It is 6:30 p.m. You are speeding home from work. It has taken you longer than normal because of a terrible wreck on the interstate. You rush to your door, dancing along the way, and as soon as you put your key in the door….it is too late. You couldn’t hold your urine any longer. It is now running down your leg as you finally get the door unlocked.
Or what about that new workout routine? The one that has you doing burpees, jumping jacks, or high kicks? Where any time you do a certain movement you leak a little? How many of us has this happened to? I mean it’s totally normal, right?! NO! We may be too embarrassed or in denial to admit that we have a problem. What is this problem you may ask? The involuntary loss of urine is called urinary incontinence1. It doesn’t matter what your age is, your activity level, or gender (for all you men who are reading this) urinary incontinence can affect anyone and everyone.
- Urinary incontinence effects 1 in 10 MEN and every 4 in 10 women2.
- Urinary incontinence is not limited by age or to post-partum individuals2.
- 41% of athletes experience incontinence2.
There are three main types of urinary incontinence. The most common type, stress incontinence, is defined as the involuntary loss of urine that occurs with physical exertion1. My patients often complain of incidents with coughing, sneezing, laughing, or with exercise. An experience as the, “lock in key syndrome” mentioned initially is known as urge incontinence. It is leakage associated with a strong urge to void1. Many patients mention that when they have the urge to urinate they have to void immediately or else it will be “bad news.” Experiencing a combination of stress and urge incontinence is known as mixed incontinence1.
Urinary continence is maintained by a network of muscles, fascia, and nerves. These systems are synchronized to “kink” the urethra and prevent urine flow. This coordination is pertinent during activity and to allow you to make it to the bathroom in time. If one of these systems is not working correctly it leads to urinary incontinence. A simple analogy is to think of this system as a garden hose that has been laid across a trampoline. The urethra (garden hose) carries urine (water). The trampoline acts as your pelvic floor muscles and supporting fascia. If you were to step on the hose the hose will bend but not completely; “kink off.” The trampoline is flexible; therefore, water is still able to “leak” out. If the trampoline was ridged (by contracting the pelvic floor) stepping on the hose would “kink” off the water. This would allow you to remain continent with the firm back drop of the pelvic floor muscles and the increased pressure from the outside1.
Treatment for incontinence is most commonly associated with performing kegels. “Just do your kegels and you will be fine!” So optimistic! However, it is not always that simple. Research has indicated a significant reduction in urinary incontinence with “coaching” during kegels3. In other words, performing kegels on your own is not enough. A pelvic health physical therapist can offer many treatment options specialized to your care.
Kegels are not the end all be all. By going to a pelvic health specialist, treatment will be tailored to your needs. Common treatment interventions range from pelvic floor strengthening, biofeedback, electrical stimulation, abdominal dyssynergia, and weighted vaginal cones. Not everyone will require all of these interventions. Treatment will be based on your deficits or what is causing your incontinence. Is it a weak pelvic floor? Are you able to correctly perform a kegel and hold it for the appropriate amount of time? Is there a dyssynergy between the pelvic floor and abdominal muscles? We answer these questions daily and have successful outcomes.
As mentioned above, research indicates better outcomes for individuals who go to a pelvic physical therapist versus those who self-treat, but most importantly, YOU ARE NOT ALONE! Urinary incontinence can be treated. Do not let urinary incontinence prevent you from living the life you want and deserve.
- Lee, D. (2010). The Pelvic Girdle: An Integration of Clinical Expertise and Research (4th ed.). Churchill Livingstone
- Ward KA, Das G, Berry JL, et al. Vitamin D status and muscle function in postmenarchal adolescent girls. J Clin Endocrinol Metab. 2009;94:559-63
- Wei JT, DeLancey JO. Functional anatomy of the pelvic floor and lower urinary tract. Clin Obstet Gynecol. 2004;47(1):3-17
As a native of Floyds Knobs, Indiana, Emily grew up just across the Ohio River from Louisville. While earning her bachelor’s of science in Biology at Indiana University Southeast, Emily played basketball and volleyball. In 2014 she earned her Doctorate of Physical Therapy at the University of Evansville and then returned home to follow her passion for Women’s Health and sports rehab working with collegiate athletes and “weekend warriors”. In 2015, Emily became a Board Certified Orthopaedic Certified Specialist (OCS), a certification from the Federation of the State Board of Physical Therapy (FSBPT). In 2016, Emily transitioned her focus to pelvic pain and dysfunction in male and female patients while continuing to incorporate her orthopedic skills into her patients’ care.
Emily continues her education by working towards becoming a Board Certified Women’s Health Specialist (WCS). She is a member of the Indiana Physical Therapy Association (INAPTA), the American Physical Therapy Association (APTA), Section on Women’s Health (SOWH), and of the Orthopaedic Section of the APTA.
Emily is married with a miniature dachshund, Millie. In her spare time, she enjoys traveling, trying new restaurants, and running. She is also an active parishioner and Eucharistic minister at St. Mary’s Catholic Church.