Physiotherapy is a safe and effective treatment for stress/urge incontinence. It will reduce your symptoms and if started in the early stages can completely cure you. This treatment has no side effects so it should be the first choice of treatment. The main aim of physiotherapy is;

• Control over symptoms
• Reduce the dependency on medicines/pads
• Reduce the chances of surgery.

After the assessment and knowing the history of the patient, we at Delhi Physio Care will tailor therapy that best suits your needs. Incontinence is more seen in women, so it is categorized under women’s health sometimes, though we see a lot of men facing the problem too.

The role of the physiotherapist is ;

• Increase the strength, coordination and endurance of the pelvic floor muscles.
• Strengthen the abdominal and lumbar muscles.
• Bladder/bowel training
• Tips on fluid management and diet modification.

The pelvic floor muscles are like a hammock extending from sacrum(tailbone) to pubic
bone, in front of abdomen. These are the muscles that need to be trained and exercised. It is important to make the patient aware of these muscles first. This can be done by teaching to first relax the other adjoining muscles like the abdominals and the muscles of the thigh. Once these muscles are relaxed, contract the pelvic floor muscles which are exactly like to hold urine or stool. These are called the KEGEL exercises. They are taught in lying, sitting, standing, walking….in all positions. You will be taught to do slow and fast squeezes as many times as possible. It is important to not hold your breath while doing them. Talking while exercising helps to breathe normally.

The posture is important while doing these exercises; eg. When doing kegel sitting, sit straight. Avoid using the core and the back. These exercises not only train and strengthen the pelvic floor muscles but also improves bladder control.

Electric muscle stimulation is clinically very useful for pelvic floor muscles. It not only makes the patient more aware of the muscles and its function but also fastens the progress of strengthening. It is possible to do the exercises along with the stimulation for as long as 30 minutes without the muscles getting fatigued. We teach the patient to actively contract the pelvic floor muscles along with the stimulation. It overcomes the bladder leakage that occurs with lost automatic activity. This aids to close the urinary tube/ urethra more effectively. Learn to lift and firm the muscles to withstand downward pressure from the abdomen. Lift and squeeze urethral/ vaginal and anal muscles. We can progress by learning to contract these muscles and then coughing or doing other activities that cause downward pressure on the pelvic floor.

Kegel is always combined with the knack principle which is a strong and well timed contraction of these muscles.

Remember; “ Squeeze before you Sneeze.” Anything that causes a downward pressure like coughing, sneezing or lifting heavy objects… tighten and lift up the pelvic floor.

Don’t strain during bowel movements. Constipation worsens the symptoms.
Identify the food items that aggravate the symptoms. Eg. Caffeine is considered a bladder irritant.

Bladder retraining is a gradual progress. It is extending the time between visits to the toilet. It could be as less as 1-2 minutes initially. A few techniques can be tried to achieve this.

• Mental distraction
• Perform quick pelvic floor muscle contractions
• Avoid precautionary use of the toilet( just in case if you have to go out)

The patient starts feeling some difference in a couple of sessions, but it would take about 6-8 weeks of regular exercises with electric muscle stimulation and bladder retraining to see improvement like fewer leakage episodes and reduced frequency of urination.

As said earlier, it is a very safe treatment with no side effects. We see a 70-80% success rate in avoiding or delaying the surgery. Patience and regularity makes the treatment successful.

Urinary incontinence; It doesn’t have to control your life. Find out your treatment options today!