How Physical Therapy Can Help Urinary Incontinence

  • author name Debbie Schrodi, DPT, CLT-LANA, MBA
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People with urinary incontinence (the involuntary leakage of urine) may benefit from physical therapy to help keep this common, sometimes embarrassing condition from affecting their daily life.

Leaking can happen after you sneeze, cough, or strain during sports or other activities. Studies say as many as one in three women report symptoms of urinary incontinence, with as many as one in two women over the age of 65 experiencing symptoms. In fact, more than 18 million women suffer from urinary incontinence, including a high percentage of female athletes.

Urinary incontinence can take a toll on mental health, social and sex life, sleep, independence, and even finances.

Types and Causes of Urinary Incontinence

There are several types of incontinence:

  • Stress incontinence occurs during activity or after sneezing, laughing or coughing
  • Overactive bladder, or urge incontinence, is a frequent and sudden urge to urinate that is hard to control
  • Mixed incontinence is a combination of stress and urge incontinence

Causes of urinary incontinence include:

  • Urinary tract or vaginal infections
  • Medication side effects
  • Constipation
  • Weakness in specific muscles
  • Diseases and disorders relating to the nerve and muscles
  • Certain types of surgery
  • Weight gain
  • Childbirth

What To Do if You Experience Urinary Incontinence

If you are experiencing urinary incontinence, the first step is to talk with your doctor. After a thorough exam and assessment, they may recommend medication, behavioral therapy, or physical therapy. Surgery is usually only considered only after other therapy options have failed.

Physical Therapy to Treat Urinary Incontinence

Based on your assessment, your physical therapist may suggest Kegel exercises or ask you to track your bladder habits (including what you eat and drink) to determine a connection to your incontinence.

Kegel Exercises

Kegel exercises are movements designed to strengthen and re-train pelvic floor muscles. Many women do not realize they are doing the exercises improperly. Repeating an exercise too many times may make your muscles tired. However, doing an exercise too few times may not help your muscles grow stronger.

To help determine if the correct muscles are contracting and relaxing during Kegel exercises, your therapist may use biofeedback—a sensor that connects to a computer. This tool helps with coaching and raises your awareness of when you contract and relax the correct muscles.

Your therapist may need to administer a brief and painless dose of electrical stimulation in the lower pelvis to stimulate and strengthen the muscles that control the emptying of the bladder. This is only necessary when you are not strong enough to perform the Kegel exercise without assistance.

How to do Kegel exercises

  • Find the muscles you use to stop urinating.
  • Squeeze these muscles for 3 seconds. Then relax for 3 seconds. Your stomach and thigh muscles should not tighten when you do this.
  • Add 1 second each week until you are able to squeeze for 10 seconds each time.
  • Repeat this exercise 10 to 15 times per session. Try to do this at least 3 times a day.
  • Don't do Kegels while you urinate. Doing them during urination can hurt your bladder.

Tracking Your Bladder Habits

To help determine foods or drinks that may bother your bladder, your therapist may ask you to record your bladder habits, including when, what, and how much you eat or drink. This can help with bladder re-training.

Some foods and beverages that can make urine leakage worse because they may cause bladder irritation include:

  • Caffeine (coffee, tea, some sodas)
  • Carbonated drinks, such as soda and sparkling water
  • Alcoholic beverages
  • Citrus fruits and juices (lemon, lime, orange, and grapefruit)
  • Tomatoes and tomato-based foods and sauces
  • Spicy foods
  • Chocolate
  • Sugars and honey
  • Artificial sweeteners

Take Action

If you are experiencing urinary incontinence, don’t suffer in silence. Your doctor can help determine the best course of treatment for you and if appropriate, refer you to our rehabilitation program.

Penn Medicine Lancaster General Health highly trained physical therapists are committed to improving patients’ quality of life through pelvic floor muscle retraining and behavioral changes. Private, personalized care, tailored to your individual needs and comfort level, can help reduce symptoms of incontinence, sexual function and pain.

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Debbie Schrodi, DPT, CLT-LANA, MBA

Debbie Schrodi DPT, MBA, CLT-LANA is the Rehab Supervisor for Women’s Health and Oncology at Penn Medicine Lancaster General Health. She received a master’s degree in Physical Therapy from Thomas Jefferson University, a doctorate in Physical Therapy from Temple University, and a master’s degree in Business Administration from Lebanon Valley College.

Call: 717-544-3270

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The LG Health Hub features breaking medical news and straightforward advice to help individuals of all ages make healthy choices and reach their wellness goals. The blog puts articles by trusted Lancaster General Health clinical experts, good 'n healthy recipes, videos, patient stories, and health risk assessments at your fingertips.


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