Urinary incontinence, or the involuntary loss of urine, can cause embarrassment, loss of self-esteem and withdrawal from daily activities. Incontinence is NOT normal at ANY age and there is often an underlying cause. The good news is that urinary incontinence can be evaluated and treated by a women’s health physical therapist at Healthy Core.
Being evaluated by a doctor or health care provider is often the first step to rule out medical issues causing the problem, although a referral for physical therapy is not required by most insurance plans in Ohio. An evaluation at our clinic includes a thorough examination of mobility and motor control from the rib cage to the knees since this area is often functioning abnormally if incontinence is present. Using a combination of manual therapy, therapeutic exercise and behavioral training to help “teach” the bladder to hold more urine, the emphasis of exercise is on retraining the deep core system (see photo to left). Often, a proper contraction cannot be achieved until normal pelvic mechanics are addressed. During the course of treatment for urinary incontinence, other dysfunctions often improve, such as menstrual cramps, pelvic pain, hip pain, low back pain and/or painful penetration.
Some women have told us that they have been doing Kegels, or pelvic floor exercises, without resolution of symptoms. However, the problem is often due to tightness rather than weakness of the pelvic floor muscles and "reverse" Kegels may need to be done first. In addition, as many as 50 percent of individuals perform these exercise incorrectly and actually bear down and hold their breath, rather than pull up with their pelvic floor muscles when exhaling. The other mistake is not exercising the endurance part of the muscle, which makes up 70 percent of its function. At Healthy Core, individuals learn to properly contract the pelvic muscles and other synergistic muscles in the hips and abdomen that are involved in lifting and supporting the pelvic floor.
Unfortunately, many individuals are not aware that physical therapy is a viable treatment option. They may pay for costly pads or medications for many years or have unnecessary surgeries. In our opinion, this is like using a Band-Aid to cover up the problem, instead of treating the actual cause, which could be an inherent weakness or dysfunction of the core musculature. Healthy Core therapists help restore wholeness and quality of life.