References:

1. https://www.ncbi.nlm.nih.gov/pubmed/21050146

2. https://www.ncbi.nlm.nih.gov/pubmed/10614977

3.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC194226/

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