How A Physical Therapist Helps Treat Urinary Incontinence

Posted on: 20 February 2015

Physical therapists don't just treat symptoms such as back pain or knee pain. With the field of physical therapy branching out into new specialty areas, doctors also are referring patients to physical therapists for urinary incontinence treatment.

Common causes of urinary incontinence include aging, pregnancy, childbirth, enlargement of the prostate gland, and certain neurological disorders that send the wrong nerve signals to the bladder. Although treatments vary depending on the cause, doctors generally recommend pelvic floor exercises, electrical muscle stimulation, and/or biofeedback -- medical interventions that physical therapists provide -- as the first line of treatment.

Pelvic Floor Exercises

Also known as Kegel exercises, pelvic floor exercises strengthen the bladder control muscles. Studies show that contracting and then relaxing these muscles helps reduce symptoms of urinary incontinence in women. Your physical therapist will instruct you on how to do the exercises and may suggest combining Kegel exercises with biofeedback.

How to do Kegel exercises:

  • Squeeze the muscles in your pelvis like you do to stop urinating.

  • Hold the squeeze for three seconds and then relax your pelvic muscles for three seconds before the next squeeze. Gradually work yourself up to holding each squeeze for 10 seconds and then relaxing for 10 seconds each time in between.

  • Repeat the exercise at least 10 times.

  • Perform sets of the exercises several times throughout the day.

Since it's easier to pull in your pelvic muscles when you're lying down, physical therapists often recommend lying on your back when first learning to do Kegel exercises. Position yourself by lying down, bending your knees, and placing your feet flat on the floor.

Focus on squeezing your internal muscles while relaxing your buttocks, stomach, and thighs. As you get the hang of it and learn to squeeze the right muscles, you can move on to doing the exercises while sitting or standing. Results won't be immediate, as it can take several weeks before your bladder control improves.

Electrical Muscle Stimulation

Electrical muscle stimulation is a method of treatment that sends mild stimulation to nerves in the pelvic muscles. Similar to the less-invasive Kegel exercises, electrical stimulation may work by causing the muscles you use for urination to contract.

Small electrodes are placed near or inside the anus or vagina. If incontinence is severe and other treatments have failed, a tiny electrode may be inserted under the skin of your lower leg or into your lower back. An electrical stimulator sends pulses to the electrode, stimulating the nerve that controls bladder function. Some patients suffer adverse side effects such as discomfort or pain.

Use of Biofeedback

A physical therapist may use biofeedback as a way to help you identify and contract the proper pelvic muscles -- keys to treating urinary incontinence. Knowing when your bladder muscles contract can help you control those muscles.

The physical therapist places sensors, which measure muscle activity, on each side of the rectum and on your abdomen. These sensors are connected to a computer screen that displays a graph that shows when you are using your pelvic muscles. If you're using your stomach muscles instead, the graph will show that. Sessions normally last about 30 minutes.

For more information, contact Park Avenue Trauma Associates or a similar organization.