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9 October 2008
Physical therapy effective option for urinary incontinence 
A study published in the Annals of Internal Medicine reports that pelvic floor muscle training, in conjunction with bladder training, can resolve the symptoms of urinary incontinence in most women. According to the American Physical Therapy Association (APTA), the findings are particularly timely given that it was recently reported that a quarter of all women suffer from this often debilitating condition. "Patients often think that because of age or medical history, incontinence is something they have to learn to live with, but in reality that couldn't be further from the truth," said Patricia J Jenkyns, a physical therapist at the Department of Rehabilitation Services at Boston's Brigham and Women's Hospital. "Health care professionals need to be aware of the role that physical therapists play in treating incontinence so that their patients know about alternatives to diapers, medication, or surgery." Jenkyns explained that physical therapists use a variety of methods to help patients correct pelvic floor dysfunction. The initial patient evaluation requires determining the type of incontinence (stress, urge, or both), the extent of incontinence, assessing the strength, motor control and endurance of pelvic floor muscles, and screening for any other musculoskeletal issues, then developing an individualized exercise treatment program, and making sure patients understand their role in the treatment program. Kegel exercises, or pelvic floor muscle exercises that involve contracting, holding, and releasing pelvic floor muscles, are the most effective weapon in the fight against stress incontinence. "Once patients have correctly identified these muscles, a physical therapist will train how to enhance pelvic floor muscle function, coordinate with abdominal muscle exercises and bring these exercises and awareness into functional activities," says Jenkyns. She notes that these exercises need to be brought into daily activities, and can be done when sitting at your desk or on the toilet, while driving, or at the gym. For those with very weak muscles, she recommends starting the exercises while lying down. Jenkyns always reminds her patients who experience stress incontinence to "squeeze as you sneeze," or to coordinate pelvic floor and abdominal muscles before doing the activity that causes leakage, (eg, sneezing, coughing, laughing, lifting, etc). Physical therapists can also offer tips on lifestyle changes that will help make the bladder less irritable: avoiding common bladder irritants, retraining the bladder, keeping a bladder diary and lifting, moving, and exercising correctly, particularly by avoiding improper sit-up techniques. Related:
Prevalence of incontinence surprises experts
Childbirth Muscle Damage Linked To Pelvic Prolapse, Incontinence
Hormone Therapy Worsens Urinary Incontinence
Loss Of Bladder Control A Taboo Subject
Source: American Physical Therapy Association
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