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Day 2 World Continence Awareness Week

Uncategorized Jun 16, 2020

What is Stress Urinary Incontinence

Any form of incontinence is the involuntary leakage of urine or stool. It is often unexpected and can be embarrassing. 

Stress urinary incontinence is the leakage of urine at points of physical stress. Anything that causes a squeeze on the bladder can cause the escape of urine. The types of stress can include coughing, sneezing, vomiting, jumping, bending, lifting or even lying on your front!

Although controlling the episodes of stress is a useful treatment, it's not always possible. For example, we can't always control our responses to pollen levels during hay fever season. We can take anti-histamines if able and keep away from the outdoors where possible. 

But, a sneeze can often take us by surprise. And we can avoid running after a toddler who is nearing the road. And should we really have to rule out going running as part of our exercise routine?

As a physio, my answer is a big no!

Movement, activity and exercise are all important for a healthy lifestyle and if your bladder is stopping you from leading that lifestyle, you need to do something about it.


This info graphic highlights how many women are affected by incontinence. If you're reading this because you experience a weak bladder, I want you to know that you're not alone.

There's help out there for you!

My advice is obviously to seek help from a specialist pelvic health physiotherapist. These physio's are experienced in helping you to manage and solve bladder, bowel and gynaecological problems. They are also experienced in pelvic floor examinations and the setting of bespoke pelvic floor training programmes.

Physiotherapy is a minimally invasive treatment for incontinence with excellent results and no negative side effects. The only limiting factor to success is your compliance to the exercise programme prescribed by your physiotherapist.

Job number one of the physio is to find out what your problem is and how it's negatively affecting your day to day life. What's the problem as you see it and what are your goals and standards for success?

Then, job number two is to find out if you are able to contract and relax the pelvic floor muscles normally. The questions a physio would ask themselves during examination are:
> Is there weakness or poor technique?
> Is there muscle wastage and thinning?
> Is there tension or overactivity?
> Is there independent and detailed control?
> Is there elevation and lift?
> Is there an ability to squeeze the bladder and bowel shut at will?
> Is there an ability to squeeze against pressure or resistance?
> Is there a problem with relaxation or release?

All of these questions are an important starting point for a physiotherapy led pelvic floor muscle training programme. But there's more to it than just the pelvic floor...

As with my RE-CORE-NECT online courses, a good pelvic floor and core training programme should take a holistic approach.

This method takes into account the effects of posture, breathing, abdominal function and buttock power on the pelvic floor. Rather than simply 'doing kugels' the process is altogether a more rounded approach and has led to greater success for all of my clients in clinic.

First, restore your breathing mechanics to allow free movement at the top of your core. Then, secure the abdominal wall with dynamic support, add in the pelvic floor muscle training in coordination with both the breath and the abdominals. Then finally top off the whole method with a boost to hip and pelvic stability with a back and buttock programme designed to increase the support of the pelvic floor.
What about bladder supports?

You saw in the infographic an advert for the Poise device for bladder support and here below are two other examples available to purchase (Contiform is available on prescription in the UK at the moment).

I think that these devices have a place in managing symptoms, but the majority of my clients improve without using them. It's worth getting set on a bespoke pelvic floor and core training programme first. After 6-12 weeks of pelvic floor training, you can review your symptoms and if still problematic, maybe think about investing in a support.

Have you heard about the knack?

The knack is an effective method to reduce the leakage of stress urinary incontinence. Once you feel confident with your squeeze technique, practice a maximum squeeze just prior to a cough or a sneeze. 

The theory is that if your bladder is closed and supported by your pelvic floor muscles at the moment of stress, the leakage will be reduced and possibly eliminated!

It's well worth a try and so much more socially acceptable than crossing your legs!

It takes a little practice, and I would suggest initially working with lighter stress, such as clearing your throat. Then progress on to full coughs, sneezes and even lifts.

I hope you have found this information useful. If you read this and feel you want to step into the world of physiotherapy rehabilitation, either contact me by email or social media, buy the RE-CORE-NECT: Foundations course or book an initial appointment online. I'll leave the link buttons here if you need them now or in the future.

Gillian x


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