What’s incontinence and can it be helped?

The aim of this article is to increase awareness surrounding incontinence related issues and give you some strategies to help.

Incontinence is when you don’t always have full control over your pee, wind or poo.
Stress incontinence is when you leak a little (or a lot) with activities like coughing, sneezing, running or jumping.
Urge incontinence is when you get a strong sudden sense of needing the loo and leak a little (or a lot) before you get there. This can be due to an overactive bladder, which can be present for various reasons including infection, neurological conditions, anxiety, diet or habits.

1 in 3 women and 1 in 4-6 men have incontinence of some form. Most people think it is a normal part of ageing or from having babies. Although it does get more frequent with age and hormones, it is still treatable and should not be ignored or masked with the use of pads or avoiding social activities.
Around 5-8 times a day and 0-2 times per night is typical for passing urine.

Your top 10 physio tips for improving incontinence.

All the Ss to stop the SxxxS and xxSSxS!

See your GP
Ask where is best for you to receive assistance. Perhaps the GP themselves, a women’s/men’s health physio, urologist, gynaecologist or neurologist. Specialist physiotherapy should be considered before any surgical intervention.

Strengthen your muscles
Maintaining strength of your pelvic floor muscles is one of the best ways to help control your bladder and bowel urgency. You do this by thinking about tensing your back passage like you are holding in wind. Build up to holding this contraction for 10 seconds and repeat it 10 times. Do this 10 x 10 3 times a day.

Stop panicking
If you feel a strong urge to wee. Take a moment, sit still. Exhale and tense your pelvic floor strongly. Then try distract yourself. Maybe go up and down on your tippy toes. When the sensation/urge passes walk slowly and calmly to the toilet. You should take a calm relaxed bladder to the toilet.

Skip unnecessary toilet visits
Your bladder function works on reflexes and habits so if you start going to the toilet when it’s not necessary ie. “just in case” this can mess up with the control system and ability to hold higher volumes of urine. Only go when you feel the need. Physiotherapists might get you to complete a toilet diary to examine these habits.

Slim down (in some cases)
We know that being overweight is a risk factor for incontinence so if your BMI is high look at reducing that. Perhaps get advice from a registered dietitian.

Stay active
Keeping fit and active will minimise a lot of the risk factors for incontinence. Find an activity that you can do without losing continence and when you get stronger build up to other activities. A pelvic health physiotherapist can help with guiding this progress.

Sip plenty of water
Even with urinary incontinence you should not limit your fluid intake. In fact keeping well hydrated will benefit you. If you follow and improve on all the other areas even with the increase in fluid you should last longer between toilet visits.
Drinking alcohol, caffeine and fizzy drinks can cause your bladder to contract. Decreasing consumption of these fluids may improve symptoms of urge and faecal incontinence.


Sit down on the toilet
Never hover….Ever! Sitting down allows your pelvic floor to relax fully so you can pee or poop fully which will help with the reflex/control system that we mentioned above.

Support your feet
While opening your bowels raise your feet up so as not to strain or stress your pelvic organs and muscles because you want them in good health to keep you dry.

Sigh out
When you try to open your bowels don’t hold your breath. Instead exhale as you go. This is to avoid undue stress on the pelvic organs, muscles and connective tissue, which are all important in you maintaining continence.

It is my intention that this information will be useful as a starting point for you to improve your continence but be aware that it is a general guide only and it is heavily recommended that you seek specialist individualised advice from a pelvic health physiotherapist and your GP.

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