Women's health physical therapy is a field of physical therapy that specializes in the evaluation and treatment of conditions that affect women. This includes conditions such as urinary incontinence, pelvic organ prolapse, and chronic pain. Pelvic floor physical therapy is a specialized form of women's health physical therapy that focuses specifically on the pelvic floor muscles. These muscles play an important role in supporting the pelvic organs and can be affected by conditions such as urinary incontinence and pelvic organ prolapse. Physical therapy can help to improve the strength and function of these muscles, which can help to reduce symptoms and improve quality of life.
What Is Incontinence Urinary incontinence is when you leak urine. This can also mean that you have trouble starting to pee and holding it in. The condition affects the muscles in the pelvic floor. These muscles attach to the bottom of your pelvic bones and go from front to back. They help support your internal organs.
Stress Incontinence When you cough, laugh, sneeze, lift, or run your body is putting pressure on the bladder. If this causes too much strain for any reason--from weak muscles to a physical injury such as vaginal childbirth which can damage supports systems around urination—you may experience leaky urine (stress incontinence). Women with stress incontinence often have pelvic floor muscle dysfunction due to:
Pregnancy and childbirth, which put stress or pressure on the bladder or cause trauma to the pelvic floor muscles.
Episiotomy (a procedure often used to ease childbirth).
Perineal injury or tearing during childbirth.
Injury or trauma, such as a pelvic fracture.
Inflammation, such as cystitis.
Surgery in the vagina or rectum.
Lack of exercise or a lifestyle that involves too much sitting.
Urge Incontinence Many people experience a sudden, strong need to pass urine. This is often called urge incontinence. People with this type of incontinence often leak before reaching the bathroom. It can help to have a strong coordinated contraction of the pelvic floor muscles as this decreases the urge to urinate. It also helps to keep the urethra closed. However, some people may lack control over their pelvic floor muscles due to weakness or tightness. Or they may experience spasms which contribute to bladder contractions. Conditions such as anxiety can increase the urge to empty the bladder.
Urge incontinence can be learned. People learn to do this by accident. For example, someone might always go to the bathroom when they get home. Over time, they might feel the need to go on the way home. This makes them feel like they have to go right away, which may lead to incontinence.
Caffeine and sugar, acidic foods, and smoking can irritate the bladder. These things can cause inflammation or cause the bladder muscle (detrusor) to contract more than it should. This contraction can contribute to incontinence.
Mixed Incontinence Some people have both urge and stress incontinence. When this occurs it is called mixed incontinence.
Functional Incontinence Leakage that is not directly related to the bladder or pelvic floor muscles is called functional incontinence. This type of incontinence results from problems other than weak pelvic floor muscles or bladder control. It happens when external factors, such difficulty walking, or pain, prevent a person from reaching the toilet in time. Even without a strong urge to urinate, people may leak urine on the way to the bathroom.