Urinary Incontinence

What is it?

Urinary incontinence — it’s more common than you think.

Urinary incontinence is a really fancy term for saying you leak urine. There are multiple types of urinary incontinence: stress, urge and mixed incontinence. Whatever type you’re experiencing, it is very common — but it is not normal, and it is absolutely something that can be addressed and improved.

Some people experience mixed incontinence — both types. Honestly, just seems really unfair. But it’s fairly easy to treat.

The tight pelvic floor paradox

Sometimes the pelvic floor is too tight, not too weak.

Sounds counterintuitive, right? If the muscles are contracted they should be doing a fantastic job at keeping you dry. But think of it this way: if you make a fist and squeeze it as tight as possible, can it get any tighter? Nope. We need the pelvic floor to be able to relax and then contract in order for it to do the best job possible.

The first step in treatment is assessing the pelvic floor — internally if you’re comfortable with this. We need to know if the muscles are tight, weak, or both. Then we can develop a treatment plan that might look like releasing tension, teaching the muscle how to relax, then how to contract, and building endurance.

How urge incontinence works

Breaking the bad feedback cycle.

Our bladder has mechanoreceptors — pressure sensors. As it fills with urine, it stretches and eventually lets you know when it’s time to empty. If we continually empty our bladder before it really fills up, we create a new behaviour. The bladder will only fill a little bit and think it must empty sooner and sooner.

Not all bladder irritants apply to every person. The first step in treating urge incontinence is urge deferral techniques — using the bladder–pelvic floor relationship to our advantage. When the bladder contracts to urinate, the pelvic floor must relax. We can contract the pelvic floor to calm the bladder.

What treatment looks like

Building a stronger, better-coordinated pelvic floor.

Building a stronger pelvic floor requires homework. We address those muscles, but also the rest of the core to keep the system as balanced as possible. Once we reach the strengthening stage you’ll have a list of exercises to progress through between sessions.

Hip strengthening is also utilised to support the pelvic floor — the muscles that rotate the hips attach to the pelvis, just like the pelvic floor. Increasing blood flow to hip rotators can have carry-over to their neighbour, the pelvic floor.

Related conditions

You might also be dealing with…

Pelvic floor conditions rarely show up alone. Here are some commonly related conditions we also treat at WildHer.