Pelvic floor dysfunction has been affecting many people, and yet it is under-recognized and not sufficiently managed.
Pelvic floor problems include:
- Stress urinary incontinence
- Urge urinary incontinence
- Stress and urge incontinence / mixed incontinence
- Overflow incontinence
- Functional incontinence
- Pelvic organ prolapse
Healthy Pelvic Floor Muscles silently function and perform their job with no interruptions, and most of us do not do much or instead do nothing to ensure its function and health. Still, some are not even aware of its presence until we start seeing issues like incontinence – urinary leakage, pelvic pain etc.
It is common to think that: it is normal to have urinary leakage after childbirth or is an inevitable part of ageing and that it is not much, we can do about these issues.
Prevalence of urinary incontinence
One in four women are affected by urinary incontinence problems. 50% of women at some point in their life-cycle experience some urinary incontinence, with 33% will be having it as a regular issue. 35% over the age of 60 years is estimated to be incontinent. Urinary leakage affects 30% and 40% of people over 65 years of age. Twenty-four percent of older adults have moderate or severe urinary incontinence.
Psycho-social consequences of Urinary Incontinence:
There are social and psychological consequences that relate to having ongoing incontinence problems leading to decreased self-esteem, depression, isolation and impedes social and physical activity.
Role of pelvic Floor muscles:
Pelvic Floor Muscles are structures that provide support to the back and pelvic girdle and stability to pelvic organs. It controls the urinary continence mechanisms and aid in sexual function and circulation.
Women who are physically active report Urine loss during recreational exercise. Women experiencing urinary incontinence during workouts report that high-impact activities as most frequently causing leakage of urine and are mostly adapting to these circumstances in various ways instead of finding a solution to this problem.
However, women are now more interested in treatment approaches and are turning towards pelvic floor physiotherapy.
To-Do or not To Do Kegels is always a question that comes up. I am doing my pelvic floor exercises, but it does not help? These are other questions. The answer is that Kegels exercises are always not indicated for pelvic floor conditions. Pelvic floor physiotherapists can help identify the problem and can provide you with appropriate pelvic floor training and activities to help find the right solution to your problem.
Pelvic Floor Physiotherapy can help:
A recent article published noted that 30%-40% of women without dysfunction and about 70% with pelvic floor dysfunction are unable to identify and perform the PFM contraction.
There is evidence that pelvic floor physiotherapy can help to manage many of these conditions and disorders.
Pelvic physiotherapy presents an exceptional opportunity to link pelvic exercise with an active training program, that meets fitness training and continence training in the active patient population.
It is, therefore, particularly relevant to implement physiotherapy treatment aimed at the early activation of PFM. Pelvic Floor physiotherapy focuses primarily on pelvic floor muscle rehabilitation and its synergistic muscles, which include the respiratory diaphragm, to improve pelvic organ support and continence mechanism. There is evidence to support the effectiveness of well-known PFM training, biofeedback, and electrostimulation for the treatment of symptoms of urinary incontinence in women.
Brennand, Erin, et al. “Urinary Leakage during Exercise: Problematic Activities, Adaptive Behaviour, and Interest in Treatment for Physically Active Canadian Women.” International Urogynecology Journal, vol. 29, no. 4, Apr. 2018, pp. 497–503. EBSCOhost, doi:10.1007/s00192-017-3409-1.
Frawley, Helena C, PT, PG Cert Phty (Pelvic Floor), PhD, FACP, et al. “An Argument for Competency-Based Training in Pelvic Floor Physiotherapy Practice.” Physiotherapy Theory and Practice, vol. 35, no. 12, Dec. 2019, pp. 1117–1130. EBSCOhost, doi:10.1080/09593985.2018.1470706.
Mazur-Bialy, Agnieszka Irena, et al. “Urinary Incontinence in Women: Modern Methods of Physiotherapy as a Support for Surgical Treatment or Independent Therapy.” Journal of Clinical Medicine, vol. 9, no. 4, Apr. 2020. EBSCOhost, doi:10.3390/jcm9041211.
“Urinary Incontinence.” Wikipedia, Wikimedia Foundation, 20 May 2020, en.wikipedia.org/wiki/Urinary incontinence.