Urinary & Faecal Incontinence

Urinary incontinence (UI) refers to involuntary leakage of urine. Faecal incontinence is the inability to control the leakage of faecal matter and both occur more often in women than in men. UI is currently the second reason behind dementia as the reason why the elderly are placed in assisted living facilities in the USA. It is a significant issue that can be effectively addressed with the expert skills and the right approach. 

 

Life events such as pregnancy, childbirth, and menopause may contribute to urinary incontinence in women. Urinary incontinence will be suffered by one-third of men and two-thirds of women in their lifetime with 55% of women over 65 years old live with leakage. Although common, it is not ‘normal’ and PhysioMotion’s skilled therapists in this area produce results that will alleviate this inconvenient problem.

For women, commonly associated problems with incontinence are pelvic organ prolapses (POP).  Rectus abdominus diastasis for both men and women are also frequently associatedd with incontinence because of the common link between non-optimal activation of the abdominal and trunk muscles placing excessive loads on the pelvic floor muscles. 

 

The most common cause of bowel incontinence is damage to the muscles around the anus (anal sphincters). Vaginal delivery during childbirth can damage the anal sphincters and their associated nerves, affecting women suffering accidental bowel leakage about twice as often as men. Although it may be a sensitive topic to discuss, it is often a very treatable condition when an accurate diagnosis of the cause is found.

The causes of incontinence are: 

  • Weak bladder or pelvic floor muscles (PFM)
  • Asymmetry in weakness & tightness in the pelvic floor muscles
  • Overactive bladder muscles
  • Nerve damage from: pregnancy, childbirth, spinal dysfunction, post-surgical procedures such as prostectomy
  • Imbalance in intra-abdominal pressure caused my musculoskeletal issues in other regions of the body
  • Imbalance in abdominal & trunk muscle activation
  • Constipation: this is due to the increased pressure on the pelvic floor muscles caused by pushing during a bowel movement

There are different types of urinary incontinence:

Stress incontinence – from physical stress such as coughing or jumping

Urge incontinence – the sensation or actual need to urinate before the bladder is full 

 

Mixed incontinence – a mixture of both stress and urge incontinence 

Neurogenic Incontinence – due to disturbance of the nervous system

Both nulliparous women (women who have not had children), mothers and men can suffer incontinence. For people who suffer UI, there are often multiple imbalances in the musculoskeletal system that are largely contributing or causing the incontinence. In healthy women, normal recruitment of the PFM and abdominal muscles is often lost in women with UI. This imbalance causes excessive pressure onto their pelvic floor muscles due to insufficiency in the abdominal and trunk muscles, whilst also not allowing optimal neuromuscular recruitment patterns of the pelvic girdle muscles.

The combination of pelvic floor muscle exercises and treatment of other musculoskeletal dysfunction is the key to successful management of incontinence.

 

At PhysioMotion, our Physiotherapist’s will perform the following to effectively treat incontinence: 

 

Conduct a full body assessment to determine whether are any contributory musculoskeletal factors 

Perform a thorough examination of the pelvic floor muscles including an internal vaginal examination conducted by a specifically trained and qualified women’s health Physiotherapist if required.

Use real time ultrasound guided imaging to assess the pelvic floor and abdominal muscles –  this can be also performed both during and after pregnancy. Ultrasound imaging equipment will help you ‘feel by seeing’ the muscles so that you can visually and objectively see which muscles are working correctly. 

For more information regarding our services for urinary and faecal incontinence, refer to women’s health or men’s health in our Services section.

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