Stress Urinary Incontinence

Stress urinary incontinence is the most well-known pelvic floor condition; however, it is one of the most complex. It’s defined as the involuntary loss of urine on effort or physical exertion (i.e sporting activities) or on sneezing or coughing.

It can affect all women of all ages and is not necessarily related to whether you have had children/laboured. It is also a large reason why many women drop out of sport or don’t return to sport after pregnancy.

There are many different causes for stress urinary incontinence. To make things simple, from a pelvic floor perspective there can be two contributing factors:

  • When the pelvic floor muscles are weak and cannot produce a contraction when needed

  • When the pelvic floor muscles are “already contracted/tight” and cannot produce a contraction when needed

A pelvic floor that is functioning well should be able to contract and relax fully. The contraction and relaxation are just as important as each other. The pelvic floor needs to start from a relaxed position so it can produce a contraction. And it needs to be strong enough to elicit a contraction.

Treatment

Treatment of stress urinary incontinence, like all pelvic floor treatment, is tailored to the individual and their goals.

Your physiotherapist may:

  • Help you to optimise your pelvic floor. It is recommended that women are offered three months of supervised pelvic floor muscle training as first line management for stress urinary incontinence

  • Teach you ‘the knack’. This is a timed contraction of your pelvic floor prior to the activities that normally make you leak. Note that this can only be used for activities such as coughing or sneezing and not for those over a long period (running)

  • Help to optimise your bowels. Bowel dysfunction can lead to increase pressure on the pelvic floor. By helping with your bowels you can often help alleviate your bladder symptoms

  • Tailor an exercise program to build strength to support you back to your goals

  • Teach you breath work. This can help your pelvic floor in several ways, one being it can help to relax your pelvic floor so you can contract it!

  • Refer you on or liaise with specialists such as a urologist or urogynaecologist where necessary