Do you know what incontinence is? Did you know that there are multiple different types of incontinence?
Incontinence is leakage of urine or stool that can occur in various positions or in various situations. This post is designed to teach you about the different types of incontinence and what you can do to help stop incontinence.
Let’s start with the types on incontinence. We’ll talk about the 3 main types: Stress Incontinence, Urge Incontinence and Mixed Incontinence.
Stress Incontinence
Stress Incontinence occurs when there is a leakage of urine in response to the body experiencing an increase in intra-abdominal pressure that is not counteracted by a pelvic floor contraction. So what does that mean? Basically, when the body undergoes physical exertion, there is an increase in intra-abdominal pressure. Intra-abdominal pressure is the pressure held within the abdominal wall. When this pressure increases, it causes the diaphragm to move up and the pelvic floor to move down. This pressure on the pelvic floor can cause leakage due to the downward force. So what can cause an increase in intra-abdominal pressure? Sneezing, coughing, laughing, lifting heavy bags/groceries, lifting children, jumping, jumping jacks… you get the idea.
In order to prevent stress incontinence, something must counteract the increase in intra-abdominal pressure. What you ask? It’s the use of correct breathing and a pelvic floor contraction (a kegel)! Ideally, when we sneeze, cough, laugh, lift a heavy object or jump, we want to be exhaling and contracting the pelvic floor in order to counteract the increase in intra-abdominal pressure. If you’re not sure that your doing a kegel correctly, reach out to me or another pelvic floor physical therapist in your area and we will assess your muscles and make sure you’re doing it correctly. If you are not doing a kegel correctly, you may cause more problems (which we certainly don’t want)!
Urge Incontinence
Urge Incontinence occurs when an individual has the urge to urinate or defecate but then cannot control it. The result, urinary or fecal leakage. Urge incontinence can occur for a variety of reasons. In some clients, the pelvic floor muscles may be tight or in spasm or there may be scar tissue present from a surgery or tearing during a vaginal delivery. This can cause a “pulling” sensation on the bladder which can result in urgency. Urinary or fecal incontinence can also be due to muscle weakness or pelvic organ prolapse. Oftentimes, by addressing spasm and tightness and teaching urge suppression techniques, bladder irritants and pelvic floor strengthening, urge incontinence can be drastically reduced.
Urge Suppression Techniques
What are some urge suppression techniques you ask? Here are a few and discriptions of how to use them.
- Quick flick kegels – this is 2 sets of 3 kegels performed one right after another. This technique should only be used if a pelvic floor physical therapist has assessed your pelvic floor and has told you that you DO NOT have spasm and that you ARE ABLE to fully relax after a kegel.
- Relaxation techniques – this includes deep breathing and consciously letting the pelvic floor muscles relax. Again, make sure a pelvic floor physical therapist has assessed your pelvic floor muscles and that you can, indeed, relax after doing a kegel
- Distraction – This can include saying the ABC’s, doing some ankle pumps, thinking about your to-do list; basically anything to get your mind off the urge. Typically with this technique, we encourage distraction initially for 5 minutes. If the urge does not go away, please go to the bathroom. If the urge does go away, GREAT! Gradually increase time – so start at waiting 5 minutes, then 10, then 15 etc. The goal is urinary frequency every 2-3 hours throughout the day!
Mixed Incontinence
Mixed Urinary Incontinence is leakage of urine that occurs with an uncontrollable urge and with exertion, coughing, laughing or sneezing. Assessing the pelvic floor muscles for spasm, weakness, and coordination is again, vitally important in treating this type of incontinence.
I know all this talk about breathing, pressures and contracting muscles in confusing. If you’re experiencing leakage with urgency, exercise or increased activity, Pelvic Floor Physical Therapy is able to help! In Pelvic Floor Physical Therapy, your physical therapist will assess your pelvic floor muscles looking for weakness, spasm and muscular incoordination. We will teach you how to breath correctly in order to optimize your kegel strength in order to reduce your symptoms.
Check out this article review on the types of incontinence and the importance of physical therapy: