Serving McKinney, Prosper, Frisco, Plano,
Dallas, North Dallas, Northeast Dallas, Richardson, Park Cities, Highland Park, University Park, Lower Greenville, White Rock, Prestonwood, Garland, Addison
Collin and Dallas Counties
Urinary Incontinence
Needing to take frequent bathroom breaks or worrying about leaking throughout the day is frustrating. We’re here to help you resolve those issues and many more. Our PTs have extensive training in working with you to get you feeling your best.
What causes urine leaking?
Bladder leakage, or urinary incontinence, is caused by a few possible problems including:
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Weakness in the pelvic floor muscles that close off the urethra. Without good strength the urethra doesn't close fully and hold the pee in the bladder.
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Decreased estrogen. The bladder and urethra require estrogen in order to work optimally which is why leaking is so common in menopause.
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Poor core coordination. Leaking occurs when the core muscles are not balanced and activate in a way that pushes pressure down onto the bladder causing urine to leak out. This is called stress incontinence.
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Years of bad bladder habits such as holding for 6+ hours, peeing every time you leave the house just in case you might need to go later.
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Dietary irritants can create inflammation on the inside wall of the bladder which causes the bladder to impulsively squeeze throughout the day to empty the bladder and decrease the irritation. These leaks may seem random.
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Neurological irritation or damage. This is less common but if the hypogastric, pudendal or pelvic nerves that go to the bladder are irritated or damaged the signals to the bladder won't be getting through the same and that can cause urine to leak.
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Overactive bladder which can also cause random leaks. This occurs when the bladder muscle squeezing quickly and random moments throughout the day causing small amounts of urine to leak.
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Giggle incontinence. This is more rare but is common in teenage women and is believed to be a neurological overload to the bladder causing full bladder emptying when laughing.
Conditions Associated with Bladder Leakage
Pregnancy and Postpartum
Menopause
Interstitial Cystitis
How Can Physical Therapy Help With Incontinence?
Pelvic PT Evaluation - What happens in the first visit?
As part of the evaluation we will assess the pelvic floor muscles, the core and abdominal muscles, rib mobility and breathing, posture and the coordination of all of those muscles together.
A pelvic floor exam includes externally looking at the tissues and muscles in the pelvic region and a vaginal and/or rectal exam to assess the pelvic floor muscle function and mobility. The exam includes inserting 1 gloved finger into the vagina or rectum and asking you to squeeze and hold, bear down, repeat quick contractions and asking you to breath. While doing this part of the exam we'll check for tenderness in the muscles, the position of the bladder, uterus and rectum and fascial mobility.
Depending on time, we may assess the strength and mobility of your hips and low back on this first visit or we may save it for a 2nd or 3rd appointment. We'll look at the way your move during the activities that cause leaking so that we can see the coordination of your muscles and the way weakness or tension may be feeding into the leaking.
What does Pelvic PT treatment include?
Treatment for urinary incontinence will vary depending on the causes listed above on this page. Many people have multiple causes that need to be resolved. Factors such as decreased estrogen need to be managed by a Urogynecologist, Gynecologist, Midwife or PCP. During the eval we'll observe the tissues and let you know if this may be worth a discussion with your medical provider.
For most people PT will include a variety of hands on treatments including fascial mobilization and joint mobilization/manipulation followed by exercises to strengthen the weaker muscles and improve mobility and coordination. Exercises may be pelvic floor specific (kegels), core focused (deadbugs and birddogs), or global (squats, planks, overhead lifts, palloff presses). We'll choose the exercises specific to your needs and progress them over time as you get stronger and the muscle coordination improves.