Specialist pelvic health physiotherapy in Cambridge

Did you know that there are lots of different ‘types’ of incontinence?

Although the symptoms of incontinence might be similar – a lack of voluntary control and leakage of urine, wind or faeces – the treatment approach for different types of incontinence can be quite different.

Pelvic floor strength – or the lack of it – might be the first thought occurring to most women with symptoms of incontinence, but this is just one aspect which would be considered by a specialist women’s pelvic health physio when assessing and treating a pelvic condition.

What is incontinence?

The symptoms of incontinence, as I’ve mentioned above, are the lack of voluntary control and leakage of urine, wind or stool.

Despite the fact that this is rarely talked about, it’s a very common problem in both women and men and can affect people at any age.

What are the different types of incontinence?

Incontinence can affect different parts of your pelvic system and the different types of leakage are generally divided into 4 subgroups based on their symptoms:

Stress urinary incontinence

Stress urinary incontinence is one of the most common types. It might be diagnosed if you leak urine when you cough, laugh, lift something, or during exercise.

This is often caused by reduced control and/or weakness of the pelvic floor muscles.

Urge urinary incontinence

Urge urinary incontinence is the inability to ‘hold it’ when you want to go to the toilet. It’s really common to experience a sudden and very immediate need to go, without much warning and possibly leak on the way.

This type of incontinence can be caused by many different factors including your bladder health (an infection), a lack of control of the bladder muscles or an underlying medical condition affecting the pelvic floor nerves.

Mixed incontinence

In some cases a combination of stress urinary and urge urinary incontinence symptoms can be experienced. This would be diagnosed as mixed incontinence.

Anal incontinence

Anal incontinence may be diagnosed if your symptoms involve a lack of control of wind or faeces.

This type of incontinence is caused by a lack of control of the anal muscles (the internal and external sphincters) and the surrounding and supporting muscles.

How does a specialist physiotherapist treat different types of incontinence?

Pelvic health is a niche area of physiotherapy practice, requiring extensive specialist training to assess and successfully treat clients with different types of incontinence.

Women’s health physiotherapy has a great success rate and over 80% of people can be treated by a physio, avoiding the need for surgery or long term management strategies, like pads.

You can expect a thorough conversation about your symptoms including questions about your medical history, sexual health and your bladder and bowel, nutritional and lifestyle habits.

This information helps to guide the tests and procedures needed to complete your physical assessment, which might include an examination of the function of your pelvic floor.

All this information is used to create a bespoke treatment programme depending on your symptoms, the issues found during your examination and your goals.

What does a physiotherapy treatment programme include?

A programme might include:

Pelvic floor exercises

These may not be traditional ‘Kegel’ exercises aimed at improving pelvic floor strength. Some women need to be able to release these muscles to enable an effective pelvic floor response and some need to improve coordination and timing of the pelvic floor muscle contraction to help relieve their incontinence symptoms.

It’s very individual and we often treat women who have been practicing traditional Kegel exercises with little or no improvement in their incontinence symptoms. This is because pelvic floor strength might not be the main issue, or if it does feature it may only be part of the problem.

Sometimes small equipment like electrical stimulation or a biofeedback machine might be recommended to help you practice the right type of pelvic floor exercises effectively at home by yourself.

Bladder retraining

Sometimes incontinence is caused by a miscommunication between the brain and the bladder. A women’s health physio will ask you to complete a bladder diary for a week and use this information to create a personalised programme to help you retrain your bladder to hold more urine and help you to reduce the frequency with which you feel the need to go to the toilet.

Constipation and the digestive system

Increased pressure from the inside or having to strain to pass faecal matter can weaken your pelvic floor muscles. Improving your digestive health and the transit of waste matter through your system may be part of a complete management programme to reduce the symptoms of incontinence.

Drinking and eating habits

Not drinking enough, drinking lots of caffeinated drinks or eating foods which slow down your digestive system can all contribute to symptoms of incontinence. A women’s health physio will pick up on any contributing factors as part of their health screen and may give simple strategies to improve these habits. If a more detailed programme is required, we may refer to a nutritional therapist specialising in women’s health to support your physiotherapy treatment programme.

With all the adverts on TV trying to sell you pads to manage your symptoms, it’s no wonder that many women resign themselves to accepting that incontinence is somehow normal. It most certainly isn’t normal and for the majority of women, their incontinence can be significantly improved by non-surgical treatment.

Contact us if you have any questions at all.

The Physiofit Team.