Does an oncoming sneeze, cough, jump or laugh make you nervous? Do you have to empty your bladder several times before you exert yourself physically in fear that you might have ‘an accident’?
Stress Urinary Incontinence (SUI) is more prevalent than people realize and unfortunately because it can be socially embarrassing, people often try and deal with their problems behind closed doors or suffer alone. For some reason woman think this is a normal part of childbirth and aging; however this is far from the truth. Many women will carry on with their daily lives refraining from enjoying their past physical pre-baby activities such as jogging; kick boxing; jumping and aerobics because they suffer from SUI. Often they even wear a daily panty liner ‘just in case’ and do so for years, until they realize that this problem can be treated.
Fortunately, there is help out there and effective treatment called Pelvic floor Rehabilitation/Physiotherapy (PFR).
Do you wonder why no one has ever told you about this treatment before? Well, 1) not a lot of physiotherapists perform this treatment, as it is a specialization and 2) because most people shy away from talking about SUI or seeking treatment, it often isn’t even explored: unfortunately as a result, a lot of medical professionals are not even aware that PFR exists.
What does PFR involve?
A trained physiotherapist in PFR will perform an initial assessment of the pelvic floor muscles (PFM) and surrounding musculoskeletal region. Treatment sessions consist of facilitating the PFM to recruit better and thus assist with supporting the bladder, which is one of their primary roles. Often what the physiotherapist finds is that the patient who thinks they are performing their ‘Kegel’ exercises correctly are not and compensating with other muscles such as their abdominals, inner thighs and gluteals. Often there is a lack of ‘control’ of these muscles. There may also be scar tissue or tightness in the muscles and myofascia in the area that need to be ‘mobilized’ (stretched); so the PFM function effectively, optimally and normally. Other techniques could also include: biofeedback; manual facilitation; bladder retraining and electrical stimulation.
You’ve heard of biofeedback treatment. What is it and how does it work?
Biofeedback is a technique employed either manually (using facilitation with the physiotherapists hands); or on a computer system or program. On the computer system a small probe is used to detect the EMG activity (electromyographic activity – muscle recruitment or activity of the PFM) or pressure generated by the PFM (pressure probe); and this can be viewed on the screen. It works well in conjunction with other techniques as it gives a ‘visual’ of how strong, fast and long you can contract your muscles and shows you when they are fatiguing and progressing. Programs can also be set up and goals set for each visit so you can map out your progress and see/feel the changes. Consequently you are more motivated; work more effectively, harder and get faster results. It’s like doing a ‘Life fitness program’ for you PFM and it’s harder work then you think! Studies have shown it to be highly successful also.
Can I train my PFM without going to a physiotherapist?
Certainly improving your PFM relies on a regular ‘Kegel type’ exercise routine; however if you still are having problems after months independently, you likely require some professional assistance on how to recruit/control the muscles properly and how to work them so they are functioning maximally to prevent any leakage during all ‘stressful’ circumstances. If there is any dysfunction (imbalance) in the PFM also, this will have to be addressed. All key components of strength, endurance, fatigability, intensity have to also be implemented in your ‘PFM training’ to address the SUI.
One last point – You may be surprised at how quickly you feel and see some improvement after only a few visits as long as you are compliant with the excises, which, of course is a huge part of the treatment! The great news is that it can only help you!