Putting a stop to incontinence

Putting a stop to incontinence

Do you leak when you laugh? Its time to raise awareness for the 5 million+ Australians who experience bladder or bowel incontinence. Yes, it really is THAT common! This can be a very debilitating condition, but unfortunately, a lot of people suffer in silence through fear of speaking out, due to the embarrassing nature of the problem.

What you may not realise is that the majority of incontinence cases can be treated, and a lot of the time, stopped completely. So, to try and help break the silence surrounding incontinence, we are going to give you a little run down on what it is, who it affects, and some tips on what you can do to help.

WHAT IS INCONTINENCE?

Incontinence is the term used to describe the uncontrollable loss of urine from the bladder or faeces from the bowel. It ranges in severity from losing only a very small amount of urine, to a complete void of the bladder or bowel. If you’ve never experienced this, you can only imagine how distressing this must be. There are different types of urinary incontinence, including:

  • STRESS INCONTINENCE, where small amounts of urine leak due to small increases in pressure on the bladder during physical activity, or from coughing, sneezing or laughing.
  • URGE INCONTINENCE, where you get an unexpected, strong urge to urinate with little to no warning. This is usually as a result of an overactive bladder muscle.
  • INCONTINENCE ASSOCIATED WITH CHRONIC RETENTION, where your bladder cannot empty fully, and you get regular leakage of small amounts of urine. There are many causes for this, including an enlarged prostate in men, or prolapsed pelvic organs in women, as well as medications and certain conditions, such as diabetes and kidney disease.
  • FUNCTIONAL INCONTINENCE, where you are unable to get to the toilet, possibly due to immobility, or wearing clothes that are not easy to get off in time.

Faecal incontinence is when you have a lack of control of bowel movements and you may accidentally pass a bowel movement, or even pass wind without meaning to. This may be due to weak muscles surrounding the back passage (Unfortunately ladies, this is common following pregnancy and childbirth), or if you have severe diarrhoea.

TAKING THE STRESS OUT OF INCONTINENCE

For all those suffering in silence, it is time to speak out.  There is no need to be embarrassed, it is surprisingly common – and like we have already mentioned, help is out there! You may not need to look very far. Being your local Osteopath, we may be able to help.

The most common type of incontinence that we see and treat is stress incontinence. Although seen across both sexes, women are three times more likely to experience it than men. It is very common in women following pregnancy and childbirth (when the pelvic floor muscles get over-stretched, and sometimes even damaged), during menopause (due to hormonal changes) and in the elderly. It commonly affects men who have had prostate surgery.

The pelvic floor muscles sit at the bottom of the pelvic bowl, spanning from the pubic bone to the tailbone (front to back) and from one sitting bone to the other (side to side). Imagine a tarpaulin stretched out with a person holding each corner and you kind of get the gist. When these muscles are strong, they help to support our internal pelvic organs (i.e. the bladder, bowel and the uterus in women) and wrap around the openings of the front and back passages, allowing us to control when we decide to do a number one or two. Following pregnancy for example, they may become weak and dysfunctional, and we can lose that ability to control voiding. It only takes something as small as a cough, or an activity like jumping or running (things many of us take for granted) that may cause a person to lose a small amount of urine.

WHAT WE CAN DO TO HELP

The most important thing to point out is that not all types of incontinence will improve or resolve with just strengthening of weak pelvic floor muscles. So, it is very important to get an accurate diagnosis, because there will likely be other factors that need addressing too. For instance, losing weight, stopping smoking, and making other lifestyle changes are just as important in the management of these conditions, if relevant to the person of course. Some people may also require release of tight and over-active muscles.

Once you have your diagnosis, then strengthening may well be a part of your therapy. In order to strengthen, you need to know where the muscles are, and how to activate them. Below is a little step by step guide to getting a grip on those pelvic floor muscles (we don’t mean literally!):

  1. Get in a comfortable position – try sitting or lying on your back and take a few breaths to relax.
  2. Imagine you are trying to stop yourself from urinating mid-stream by squeezing for about a second. If this is not easy to feel, next time you are on the toilet emptying your bladder, have a go at stopping mid-stream and then relaxing again to finish emptying (don’t hold it for too long please – just enough to feel which muscles you need to use).
  3. Do the same as step two for the back passage – this time imagine you are trying to stop yourself from passing wind by squeezing.
  4. Do these quick squeezes 3 x 20 reps a day. Once you’re comfortable, you can do it sitting or standing. Make it routine… Do it when you’re brushing your teeth, eating lunch, or in the ad breaks of your favourite TV show.

These two contractions together form the basis of what you need to be able to do to begin your pelvic floor muscle training. If you struggle to feel this, then ask for help from your therapist. They will be able to help you perfect the activation of the correct muscles.

We hope you have found this blog interesting and helpful. If you, or someone you know is looking for answers to questions and advice on the management of these conditions, then please get in touch. We are ready to offer advice and/or treatment. 

