Bladder leaking is common, but it is not normal!
The Canadian Continence Foundation estimates 1 in 3 people suffer from some degree of involuntary loss of urine from the bladder. In Canada, that means about 3.3 million Canadians are affected. I suspect this statistic is actually higher due to the under-reporting. Many people are still uncomfortable talking about it, and for some, it is still a very taboo subject.
There are two types of bladder leaking that can be helped by physiotherapy – stress and urge incontinence. Stress incontinence occurs when the intra-abdominal pressures overcome the pelvic floor’s ability to squeeze the urethra (bladder tube) closed. Leaking when you sneeze, cough or jump would by typical examples of this. Urge incontinence occurs when the bladder itself contracts too forcefully for the pelvic floor muscles to control and results in a leak when a person tries to hold and get to the toilet on time. A person can also experience a mix of both types.
As you can see, the pelvic floor muscles are the common element in both types of leaking. Learning how to contract these muscles correctly with guidance from a qualified Pelvic Floor Physiotherapist can help improve both conditions. One recent study showed that 50% of the women in the study were not contracting their pelvic floor properly when only given verbal instructions! Half of the people were doing it wrong!
Tips to stop a leaky bladder:
- Exercise your pelvic floor! Proper performance of a pelvic floor contraction is essential to improving urethral closure. For many people a conventional “Kegel” exercise is not the answer. For some people, the pelvic floor is not just weak; it can be too tense and the ability to full relax the muscles is affected. For this reason, just squeezing and holding the pelvic floor is not enough. It is essential for the muscles to move through a full range of motion, and through a full cycle of contraction AND relaxation. If tension is a factor in the muscles, “modified” exercises are prescribed to focus on down-training these tense muscles. A person may also lack strength, endurance or co-ordination with the core muscles. A physiotherapy pelvic floor evaluation will help you learn how to contract effectively, and co-ordinate breathing and your core muscles.
- Take care when you cough or sneeze. Get in the habit of contracting the pelvic floor muscles before you cough, sneeze or lift something heavy.
- Pregnancy and childbirth can weaken the pelvic floor so remember to practice your pelvic floor exercises before and after the birth of your baby. Recovering core and abdominal strength is also very important in restoring continence post-partum.
- Avoid constipation. Straining and bearing down for a bowel movement can weaken pelvic floor muscles. Eat plenty of fibre and drink plenty of fluids.
- Limit your caffeine intake. Caffeine from coffee, tea, soda pop, and chocolate can irritate the bladder lining, increasing leaking and urgency.
- Don’t go to the toilet “just in case”. Normal frequency for voiding is 5 -8 times per day. Most people can hold their bladders for 2-3 hours before having to empty. Empty your bladder only when it is full. Help delay your trips to the toilet by practicing pelvic floor exercises.
- Urinary tract and bladder infections can increase urgency. Be sure to wipe from front to back to avoid the spread of bacteria.
- Being overweight can put extra strain on the pelvic floor muscles. Maintain a health body weight through a healthy diet and exercise.
Don’t just live with bladder leaking and having the expense of wearing pads. A leaky bladder is not a laughing matter! If you would like to learn more and talk about whether we can help, contact the clinic at 613-692-1847 or feel free to book an assessment by phone or email at firstname.lastname@example.org.
By: Cathy Cooney
Registered Physiotherapist/Clinic Co-Owner with a Special Interest in Pelvic Floor Disorders