Sarton Physical Therapy

Hope and healing for pelvic floor dysfunction

Urinary Incontinence | Sarton Physical Therapy

Urinary Incontinence

It is not just older patients who suffer from urinary incontinence.

Urinary incontinence affects four out of every ten women, one out of every ten men, and 17 percent of children under the age of 15. Additionally, 28 percent of male and female athletes between 18 to 21 years old experience stress incontinence. Pregnant women are also at a higher risk for urinary incontinence because their pelvic floor muscles and the pudendal nerve are significantly stretched during pregnancy. Overall, more than 25 million Americans suffer from urinary incontinence and the experience can often leave them feeling ashamed, socially isolated and depressed. Fortunately, Sarton Physical Therapy offers the highest level of conservative treatment for this frequent condition.

Our expert physical therapists treat the 3 most common types of incontinence:

Stress incontinence:
Urinary leakage caused by coughing, sneezing, laughing or exertion
Urge incontinence:
A sudden and strong urge to urinate, along with the inability to control it
Mixed incontinence:
A combination of stress loss and urge loss together.
Continence requires the complex integration of signals among the smooth muscle of the colon and rectum, the puborectalis muscle, and the anal sphincters. In essence, any process that interferes with these mechanisms, including trauma from vaginal delivery or a neurological insult, can result in fecal incontinence.

How does pelvic floor physical therapy help?

According to the American Physical Therapy Association (APTA), proper preventive measures and treatment by a pelvic floor physical therapist can help patients manage, or alleviate urinary incontinence. In fact, APTA quotes a study published in 2008 in the Annals of Internal Medicine that said that pelvic floor muscle training, in conjunction with bladder training, resolved the symptoms of this often debilitating condition in women. Also quoted is a study published in the New England Journal of Medicine, which stated that "first-line treatment for stress incontinence includes pelvic floor muscle training.” This study further highlights that women unable to control their pelvic floor muscles "may benefit from seeing a physical therapist trained in pelvic floor therapy."

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During the initial evaluation, our physical therapists will evaluate any musculoskeletal impairment present by assessing the strength, motor control, and endurance of the pelvic floor muscles. We then evaluate the trunk muscles, including the transversus abdominus and multifidus, as research shows these muscles activate with the pelvic floor and can contribute to the patients condition when weak. Additionally, we assess other musculoskeletal issues such as trigger points, myofascial tightness, and the misalignment of the pelvic, sacroiliac, spine, and hip joints to rule these out as causative or perpetuating factors.

Next, an individualized treatment program is developed for each patient. It is reported in the literature that 40 percent of women perform a kegel incorrectly; therefore biofeedback is often used to help a patient effectively learn how to isolate and contract the pelvic floor. Once mastered, patients are progressed to a research-based pelvic floor Pilates exercise program to enhance pelvic floor activation and function. Prescriptive, upright, tri-planar exercises are also given by our therapists to reinforce the activation of the patient’s pelvic floor muscles with the other core muscles in functional positions. Our team additionally teaches behavioral modification techniques such as how to avoid certain bladder irritants in the diet which can also increase the incidence of incontinence episodes. To insure the best possible results, the therapists at Sarton Physical Therapy always spend an hour with each patient during every appointment.

Let our expert Physical Therapists with advanced board certification in pelvic floor physical therapy help. Please contact Sarton Physical Therapy with any questions or to have your patients schedule an appointment.
“I am so glad my urologist referred me to Sarton Physical Therapy. The treatments and exercises prescribed to me have helped me greatly with my incontinence issues allowing me to avoid surgery.”

K.H., Patient

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1) Fantl, J. A., et al. "Urinary Incontinence in Adults: Acute and Chronic Management. Clinical Practice Guideline No. 2, 1996 Update (AHCPR Publication No. 96–0682). Rockville, MD: US Department of Health and Human Services." Public Health Service, Agency for Health Care Policy and Research (1996).
2) A. Ashton-Miller, Denise Howard, John OL Delancey, James. "The functional anatomy of the female pelvic floor and stress continence control system." Scandinavian Journal of Urology and Nephrology 35.207 (2001): 1-7.
3) Others: APTA Women’s health across the lifespan brochure, Medical News Today