Let’s face it, ladies. It’s one of those unspeakable topics that you probably won’t hear us openly talking about over coffee, in lines at grocery stores, or at the book club. It’s inconvenient, stressful, and often embarrassing. Those affected may cringe at the thought of coughing, sneezing, or laughing in public. Others may search for their favorite department stores based on bathroom accessibility rather than the latest clothing fashions. And some avoid that favorite kickboxing class that everyone talks about for fear of losing bladder control with that first lunge or jump. Yes, we are talking about URINARY INCONTINENCE, a condition that affects 26% of women between 18 and 59 years old and is to blame for the activity restriction of millions of women in our country every day. Although common, urinary incontinence is NOT normal and every day we learn more about what can be done to help improve bladder function.

Most of us probably understand the symptoms of urinary incontinence (UI) quite well. By definition, UI is the involuntary loss of urine accompanied by a strong desire to urinate (INCONTINENCE OF URGENCY) or physical exertion (INCONTINENCE OF STRESS). Less formally, it is described as “I pee when I sneeze”, “I feel like I always have to RUN to the bathroom” or “I would feel more rested if I didn’t have to get up to go so much in the middle of the night.” UTI is often caused by pelvic floor muscle weakness or, in some cases, abnormal tightness of these same muscles. Pregnancy can certainly contribute to changes in these muscles, but so can menopause, abdominal surgery, specific sports activities, and age. It is important to determine the cause of the UI in order to establish the appropriate treatment approach. Pelvic floor physical therapists are trained to assess the strength of these muscles and, together with your referring physician, develop a treatment plan specific to YOUR body and YOUR needs that can help improve the quality of YOUR life.

So what exactly is the “treatment plan” for UI? Each plan is unique and individualized for each patient. It can include pelvic floor strengthening exercises (yes, I know EVERYONE has heard of Kegel exercises, but are you doing them correctly? Should you be doing them?), Biofeedback Training (for muscle strength, coordination, and endurance) and bladder modification activities. (bladder irritation education, bladder journal) to maximize good bladder habits and promote fitness. The good news is that conservative care, such as pelvic floor physical therapy, has been shown to be effective in reducing incontinence episodes and helping women return to a healthier and more active state. Lifestyle!

To finish, I give you some recommendations to achieve an optimal state of the bladder.

MAKE

1. Urinate 5-7 times a day

2. Sit on the toilet to urinate

3. Drink enough water (32-64 oz / day)

WHOSE

1. “JIC” – “Just in case” pee

2. “Float” on the toilet to urinate

3. Pushing or straining to empty the bladder