Urinary Incontinence - Management Solutions

Your women’s health physiotherapist will be able to determine if your pelvic floor muscles need to be strengthened, relaxed, or both with a pelvic floor examination.

Some people think their pelvic floor muscles are weak and stretched, while the opposite may be the case. For some people the pelvic floor muscles are too active and they will need to be taught to relax these muscles. You will learn how to exercise your pelvic floor muscles according to what is needed for you.

Kegels are commonly prescribed to women when they say they have a pelvic floor dysfunction. Most women do not know how to perform a pelvic floor muscle contraction correctly. They may be using other muscles or bearing down. Kegels may do you a disservice and increase your symptoms. Your women’s health physiotherapist will guide you on whether or not you should start performing pelvic floor muscle contractions or if they need to be relaxed.

No. In fact, we encourage you to continue exercising as it has many physical and mental benefits. We may ask you to take a short break from some of the activities that are causing you to leak or may modify an exercise so you can still participate in the activities you enjoy. For instance, if doing double unders while skipping causes you to leak, we may suggest you do single jumps if it does not cause you to leak. Other forms of exercise include Foundation Pilates (we offer reformer pilates at Body Logic Health), swimming, indoor or outdoor cycling, water aerobics, walking, and low impact resistance exercises

This is not required, and is sometimes not necessary, however your pelvic floor physical therapist will be able to tell you what is best for your current situation. A pelvic floor assessment will be beneficial for your treatment by showing if your pelvic floor muscles are tight, weak, or both. This will be helpful to get baseline information for your progression and put the best management plan in place.

Your women’s health physiotherapist will first ask for your consent to perform the examination. An external examination will be performed looking at your skin, assessing sensation, mobility, and manually checking your strength. The internal assessment will be guided by you. No instrumentation will be used. This is performed using one digit.

Yes. Taking a proactive approach is the best way to prevent urinary incontinence. Even if you are feeling fine during your pregnancy and especially postpartum, the best thing you can do for your body is to see a women’s health physiotherapist to assess your core and pelvic floor. This applies to those that have never had children and are experiencing these symptoms.

You should call your clinician if you are experiencing any urinary leakage, even if it is occasional. This is extremely common in women, however it is not normal and should be addressed. You should also schedule an appointment if you have urinary incontinence that has not improved with other treatment options, if you have a surgery scheduled, or after surgery. If surgery is required, a collaborative approach with your surgeon and women’s pelvic health physiotherapist is recommended to ensure a successful outcome.

These are common, but not normal and should be addressed. Waiting to see if your symptoms resolve on their own is taking a reactive approach. We recommend making an appointment with your women’s health hpysiotherapist for a full assessment to improve your symptoms and determine if a referral is needed.

Foundation Pilates is a method of exercising that targets your deep postural muscles, training them to work better to control your lumbar spine and pelvic joints. This is treating “the cause” rather than just treating the symptoms. Foundation Reformer Pilates offers individually prescribed exercises in a 1.2.1 environment, after a full assessment, by the instructor, we have two who are experienced with pelvic health recovery.

Once per week is the minimum you should do Reformer Pilates initially. Foundation Pilates is a “skill” more than “fitness”, just like learning a new tennis shot, or golf swing. If you have a lesson once per week, you will learn to play tennis. If you have a lesson twice a week, you will learn to play faster. When your body is learning something new, it is important to regularly attend your classes, or perform your exercises. This is how your neural pathway learns most effectively.

We encourage you to maintain an exercise routine, however some exercises may be worsening your urinary incontinence, which could lead to other complications, such as pelvic organ prolapse. Your Women’s Health Physical Therapist will be able to guide you to find an exercise that is safe for you to do.

This depends on a few factors: compliance with the protocol your women’s health physiotherapist provides you, complications with pregnancy/delivery, and illness or injuries can cause a recurrence of UI. The best way to prevent this from returning is to maintain a healthy and active lifestyle and follow up with your provider and physical therapist if you have any concerns.
Conditions that pelvic health physical therapists treat include:
• Stress urinary incontinence
• Urge urinary incontinence and urinary urgency
• Urinary frequency and nocturia
• Pelvic organ prolapse
• Post-gynecological surgery management
• Pre- and post-natal care, including pregnancy-related pelvic girdle pain, abdominal separation and mastitis
• Pelvic pain including vaginismus, dyspareunia and chronic pelvic pain.