Bladder Leakage Explained
What is Incontinence?
Urinary incontinence (aka bladder leakage) is defined as the accidental loss of urine. There are a few different kinds of bladder leakage which we will outline for you here. Scroll down to read about the more common types of incontinence treated with pelvic floor therapy, and what you can do if you’re experiencing these symptoms.
*Stress Incontinence - leakage due to downward pressure like coughing, sneezing, laughing, jumping.
*Urge Incontinence - leakage that occurs while you’re trying to get to the toilet.
Mixed Incontinence - a combination of the two prior forms.
*Functional Incontinence -leakage when trying to get to the toilet, due to a physical limitation/disability or injury.
Overflow Incontinence - leakage due to the quantity of urine being produced exceeding bladder capacity.
Stress Incontinence
Stress Incontinence occurs when there is too much pressure downward on the bladder and pelvic floor and your pelvic floor support is not meeting or exceeding that pressure to counteract it. The amount of urine loss is typically smaller, but there is a lot of variation among people. Common triggers for stress incontinence include:
Laughing/coughing/sneezing
Jumping/running/lifting
Exercising
Standing up
Having sex
Pelvic floor therapy is especially helpful in resolving this, as we look at pelvic floor strength, endurance, coordination, posture, and pressure management and focus on getting all of these factors to integrate together. A study done in 2020 revealed that hip weakness can be a major contributor to stress incontinence. Speaking of the hip, we have a blog post (here) you can check out that dives into this in more detail. Knowing how to contract your pelvic floor muscles (correctly) with sudden pressure changes like coughing and sneezing can be very helpful, while regularly performing ongoing kegels is often not the long-term solution and can in fact worsen the problem!
Urge Incontinence
Urge Incontinence is when you leak urine while trying to get to the toilet, after feeling an urge to urinate. Picture the person holding themselves or doing the “potty dance” and then rushing to the toilet. We sometimes refer to this as the “key-in-lock syndrome” because people often report that the closer they get to the bathroom, the more intense the urge becomes and the more likely they are to leak. Typically, this results in a larger volume of urine loss and can be very impactful on one’s mental health and willingness to socialize for fear of losing control. This is often associated with:
Increased frequency of urination - needing to pee more than 8x/day
Urgency - sudden strong urges to urinate instead of a gradual, subtle signal
Pelvic floor therapy addresses this type of incontinence through bladder retraining and muscle re-education. One thing you can try at home is to identify any bladder irritants you may be consuming by noting if your symptoms worsen in the hour or two after consuming them. Common irritants include, but are not limited to, coffee, alcohol, and carbonated beverages.
Functional Incontinence
As the name implies, functional incontinence is bladder leakage due to a functional limitation/disability that prevents the person from getting to the toilet in time. This is less of a bladder issue and more of a mobility issue, although pelvic floor dysfunction can commonly co-exist. Those who may experience functional incontinence can include:
Individuals using a wheelchair or walker, who may need extra time to get to the restroom
Those with limited abilities concerning undressing, making it more difficult and time consuming to access a toilet
People who sustain an injury, impacting their access to a toilet
Pelvic floor therapy can help in this case, by addressing the functional needs and limitations of the person and creating ways for them to access the toilet more successfully. This may look like strengthening, training with an assistive device, addressing toileting habits, & modifying the environment to help match the person’s abilities.
Important Points 👇
The various types of incontinence can be greatly improved with pelvic floor therapy but it is ESSENTIAL to consider the following:
A pelvic floor evaluation is the best way to determine WHY you’re experiencing these symptoms in the first place. For example, two people can have stress incontinence for different underlying reasons. This means their treatment approaches will be different.
Bladder leakage can be a stand alone diagnosis as a direct result of pelvic floor dysfunction but it can also be a symptom of an underlying medical condition. One should alwasy consider checking with a physician to rule out any medical diagnoses.
Bladder leakage is NEVER normal, although very common. Knowing that help exists is the first step to addressing and overcoming these symptoms and living life more confidently!
Finally, avoid the gimmicks that promise a quick/easy fix, like the vibrating devices that cause your muscles to kegel via electric stimulation - They assume each person is leaking due to pelvic floor weakness and they just don’t work! You can read more on why theses incontinence devices don’t work here.