References

  1. Continence Foundation of Australia. 2019. World Continence Week. [Online]. [Accessed 07 May 2019]. Available from: https://www.continence.org.au/events_calendar.php/482/world-continence-week
  2. Continence Foundation of Australia. 2019. Laugh Without Leaking. [Online]. [Accessed 07 May 2019]. Available from: http://www.laughwithoutleaking.com.au
  3. Continence Foundation of Australia. 2019. Key Statistics. [Online]. [Accessed 08 May 2019]. Available from: https://www.continence.org.au/pages/key-statistics.html
  4. Milsom, I. and Gyhagen, M. 2018. The Prevalence of Urinary Incontinence. Climacteric. 22(3). 217-222. DOI: 10.1080/13697137.2018.1543263
  5. Continence Foundation of Australia. 2019. Pelvic Floor Muscles in Women. [Online]. [Accessed 08 May 2019]. Available from: https://www.continence.org.au/pages/pelvic-floor-women.html

Rectus Diastasis (Abdominal Separation)

Rectus diastasis physiotherapy
What is it?

Ask any woman who’s been pregnant and she’ll tell you that the bigger the baby grows the harder even the simplest tasks become (try putting your socks on with a basketball strapped to the front of you sometime!). With foetal growth and uterine expansion there is a widening and thinning of the gap between the two sections of the rectus abdominis muscle (AKA the 6-pack muscles). This gap is called rectus diastasis. The muscles have not “torn”, simply separated. The split occurs in the mid-line collagen structures of connective tissue at the front of the abdomen.

An easy way to check if you rectus diastasis in if you have a ‘pooching’ or ‘doming’ of your stomach, especially when coming up from a lying position on your back. Women often describe looking several months pregnant, many months after the birth of their child.

Whilst rectus diastasis most commonly occurs during pregnancy, women are not the only ones to suffer it. Newborn babies can also have a diastasis. Men can also experience a diastasis as a result of yo-yo dieting, an incorrect technique of doing sit-ups or weightlifting. This is most commonly linked to poor internal abdominal pressure control and biomechanics. It means you can be fit, and still have a diastasis.

Is it common?

Yes! 2 out of 3 women will experience some degree of rectus diastasis in the first two trimesters of pregnancy and 100% of women have a diastasis during their 3rd trimester. A staggering 66% of women with a diastasis will also have some level of pelvic floor dysfunction and 75% of women will suffer from a pelvic organ prolapse. Although common, this is not normal and can be improved with correct exercise.

Signs to look out for:

• Looking pregnant even though back to pre-pregnancy weight

• Pooching or doming of your stomach

• Weak core and pelvic floor

• Lack of strength and stability in the entire pelvic region and midsection

Why is this so important to fix?

Healing the connective tissue and reducing your diastasis is important as these muscles are what protects our internal organs and back. Other areas where you can be at increased risk of if not fixed include:

• Lower back pain

• Constipation

Incontinence

• Breathing difficulties

• Hernias

• Pelvic organ prolapse

What should I avoid and what should I do to heal or prevent rectus diastasis?

Exercises to avoid include those that place a huge load on your back and excessive forces through your pelvic floor like:

  • running,
  • jumping,
  • sit-ups,
  • deep lunges and
  • some pilates movements.
  • Holding your breath when lifting heavy objects (including your toddler) should be avoided also.

The majority of cases can be greatly improved as well as prevented through specific core and breathing exercises, correct lifting technique and posture, as well as wearing a splint.

Walking, swimming and stationary cycling are all safe forms of cardiovascular exercise you can partake in with rectus diastasis.

For an assessment of your diastasis and a comprehensive exercise rehabilitation program call 02 4655 5588 or book an appointment now to see one of our Osteopaths.

Urinary incontinence – Do you feel like a leaky tap?

urinary incontinence physiotherapy camden

Have you ever laughed too hard, coughed too much, or simply tried to recapture your youth by jumping on the trampoline with the kids and started leaking like a broken tap. It’s called urinary incontinence and it’s common! Urinary incontinence is often associated with childbirth, pregnancy, and menopause and can range in severity from just a small leak to complete loss of bladder control. Some women also experience the need to urgently or frequently go to the toilet. Almost one-third of women who have had children experience some form of incontinence, and while this makes it common it is never normal. Bladder control problems can affect people of all ages, gender, cultures and backgrounds and should not be considered a normal part of the ageing process.

How do you know if your bladder or toilet habits are normal?

If you answer yes to any of the following questions there is a good chance that they are not and you should seek some advice on how to improve them.

 

  1. Do you leak urine when you cough, sneeze, lift or exercise?Bladder weakness camden
  2. Do you pass urine frequently?
  3. Do you have to run to the toilet or experience urgency?
  4. Do you feel that you cant completely empty your bladder?
  5. Do you have a poor or slow flow of urine?
  6. Do you have to strain to empty your bladder?

There are many things you can do to improve if not cure urinary incontinence, starting with understanding how to engage your pelvic floor, to performing correct pelvic floor exercises, and safe toileting posture.

If you would like any help in improving your urinary incontinence or would like to discuss this further please call 02 4655 5588 to find out how we can assist you further. Alternatively, you can book an appointment now with one of our Osteopaths.

 

For more information check out the Continence Foundation of Australia for some great information and resources.