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Let’s Talk About Pee: Continence, Incontinence and How Physiotherapy Can Help

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Do you leak when you cough or sneeze? Are you too scared to jump on the trampoline with the kids because you might leak? Do you experience a sudden desire to urinate and loose some or all of it on the way to the toilet? Are you a cross fitter who thinks it’s normal to leak when you work out?


Bladder control problems are COMMON but not NORMAL.

A quarter of New Zealanders and one in three women who have ever had a baby experience symptoms of incontinence. Unfortunately we don’t talk about it enough, so most women suffer in silence and believe that nothing can be done about it.

Statistics from Continence NZ show that 70% of women with bladder control problems can become dry or experience significant improvement with the right intervention. Thankfully it’s not all doom, gloom, panty liners, wet patches and embarrassment. There is help available!


Physiotherapy can help in the treatment of incontinence.

Urinary incontinence is a sign that part of the system which keeps us dry is not functioning. Pelvic floor muscles that function well are an important part of the system. We all need strong, but flexible muscles that tighten when they need to and relax when they need to - including the pelvic floor! A physiotherapist can prescribe the specific exercises and lifestyle changes necessary to help YOU.


Not all bladder control problems are the same.

The two most common types of incontinence are stress urinary incontinence and urge urinary incontinence. Stress urinary incontinence is the involuntary leakage of urine with exertion. This commonly occurs during activities such as coughing, sneezing, jumping, straining or playing sport (including elite athletes). Urgency is when a person feels a sudden, overwhelming desire to pass urine and urge incontinence is if leakage occurs before getting to the toilet.


So how exactly can physiotherapy help?

The good news is that a high percentage of women experiencing stress urinary incontinence can fully recover or significantly improve from doing correct pelvic floor exercises. The bad news is that up to 50% of women do pelvic floor exercises incorrectly which in some instances can make the symptoms worse! A physiotherapist with a special interest in women’s health can teach you how to correctly exercise your pelvic floor muscles.

Most urge incontinence can be helped by bladder retraining. It may come as a surprise but yes you can train your bladder!  A physiotherapist can help guide you with bladder retraining. The aim is to be able to suppress the strong desire to pass urine and reduce symptoms such as frequent ‘just in case’ visits to the toilet, feelings of panic that you may not make it to the toilet and stop any leakage.


Talk about it.

The reality is that incontinence is an issue for many women, so if you do have signs and symptoms of a bladder control issue you are not alone, you do not need to feel ashamed. Talk to your closest girlfriend, your sister, mother or cousin and you’ll probably find they have experienced similar symptoms. Realising it is COMMON but not NORMAL is an important first step. Then make the decision to do something about it. Talk to your Motus physiotherapist with a special interest in women's health, they can help.

In the meantime here are some handy tips on healthy bladder habits..

  • Avoid going to the toilet if you don’t really need to go, don’t go ‘just in case’
  • Sit down on the toilet, relax and don’t hover over the toilet seat
  • Only go to the toilet 4-6 times during the day and no more than once during the night
  • Cut down on bladder irritants such as caffeine, alcohol and artificial sweeteners
  • Your bowel is as important as your bladder, eat adequate amounts of fibre and don’t strain

ABOUT THE AUTHOR: Kelly Stembridge is a senior physiotherapist working at SportsMed Bealey Ave, Kelly has a Clinical Masters in Musculo-Skeletal Physiotherapy and a special interest in Women’s Health

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