The subject no one wants to talk about.

The facts

Incontinence affects 4.8 Million Australian Adults, making it more prevalent than:

  • Arthritis (3.1 million)
  • Anxiety Disorders (2.3 million)
  • Asthma (2 million)
  •  2 in 5 woman experience incontinence
  • 68% of woman leak when they sneeze
  • 1 in 3 leak when they laugh
  • 1 in 3 leak during exercise
  • 7 out of 10 woman laugh off the issue of bladder leakage (results from a recent survey of 1000 woman with bladder leakage) Continence Foundation of Australia
    What should you do?
  • Physio should always be the first port of call for treatment of incontinence
  • Physio has an equally  high success rate in approximately 3 months of treatment and is 16 times cheaper than surgery (not to mention less intrusive)
  • Up to 84% of woman with stress urinary incontinence can become dry with physiotherapy input

Common Questions

  1. Isn’t it normal to be a little bit incontinent after childbirth? NO
  2. Is a small amount of bladder leakage normal as I get older? NO – no matter how light it is, it is not normal and in most cases can be cured or better managed 
  3. If I ignore it will it just get better? NO – in most cases it will not improve without muscle training and it may worsen with successive births

What is Incontinence?

Incontinence is a term that describes any accidental or involuntary loss of urine from the bladder (urinary incontinence) or stool from the bowel (can be either flatus or faecal incontinence)

  • Urgency/Urge Incontinence – A ‘sudden’ urge to empty the bladder, possibly leaking before reaching the toilet
  • Stress Urinary Incontinence – leaking of urine with physical exertion, or on sneezing , coughing, laughing etc.
  • Faecal Incontinence – involuntary loss of faeces or flatus/wind (flatal Incontinence)

 Who is at Risk?

  • Anyone at any age can develop some form of incontinence
  • Some health conditions and life events can put you at increased risk
    • Pregnancy (both pre & post-natal)
    • Menopause
    • Obesity
    • UTI’s
    • Constipation
    • Specific types of surgery (hysterectomy – removal of all or part of the uterus and/or ovaries)
    • Reduced mobility (preventing you from getting to or using the toilet)
    • Chronic cough/asthma/respiratory conditions
    • Neurological and MSK conditions (e.g. Multiple Sclerosis, arthritis)

Sign’s of Poorly Controlled Pelvic Floor Muscles

  • Leaking urine when sneezing, coughing, running, laughing (or other sudden action)
  • Not getting to the toilet in time
  • Tampons don’t stay in place
  • Vaginal or anal wind (flatus) that you cannot control
  • Bulging felt at the vaginal opening (prolapse)
  • Difficulty emptying bowel completely

What issues can Physiotherapy Assess/Treat

  • Post-Natal Check (6 weeks)
    • Check pelvic floor activation
    • Check for prolapse
    • Assess and treat any continence issues (bladder & bowel)/pelvic floor dysfunction
    • Check for abdominal separation (diastasis rectus)
      • Measure separation
      • Provide safe exercises to increase core activation and strengthen abdominals
    • Assess and treat any other musculoskeletal issues
      • Back pain
      • Sacro-illiac dysfunction
      • Wrist/thumb pain/carpel tunnel syndrome
    • Advice and exercise programs for safe return to previous activity levels
  • Incontinence Issues
    • Bladder
    • Bowel
  • Pelvic Organ Prolapse
  • Pelvic Floor Dysfunction
  • Constipation
  • Pilates programmes and 1:1 reformer sessions

Useful Reference

Continence Foundation of Australia

1800 330066 – National Continence Helpline

Written by:

Laura Wickens
BSc (Hons) Physiotherapy
Woman’s Health, Musculoskeletal Physiotherapy, Clinical Pilates

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